Dear Dr. Roach: My husband has a problem. His foreskin gets so tight that it is painful to pull back. His doctor gave him some cream but said the next step was surgery. He has high blood pressure, diabetes and high cholesterol. Is there anything else he can do?
Dear M.J.: It sounds as though your husband has phimosis. Phimosis is the inability for the foreskin to be retracted over the glans penis.
Uncircumcised men, particularly those with phimosis, are at risk for a condition called balanitis — inflammation of the foreskin. Balanitis can be inflammatory or infectious. Infectious balanitis is especially common among diabetics, and I have had several cases where the first time diabetes is suspected is when the man has come in for balanitis. Treatment is with antifungal creams, and often with oral antibiotics as well. Repeated bouts of this infection can cause scarring of the foreskin, so that eventually it can become impossible to retract. Steroid creams often are effective, so surgery is not always required.
If it is, the surgical treatment is circumcision (or closely related surgery), which is not a simple procedure.
Dear Dr. Roach: I am 79 and dread the annual Pap test. Is it really necessary for me to continue it?
Dear D.M.: If a woman is 65 or older and has had three normal consecutive Pap smears, she can stop having the test. Talk to your doctor about this. The doctor might have reasons for continuing the test that aren't known by you or me.
Email questions to ToYourGoodHealth@med.cornell.edu.
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