Reasons Your Foreskin Won’t Retract When Erect

For centuries, circumcision has been performed on male infants for various cultural, social, and religious reasons and traditions. However, according to recent publications from the Canadian Paediatric Society, the number of neonatal circumcision undertaken, seems to have gradually decreased over the years.

With more and more parents electing not to circumcise their boys, physicians, especially in the United States, have built up their experience in treating issues with foreskins.

An understanding of the basic anatomy and development of foreskin is essential information to know when attempting to understand normal versus irregular retraction.

When boys are infants and prepubescents, the foreskin is tight and can’t be retracted or pulled down from the tip of the penis. However, as boys develop into men, the foreskin should loosen and retract on its own, and by the time adulthood sets in, most men no longer have a foreskin that’s too tight.

However, there are times when a tight foreskin doesn’t naturally resolve or creates medical issues. For example, phimosis, paraphimosis, and frenulum breve are common medical conditions concerning the uncircumcised penis’ foreskin.

What Is Phimosis?

Phimosis is a standard developmental feature of an uncircumcised penis in new-born boys and typically doesn’t create concerns. However, it’s a problem if phimosis doesn’t naturally resolve as the child ages into adulthood.

Phimosis is a medical term for foreskin that doesn’t pull away naturally from the tip of the penis. This condition requires a medical diagnosis, and is defined as the physical inability for the foreskin to naturally release and pull back from the head of the penis.

When the foreskin is unable to retract fully, it can create a tightening sensation that causes phimosis. Over time, as an infant develops, the foreskin should begin to loosen and be gently pulled away from the tip. By age 17, according to the Healthcare facility Cedars Sinai, boys should have a completely retractable foreskin.

If you attempt to pull the foreskin back prematurely, this can cause phimosis and painful scarring.

Symptoms of Phimosis

Symptoms of Phimosis can vary on a case-by-case basis and typically only occur in children and adolescents. However, most symptoms involve bulging or swelling of the foreskin, especially when you’re trying to urinate.

Most boys have a mostly retractable foreskin by age three. However, if your child doesn’t, it may be time to seek professional medical help. Sometimes, the developmental process takes longer than others and could take as long as seven years of age before the foreskin completely retracts. While some medical personnel claim that there is no cause for alarm if the foreskin retracts by age 17, the general professional consensus is no later than age 7.

Although unusual, other symptoms of phimosis include pain and discoloration. In addition, if the foreskin is tight, it can turn the tip of the penis blue or dark red. If this occurs, it could spur or indicate a more complicated medical condition, and you should seek help immediately.

What Is Paraphimosis?

If the foreskin of the penis is tight but is forced to retract, it can cause the foreskin to become stuck and unable to be moved back to the tip of the penis.

Paraphimosis is a severe medical condition, typically in uncircumcised male infants and prepubescent boys, that happens when the foreskin is forced behind the crown of the penis, becomes stuck there, and is unable to retract.

Paraphimosis requires a medical diagnosis and can have serious complications associated with it. Treatment depends greatly on your age, severity of symptoms, and overall health. If your penis is bulging and in pain, especially when attempting to urinate, this needs to be addressed by a urologist to prevent further complications.

What Is Frenulum Breve?

If you’re an adult male with an uncircumcised penis that doesn’t retract when erect, one likely cause could be a medical condition called frenulum breve.

Frenulum breve, a medical condition caused by a small section of skin partially covering the head of the penis, refers to a short frenulum that restricts foreskin movement. This condition can result in difficulty retracting the foreskin completely, especially during an erection.

A frenulum on an uncircumcised penis is a small piece of skin that connects the glans, or the head of the penis, to the foreskin. Think of it as similar to the connecting portion of tissue under your tongue.

In most uncircumcised men, a frenulum is not bothersome, and it allows for full retraction of the foreskin. However, if the frenulum is shorter than usual, it results in the condition known as frenulum breve.

If you have a frenulum breve, you likely have noticed that your foreskin doesn’t entirely pull back when erect. The difference between frenulum breve and paraphimosis or phimosis is that with frenulum breve, the foreskin does retract, but not 100%, while the other two prevent retraction entirely.

Frenulum breve can be incredibly annoying if it causes pain – particularly during intercourse. If you notice a gap between the foreskin and underneath the penis head, it could indicate that you have this condition.

