Why excess skin on the penis should worry men

Many men worry about the idea that size matters. What they should pay attention to, however, is the excess skin around their friend and their hygiene. Inadequate cleaning and phimosis can cause penile cancer, a disease that kills an average of 400 people in the country every year and has about 500 new diagnoses. In addition, there have been more than 7,000 amputations in the last 14 years.

In order to reduce these numbers and inform the population, doctors linked to the Brazilian Society of Urology (SBU) carried out in February a joint effort for phimosis surgeries –removal of the foreskin that is on the glans– in states of the North and Northeast.

Initially, the group estimated to perform 100 circumcisions, but until the 25th, there were 187. During the month, states joined as elective surgeries were released, as they were vetoed because of the omicron variant of Covid-19.

The queue for procedures like this is long in the SUS, and the disadvantage is the time involved and the few rooms for the operation. “The problem of postectomy surgery [como também é conhecida a circuncisão] is that, especially in adults, it takes longer because of the suture, because you have to have the skill of a plastic surgeon, so it doesn’t become an ugly thing. You go step by step”, explains Alfredo Canalini, president of the SBU.

Phimosis is when the man is unable to pull the skin that covers the glans, so the head of the penis is not exposed, or when he has the feeling that the organ is being crushed. According to urologist Fernando Tardelli, this favors the accumulation of smegma – a secretion produced by the glands of the penis – in this region, which can lead to changes in local cells and thus progress to a tumor of the penis.

“It is very interesting for those who have phimosis to undergo surgery to remove the excess foreskin, thus improving the hygiene of the penile head and body. limb, does not need to perform the surgery”, says Tardelli.

Hygiene on the spot is the number one expert advice for preventing penile cancer. And no big investment is necessary, since soap and water will do the trick. The orientation is, during the bath, to pull the skin until the head of the organ is exposed, clean with water and soap, rinse well, dry and put the foreskin back in place.

It is necessary to be careful when drying the penis, both after the bath and after urinating and ejaculating, so that the place does not stay wet for a long time. If the organ is no longer in a normally ventilated environment, imagine the part covered by skin?

Doctors also recommend keeping up to date the vaccination against HPV (Human Papillomavirus), available in the SUS for boys aged 11 to 14 years and girls aged 9 to 14 years, and using condoms during sexual intercourse.

The penis tumor usually appears as a lesion that increases in size and can present itself in several ways. “Such as an area of ​​skin changing color or thickening, a superficial lump or lump on the penis, a superficial or deep wound (ulcer) that bleeds and does not heal, reddened and velvety skin bumps, brownish-colored lesions, persistent discharge , often with a bad smell”, lists Tardelli.

This stench, says the doctor, often makes the man withdraw from romantic relationships and social life, only seeking help when the disease is advanced.

These lesions usually appear on the head of the penis, but they can also appear on the foreskin or penile shaft. The indication of the specialists is that, if a lesion does not improve, the man goes to the urologist to investigate the reasons.

Canalini, the president of the SBU, also recommends keeping an eye out for candidiasis and diabetes, two diseases that facilitate infections in the penis. He says he learned this in college, when an endocrinology resident went to a urology resident and reported having inflammation in his limb. The first did not believe when the second raised the hypothesis of diabetes, but it was there that the doctor discovered he had the disease.

Like other diseases, the diagnosis of new cases of penile cancer has declined in recent years. While in 2018 and 2019 there were 2,142 and 2,197 registrations, respectively, in 2020 2,095 were reported and, in 2021, 1,791.

The president of the SBU believes that the decrease is a consequence of the Covid-19 pandemic, as many people stopped looking for doctors for fear of contamination, as well as many hospital centers turned their efforts to the health crisis.

Another fact that draws attention is that São Paulo and Minas Gerais lead the ranking of states with the most records of penile cancer. According to Canalini, statistics from the Ministry of Health give the false impression that there are more cases in the Southeast.

What happens, according to him, is that the government is based on where the patient is being treated, not where he lives. The doctor says that it is common for sick people to look for large centers for treatment, which ends up interfering with national data.

“We know, from our studies and observations, that most of these patients come from the North and Northeast regions of the country”, explains Canalini. That’s why the surgery campaign took place in Alagoas, Amazonas, Ceará, Espírito Santo, Maranhão, Pará, Paraíba, Piauí, Rondônia and Tocantins.

early operation

But if there is a chance that a boy will develop phimosis in the future, why not operate when he is born or in the first years of life? This practice was even common decades ago, when a doctor performed circumcision in the delivery room.

Urologist Tardelli says this is a very controversial issue in the medical literature. “What we do know is that circumcising male children in areas of higher incidence of penile tumors is a welcome strategy, because who knows when that child will have access to health care again.”

On the other hand, points out the doctor, if the family finds it easier to go to the doctor, it is possible to wait and monitor how the skin around the boy’s penis will look.

According to Canalini, the natural adhesions between the skin and glans break down over time, and there are also ointments that can be applied to aid the process. “When the boy reaches adolescence and does not get this retraction, he has a kettle spout and the tip doesn’t let him put it on. [a glande] out, you have to operate”, he explains.

Anyway, what matters is that people learn from an early age to take care of themselves and pay attention to their own bodies. As the president of the SBU says, “we have to keep this in mind, informing is a way of promoting health”.