Treat with 4/52 of a moderate to strong steroid cream (e.g. 0.1% Betamethasone), applied to the foreskin but avoiding the glans, and review 1 – 2 weeks later. If symptoms are still troublesome, refer for consideration of circumcision.
Condom use can be helpful with sexual symptoms. In diabetics, improved diabetic control can help. Stretching of the foreskin is not recommended as it can produce scarring.
Other reasons for referral
- Non-reducible paraphimosis – refer same-day.
- Hard palpable lump – refer as 2ww.
- Balanitis xerotica obliterans (which gives a whitish dull hue) should be referred, though no timescale given.
BMJ 8.10.16 76 – 77.
(NB – Did this as a module on BMJ Learning, but for some reason it’s registering as incomplete. As I did do it and make the notes, I’ll put it down as my own learning; I’m keeping records and will be sure not to count it twice.)