Factors to think through before having your foreskin lengthened


MEN'S HEALTH MATTERS:Q I WAS BORN in the United States and as is customary I had a circumcision shortly after I was born. I am now 34 and I read recently that it is possible to have my foreskin lengthened. What does this entail and where can I have it done?

ARoutine infantile circumcision was practised widely in the US and 34 years ago it was the norm for young male infants to be circumcised a few days after birth. There are no clinical indications for routine circumcision, although circumcision was recommended to reduce febrile urinary tract infections in young boys with urinary reflux.

Unfortunately, it has since been shown that you have to circumcise 94 boys to prevent one urinary infection.

Apart from the questionable ethics of subjecting young infants to such unnecessary surgery, there are side effects and alterations in penile sensitivity associated with the operation.

Loss of the inner aspect of the foreskin reduces the sensitivity of the glans penis and paradoxically some men feel the glans, as it is exposed to air, becomes more sensitive and indeed uncomfortable.

Foreskin restoration aims to replace penile shaft skin over the glans penis and protect it. It does not, however, replace the lost sensitive tissue that has been excised.

Once covered the glans stays moist which has been said to improve sexual sensitivity. The extra skin increases skin mobility that may help reduce painful friction during intercourse.

Foreskin restoration can be achieved by surgical or non-surgical means. Non-surgical means all involve various techniques designed to tug the penile shaft skin over the glans penis.

There are websites dedicated to foreskin restoration describing these techniques but there are no good scientific studies, which document results of foreskin restoration objectively.

It may take several months to develop enough elongation of the skin to cover the glans. Non-surgical restoration devices are widely available on the internet although medical recommendations are not available for these devices, as they have not undergone formal evaluation and licensing.

Surgical restoration is a cosmetic procedure and is not widely available. Surgical means include the use of skin grafts and tissues expanders and may require several operations.

A high level of dissatisfaction has been reported for whatever method is used so if you are thinking about having your foreskin lengthened think long and hard before making a decision.

QI have just had my prostate PSA (prostate specific antigen) blood test done. How are PSA test results reported and what is the risk of prostate cancer with different levels of PSA?

AProstate-specific antigen (PSA) is a protein produced by the cells of the prostate gland and can be used to help determine if a man has underlying prostate cancer. PSA test results report the level of PSA detected in the blood.

The test results are usually reported as nanograms of PSA per millilitre (ng/ml) of blood. In the past, most doctors considered PSA values below 4.0 ng/ml as normal however, prostate cancer can be found in men with PSA levels below 4.0 ng/ml.

Many doctors are now using the following ranges with some variation:

-0 to 2.5 ng/ml risk is low.

-2.6 to 10 ng/ml risk is slightly to moderately elevated.

-10 to 19.9 ng/ml risk is moderately elevated.

-20 ng/ml or more risk is significantly elevated.

There is no specific normal or abnormal PSA level. The higher a man's PSA level, the more likely it is that cancer is present. But because various factors (such as the person's age) can cause PSA levels to fluctuate, one abnormal PSA test does not necessarily indicate a need for other diagnostic tests. When PSA levels continue to rise over time, other tests may be needed.

This weekly column is edited by Thomas Lynch, consultant urological surgeon, St James's Hospital, Dublin with a contribution from Mr Hugh Gallagher, consultant urological surgeon, Bon Secours Hospital, Glasnevin and Beacon Hospital

If you have a health question you would like addressed, e-mail healthsupplement@irish-times.ie

Bowel cancer: who is most at risk?

Your risk is higher if:

You eat lots of junk food, fat and sugar and not enough fibre;

Someone in your close family has bowel cancer;

You don't exercise;

You're overweight;

You smoke;

You or a member of your family have a bowel condition called polyps or adenomatous polyposis. This can significantly increase your risk.

The good news is that you can reduce your risk, even if bowel cancer is in the family.

Check out your diet. Reduce the amount of fat and sugars and eat more fruit, vegetables and fibre;

Try to keep active regularly and keep your weight under control;

Discuss your family history with your doctor. Your GP may advise more frequent visits;

Quit smoking.

Source: Irish Cancer Society