Q: I am 40 years old male having congenital phimosis and have been recently diagnosed with UTI. I have done a urine culture and an organism called Pseudomonas aeruginosa has been found. I had burning after passing urine and now after medication it has gone but I am feeling some discomfort at the tip of the penis (sometimes burning, sometimes itching). Is it something serious and not UTI? I married late and we are now trying to have children since the last 4-5 months. My wife has not conceived yet and I am wondering whether phimosis has any connection with this. I do not have a painful erection, although my foreskin does not retract and the tip of penis never comes out. I saw a urologist for UTI who advised me for circumcision. Do I need it absolutely? What are the risks if I don't undergo it. I have read about some surgery called preputial plasty, which my urologist has not heard of - my research from the Internet tells me that it is preferred by many over circumcision as it has low morbidity, quick healing and better cosmetic effect. Can this operation be done in India and specially Bangalore?

A:Depending upon the age and severity, and the cause of phimosis, treatment is decided. If in your case, it is by birth, then preputial plasty is an alternative. It does not look as good but is certainly more quick and heals much faster. In normal circumcision, you are not able to have intercourse for over a month while in this you can do it after about 2 weeks. The only disadvantage is that skin on the opposite side of cut can sag, so little modification like multiple plasty can improve looks. Other alternatives are partial circumcision. As for the complication of circumcision, usually these occur in small children and when it is done by less experienced surgeon or those who take it lightly. At your age, even circumcision is safe. Now the decision. Choose any of them. Both are good. Plasty is less troublesome. Circumcision not absolutely required. So go for plasty.