Q: I just underwent a surgery called preputial plasty to correct phimosis. I want to know how the surgery is performed as I have a doubt that the doctor did not use the correct technique. The doctor made an open ‘v’ shape cut on my foreskin and folded most of the foreskin with dissolvable stitches, which does not look good at all. He also told me it would take one year for the foreskin to take correct shape. Will you please let me know what is the correct procedure of performing preputial plasty. I thought circumcision would have been much better. He also told me it would take one year for foreskin to take correct shape.

A:All these surgeries, preputial plasty or circumcision, are done to widen the prepucial opening. Indication to do it could be religious, or a tight opening getting cracked or causing pain at stretch over the engorged glans. There are certain patients who may like to have it for cosmetic reasons. While circumcision gets rid of all the loose skin, baring glans at all time, a preputial plasty retains the foreskin and would just widen the opening and glans remains partly covered with foreskin at rest. There is no special way of doing it and the result needs to be judged against the indication. Foreskin opening should not be tight over the swollen glans, and is the primary end point if the indication to perform surgery was medical. If the indication was cosmetic the outcome has to match the desired outcome. The penile skin is loose and may indeed take a long time to refashion.