How to Safely Stretch a Tight Foreskin to Treat Phimosis.

During my years of clinical practice, I have frequently been faced with the extremely common incidence of phimosis, and have often been asked the following question: 

Can I just stretch my foreskin to resolve my tight foreskin?

The question was almost always met with “it’s not possible, the only method to treat phimosis reliably, is circumcision”.

More recently however, I have changed my thought process, and this is what has led me to write the Foreskin Stretching Guide, for those who would prefer an alternative to circumcision.

When we read statistical data, showing the number of adult males suffering from phimosis, they show that it is relatively uncommon, affecting 2-5% of adult males worldwide. I can say with absolute certainty that the data is inaccurate, as the majority of males with phimosis, will refuse to seek medical assistance, either as a result of embarrassment, fear of the probability of surgery, or just plain apathy, and therefore we have to assume that a significant number of adult males are suffering with phimosis and are not counted within the statistical data. 

As clinicians, we can only treat the individuals who approach us, so without a multi national campaign to educate the world on this subject, we need to occasionally respect that some issues need to be resolved with suitable and safe ‘self help’ articles.

This leads me to my intention, of providing some tried and tested techniques to safely stretch the foreskin until it can be retracted without discomfort. 

So, what is phimosis and how can it affect an individual’s life?

Phimosis refers to a tightening of the foreskin, preventing or limiting retraction over the glans penis. To those who have not encountered phimosis, this may seem like a trivial issue, however it is often a cause of significant stress.

When the foreskin cannot be retracted at all, the sufferer will often encounter a build up of smegma, as the usual daily washing regime is limited by an inability to retract and wash beneath the foreskin. One of the main roles of smegma, is to lubricate the cavity between the foreskin and glans. But an inability to effectively wash away old smegma can often lead to an elevation of bacteria in the region, causing a higher incidence of infections, irritation, and psychological suffering due to it’s unpleasant smell.

If the foreskin can be retracted when the penis is flaccid, but not erect, this will frequently cause issues during sexual intercourse, as the enlarged glans tries to push though the foreskin, it causes pain, irritation and minor skin lesions. This can frequently lead to reduced sexual satisfaction and desire, and can often cause ‘performance anxiety’ leading to erectile dysfunction. The implications of this are inevitably highly significant to the individual’s life.

When we consider the significance of phimosis, and the likely unwillingness to seek medical assistance, we need to adopt a more empathetic strategy to serve the affected individuals. 

Before you begin the stretching regime it is important to check the following flow chart, to ensure that stretching is appropriate for you. 

A flow chart, to check whether foreskin stretching is a suitable option
Foreskin stretching flow chart, to check the suitability of stretching for an individual’s phimosis

Assuming that you do not have an existing issue such as inflammation, recent foreskin damage, or a medical condition which may limit the foreskin’s ability to stretch, you can proceed to a daily stretching plan.

How to Stretch Your Tight Foreskin

The foreskin will usually stretch more effectively following a long soak (30+ minutes) in a bath, so if this is a possible option, you should try this frequently. If you do not have access to a bath, a warm shower can help also.Stretching frequency should be regular, by performing 10-30 minutes of foreskin stretching, with the following three types of stretches, each performed once per day with at least 4 hours rest between. Aggressive stretching should be avoided, as this will, at some point lead to inflammation. Although the process can be time consuming, and it may be tempting to exert an excessive level of force to speed up the process, this should be avoided, as despite various sites claiming to resolve the issue in a day or so, it is not possible to rush the expansion of connecting fibres in the dermis without causing tears.Morning: This foreskin stretch can be performed by pinching the tip of the foreskin between the fingers and thumbs, and applying an outward (lateral) stretch for 60 seconds, release for 30 seconds, and repeat approximately 10 times. Shown in image 1:

Foreskin stretching vector drawing, lateral stretching for severe phimosis
How to perform the lateral foreskin stretch, for severe phimosis

Midday: The next type of stretch can be extremely helpful, as it can prevent the frenulum from limiting the foreskin’s ability to retract as progress is made. As the frenulum can be slightly more delicate, it should be stretched with slightly less force, for a duration of 10 seconds, release for 10 seconds, and repeat 10 times. As shown in image 2:

Frenulum Stretch Vector Drawing, showing distal stretching of the frenulum to assist the phimosis stretching process
Essential frenulum stretch, to ensure that the frenulum does not inhibit the foreskin stretching progress.

Evening: The following stretch should be performed with an erect penis, as the domed shape of the glans pushing into the tightest region of the foreskin, will help to reduce the width of the phimotic ring, which will promote quicker progress. Shown in image 3:

Vector drawing of foreskin stretching, by applying proximal pressure against the glans
Applying inward (proximal) pressure against an erect penis helps to reduce the width of the phimotic band, as the domed glans of the erect penis, pushes into the tight foreskin

 

When the phimosis stretching has reduced the severity of the foreskin tightness, the following additional stretch should be included

Place the tip of the two index fingers inside the foreskin, and apply outward pressure, hold for 60 seconds and release for 30 seconds, then repeat approximately 10 times. Shown in image 4:

Fingertips shown inside foreskin and gently pulling laterally to expose glans
Using the fingertips to stretch with a lateral pull

The following stretch is extremely useful, as it helps to dissipate the force, which can prevent localised weakening of the phimotic band. This has to be performed with lubrication (a gentle oily moisturiser works well). Insert the tip of the index fingers into the foreskin, apply an outward (lateral) force as in the previous stretch, and while maintaining this stretch, slide the tip of the fingers over, then under each other in a circular pattern as shown in image 5: 

Fingertips shown inside a tight foreskin, pulling laterally and with a circular motion
Applying a lateral stretch, with rotation

At this point, you will be nearing completion of the stretching process, and the glans will be clearly visible, therefore you will now be able to wash the cavity between the foreskin and glans, without too much difficulty. You should wash with a mild soap and warm water, every day. It is important to avoid washing too frequently as this can cause irritation. As the foreskin may now be stretched enough to retract over the glans, care must be taken to avoid retracting too soon, as the foreskin can become stuck behind the glans. Should this occur, it has to be dealt with swiftly, to ensure that blood flow to the glans is not impaired. This is known as paraphimosis, and in the first instance an attempt to push the foreskin forward to cover the glans can be performed by taking the glans between the finger and thumb, and squeezing to push the blood toward the penis shaft, and therefore reducing the size of the glans. With the index finger and thumb of the other hand, now attempt to push the foreskin forward, as shown in image 6:  

Urgent action for accidental paraphmosis. The glans is squeezed between the finger and thumb, to allow the foreskin to be pulled forward
Swift action is required if the tight foreskin is accidentally retracted and becomes stuck behind the glans. A lubricant can help, and the issue needs to be dealt with promptly to prevent the restriction of blood flow.

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