What's going on with the swollen foreskin?

Foreskin swelling may be caused by local infection, allergic reaction, trauma, phimosis or foreskin incarceration, and can be relieved by local cleaning, anti-infective treatment, antispasmodic and analgesic, manual reduction and surgery.

1. Local infection

Foreskin redness and swelling with increased discharge are common due to bacterial or fungal infections, such as balanitis. Usually related to insufficient cleansing or exposure to contaminants, it manifests as flushing, erosion, or white patches of skin. Soak in potassium permanganate solution, and use antibiotics or antifungal drugs such as erythromycin ointment and clotrimazole cream as directed by your doctor. The perineum should be kept dry on a daily basis and avoid scratching.

2. Allergic reaction

Contact with detergents, condom materials or drugs may cause allergic foreskin edema, which manifests as sudden swelling with itching and no discharge. Allergens need to be removed immediately, cold compresses with normal saline can be used, and symptoms can be relieved by short-term topical hydrocortisone cream. People with repeated allergies need to do a patch test to identify the allergenic substance.

3. Traumatic stimulation

Friction during sexual life, scratches from clothing, or sports injuries can lead to mechanical edema of the foreskin, accompanied by congestion or epidermal damage. In the acute stage, sexual activities need to be suspended, and mupirocin ointment should be applied after disinfection with iodophor to prevent infection. If the hematoma continues to increase, injury to the corpus cavernosum needs to be ruled out.

4. Complications of phimosis

Congenital or cicatricial phimosis can easily lead to obstruction of lymphatic flow due to forcible turning, resulting in ring-shaped swelling. In mild cases, manual dilation can be attempted; in severe cases, lidocaine gel anesthesia is required and a dorsal foreskin incision is performed. For recurrent cases, the author recommends elective circumcision to avoid secondary foreskin incarceration.

5. Foreskin incarceration

Failure to promptly reset the foreskin after inversion can cause ischemia of the glans, manifesting as severe pain, cyanosis, and edema. It is a urological emergency and requires immediate manual reduction or surgical treatment. Delayed treatment may lead to tissue necrosis. Amoxicillin and clavulanate potassium dispersible tablets need to be used to prevent infection after surgery.

You should choose breathable cotton underwear for daily use and avoid excessive cleaning or using alkaline shower gel. Pay attention to cleaning before and after sex, and do not forcefully turn up the foreskin if you have phimosis. If the swelling lasts for more than 24 hours and is accompanied by fever and difficulty urinating, systemic diseases such as diabetes need to be ruled out and timely medical attention should be sought. In the acute stage, the scrotum can be elevated to reduce edema, and self-heating or squeezing is prohibited.