Frenulum breve alone isn’t necessarily a concern; in fact, some men with the condition claim it intensifies arousal. It can become an issue if the frenulum is torn, however.

Rigorous sex or masturbation can create more friction around the skin, especially the foreskin of the penis, making it particularly at risk for tearing. In addition, tight-fitting clothing, especially underwear or pants, and intense physical activities, can pose a danger to your frenulum.

The frenulum connecting your foreskin is similar to the cuticles connecting your fingernails to your fingers. When your cuticles tear, it’s painful; so imagine the pain of tearing your frenulum.

If you intend to keep your foreskin, it’s essential to take preventative and protective measures to guard your frenulum against tearing. For tips, check out this article from GHC Health.

What Is Frenuloplasty?

Frenulum breve requires a medical diagnosis, typically from a urologist, and can be treated with surgery. However, this condition won’t naturally resolve itself, as paraphimosis and phimosis sometimes do, so if natural remedies like extra lubricants and protective measures aren’t giving you the results you want, consult with a medical professional about frenuloplasty.

Frenuloplasty is an outpatient surgery done with local anaesthetics and minimal recovery time to extend the length of the foreskin’s frenulum to allow complete retraction and movement.

Most patients who undergo the procedure report little to no pain after the procedure and zero hospital stay. However, if you notice pain or decreased sexual pleasure due to incomplete foreskin retraction, you should consult a urologist about treatment options.

However, treatment probably isn’t necessary if the partial retraction isn’t bothersome, doesn’t disturb your daily routine, or your sexuality.

When To See a Healthcare Provider

A tight, restricting, or non-retracting foreskin on an uncircumcised penis is normal for babies and prepubescent boys.

However, if you’re experiencing phimosis, frenulum breve, or paraphimosis as a pubescent teen or adult, this could indicate a possible problem that requires medical attention.

When boys are born, the foreskin is attached to the head of the penis with a thin layer of skin. Usually, around age three, this skin tends to loosen or separate so that the foreskin can completely retract. Sometimes, this development is delayed up to age five or seven.

There is some debate among medical professionals about how long retractable foreskins take to develop in boys with some doctors saying it could be as long as 17, but most say that the penis’ foreskin should be fully retractable by age seven.

You know your body best. If you’re concerned about your foreskin, you likely need to see a healthcare provider or urologist.

You should especially consider medical treatment if you’re in pain, unable to urinate, or have other symptoms or discomfort. Otherwise, medical treatment may not be required.

What Is Ballooning?

Medical treatment may become necessary if you’re an adult experiencing a symptom called ballooning, which causes painful urination.

As the foreskin separates from the head of the penis, you may notice a bulging referred to as “ballooning.” Ballooning foreskin occurs when urine inflates the pockets of the foreskin that has detached from the glans.

In children, ballooning is usually of no consequence, according to this article from Your Whole Baby. Typically, young boys that experience ballooning are in the process of urinating and are still able to pass urine, despite the bulging.

However, the University of California cautions adults who are also experiencing one of the above medical conditions or painful urination to seek medical help.

When To Consider Circumcision

If your uncircumcised penis doesn’t fully retract, there are some home remedies that you can try first before undergoing circumcision.

If it’s only partially tight or non-retractable, such as the condition frenulum breve, sometimes topical lubricants or hydrocortisone can help reduce or eliminate discomfort.

Also, try gently pushing and pulling the foreskin to loosen and separate the skin naturally. If this works, circumcision may not be necessary.

However, sometimes circumcision is the preferred treatment option when specific symptom severities are met.

For example, if scarring is present at the tip of the foreskin that does not resolve naturally, it may be best to consider circumcision. However, scarring can create painful intercourse and urination if severe enough and may not be preferred by some.

Other times, unresolved medical conditions dictate when you should get circumcised. For instance, if you develop an infection (which is why I got circumcised), swelling or bulging, scarring, or if you’re experiencing pain, circumcision should be explored.

Sometimes, other surgical procedures are available to resolve foreskin issues while still preserving the foreskin. One method was referenced earlier and is referred to as frenuloplasty.

The previously mentioned procedure, frenuloplasty, is a relatively painless surgery that makes minor cuts in the skin connecting the foreskin to the glans to extend it and allow the foreskin to retract fully.

