Penile preputioplasty or Y-V preputioplasty
You have a tight foreskin that cannot be fully retracted (pulled back). This can cause problems with recurring infections or scarring of the foreskin area. The preputioplasty is not suitable if your foreskin is scarred due to balanitis xerotica obliterans (BXO) or lichen Scrolosis.
There are 3 options with regard to treating a tight foreskin without BXO:
- Observation or steroid cream, no specific treatment in mild cases or use of steroid use may help.
- Circumcision, which means that the foreskin is removed completely. The advantage of this operation is that once the foreskin is removed then you will not have any problem related foreskin. Head of the penis is exposed permanently after the operation and the procedure is irreversible.
- Preputioplasty, which is simply a foreskin releasing procedure at the top of the foreskin (dorsal slit). An incision is made on top of the foreskin, thus allowing full retraction. This will allow you to retain your foreskin, but at the same time be able to keep the area underneath clean.
What does Preputioplasty involve?
An incision is made on either side of the foreskin to widen it, thus allowing full retraction.The benefit is that he retains foreskin, but looks like fish mouth appearance of foreskin, which may dislike by some patients.
What are the benefits of having a Preputioplasty?
The benefit is that you retain foreskin. Preputioplasty helps to get rid of tight ring of the foreskin during intercourse. Circumcision used to be a commonly practiced operation and on many occasions was performed with excellent results.
Details of the procedure: Preputioplasty
- I usually carry out the procedure under a local anaesthetic.
- Local anaesthetic nerve blocks also provide post-operative pain relief
- I divide the foreskin on the top across and re-stitch it in lengthwise fashion, which results in lengthening the ring of foreskin.
- I use dissolvable stitches throughout which usually disappear within two to three weeks.
- I apply and seal the wound with glue which sloughs off within 10 days.
- We normally wrap the penis in a loose bandage which you can remove it after 1-2 days.
What are the Risks and Consequences of having a Preputioplasty?
Bruising and swelling of the penis which may last a few days. Most operations are straightforward; however as with any surgical procedure, there is some chance of side-effects or complications such as: Bleeding from the wound site but is usually minimal and settles quickly. Infection can occur and is usually mild but can be potentially serious (less than 1% of patients). An infection, which may require antibiotics and medicated honey dressing/gel. Tenderness of the scar at the site of your frenulum. Dissatisfaction can occur with the cosmetic result. Failure to improve your symptoms which may result in the need for a full circumcision redo operation or full circumcision: 25% foreskin becoming tight again due to scarring.
Best alternative for tight foreskin is circumcision.
What can I expect when I get home?
• You will get some swelling and bruising of the penis which may last several days
• All your stitches will disappear, usually within two to three weeks, but may sometimes take a little longer
• Simple painkillers such as paracetamol or Ibuprofen are helpful if you have any discomfort
• Any dressing should fall off within 24 hours; if it does not, or if it becomes soaked with urine, it should be removed
• Keep the area dry for 48 hours; avoid soaking in a bath
• You should not swim or any exercise for two weeks
• Try to keep your wound clean and dry after passing urine
• Apply a little Vaseline to the tip of your penis and around the stitch line to stop it sticking to your clothing
• Wear tight-fitting clothing for two to three days
• You should retract your foreskin on a daily basis to maintain the benefits of the surgery after 3 days
• You will be given a copy of letter which should be given to your GP
• Any antibiotics or other cream, you need to get from any pharmacy
• You should refrain from sexual activity (intercourse and masturbation) for up to four to six weeks
Smoking and surgery: Ideally, we would prefer you to stop smoking before any procedure. Smoking can worsen some urological conditions and makes complications more likely after surgery.
Following 3 days after the operation, it is VERY IMPORTANT that you retract his foreskin each day to avoid the foreskin becoming tight again due to scarring. If you are concerned about any of these risks, or have any further queries, please speak to us immediately.
This information contains evidence-based information about your proposed by the medical literature. This is the information for guidance only, it will not be a replacement of professional opinion by medical doctors.