There are other methods available for correcting a non-retracting penis, like burning the surrounding skin. All treatment options should be considered and discussed with you and your doctor before making a decision.

How Is Circumcision Performed?

Circumcision is the surgical removal of the foreskin typically conducted during a boy’s infancy. However, it can be completed in adulthood with local anaesthesia.

Circumcision is performed by a medical professional using a general anaesthetic for young boys or infants and local anaesthesia for adults. Circumcision can be partial or complete depending on the patient and their condition.

The debate on whether or not to circumcise has been a long disagreement on both sides of the fence. However, the most significant factor typically considered with circumcision is the sensitivity of the penis for cut and uncut males.

Some argue that circumcision reduces sexual arousal and sensitivity, but this article from Top Doctors states that this premise doesn’t have solid scientific backing to support the argument. Though there have been studies done that perpetuate the idea that cut males have a less sexually sensitive erection, there were holes in their research that question the validity of their results.

Ultimately, circumcision is a relatively simple procedure that can help men who can’t fully retract their foreskin due to an underlying medical condition. The risks are minimal but do include a possibility of reduced sexual stimulation.

From personal experience, having been circumcised during my early teenage year, I definitely wouldn’t discourage anyone from having the procedure – whether for medical or purely personal reasons. I don’t have any issues with sensitivity, not having a foreskin means I have a cleaner, heathier penis, and the added contours provide an obvious benefit to my partner during intercourse.

You have options when considering circumcision, though, as there are three different types you could undergo. Read on to learn more.

What Is the Difference Between Partial and Complete Circumcision?

There are three different types of circumcision, and it’s essential to discuss each with your doctor ahead of time to determine the best treatment plan for you. The most common two types of circumcisions are partial and complete.

Partial and complete circumcision vary in the amount of foreskin that is removed from the penial glans. In a full circumcision, the entire foreskin is removed, while a partial circumcision leaves some of the foreskin behind to cover the glans.

A partial circumcision, although debatable, may preserve sensitivity in your penis, resulting in better sexual pleasure. Either of these options can be completed per patient request or medical condition.

What Is Preputioplasty?

If you’ve made it this far in the article, you’ve learned some impressive new medical vocabulary terms. So let’s add one more to your list and find out what preputioplasty is.

Preputioplasty is a type of circumcision surgical procedure used when the patient wants to preserve their foreskin. In the surgery, the foreskin is only slightly shortened, maintaining the look of the penis.

This surgery is done by making an incision lengthwise along the tight ring of the foreskin, releasing it. Then, the incision is closed with dissolvable stitches. The procedure is minimally invasive and optimal for patients who want to save their foreskin.

This procedure is best for men whose only complaint is the tightness of the ring of the foreskin, typically only when an erection occurs. The tightness can cause pain during sex or restrict movement. With preputioplasty, movement is restored, and tightness is relieved.

Foreskin complaints in childhood typically resolve naturally on their own. However, for those that don’t, circumcision is the go-to treatment option.

Preputioplasty can be done to preserve the foreskin and eliminate the need for full circumcision. This procedure is generally adequate. This study researched the effects of this procedure on 23 prepubescent boys and found that they had no complaints following the process and that most boys were back to normal after about ten days following the surgery.

However, the same study found that about 36% of the participants later regretted the surgery and would have altered their decision instead and opted for a full circumcision. Yet, after the preputioplasty was completed, 77% of the participants had a retractable foreskin.

Another fact about retraction from the same article says that only 1% of uncircumcised males have retraction issues after 17. So, statistically, not many men should need surgical intervention if they don’t want it.

Conclusion

There are several medical reasons why a fully erect uncircumcised penis may have foreskin retraction issues. Most foreskin complications occur typically before age five.

However, unresolved or lingering foreskin problems can arise in adulthood. While there are several ways to treat retraction problems, including at-home lubricants and hydrocortisone, circumcision remains a top choice for foreskin corrective measures.

Remember: You have options. If your foreskin issues aren’t painful, you don’t need a circumcision. However, some men find that having a “cut” penis is best for functionality – I definitely agree with this!

Always consult with a medical professional, preferably a urologist, regarding your foreskin or penial issues. Obviously if you’ve got any questions or indeed experiences to share, feel free to add them via the questions and comments section below.