Betamethasone is considered "potent" as a topical steroid, which is why it can only usually be purchased with a doctor's prescription. It works by thinning the skin, which reduces its strength, which makes it more easily stretched. It also helps dampen the skin's inflammatory response, triggered by stretching, which can lead to redness, tightness, swelling etc. So it is a useful medicine for phimosis. But because the skin thinning is often permanent, the maximum time during which it can be used will usually be limited by a doctor for a maximum of around 8 weeks. This is to avoid the skin becoming too thin which could lead to future problems associated with skin tears and subsequent tightening.

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​If this low-risk approach does not resolve the phimosis after a few weeks then the next stage, if the patient remains in discomfort, would usually be referral to a urologist.

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​Urologists, also known as urological surgeons, perform surgery related to the kidneys and sexual organs, including circumcision. Though not without risk, circumcision is a well-understood procedure that will, in most cases, resolve phimosis satisfactorily because it removes the source of the problem; the foreskin.

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Surgical Options - Circumcision

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A urologist is unlikely to propose foreskin stretching with a device because the efficacy of this approach has not (yet) been proven to work in a clinical research trial. Because stretching is not proven they will use the method that is proven and in which they have trained, which is circumcision. Circumcision fixes the problem of phimosis because it removes the cause of the problem, the foreskin. The operation generally, though not always, produces a satisfactory outcome. This tragic story published in 2019 tells the impact of an unsuccessful circumcision and, in my opinion, makes exploring foreskin stretching wise because even if stretching does not produce the desired result, it does not close off any other treatment route. There are 3 main ways of performing a circumcision which are shield and clamp, dorsal slit, and excision. These methods are are described in this article.

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​Surgical Options - Preputioplasty

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Also performed by specialised urologists, preputioplasty is a specialist surgical procedure that seeks to solving the problem of phimosis but without partial or full surgical removal of the foreskin - there is an alteration of the foreskin to remove the tight ring of skin called the phimotic band, but no removal of the foreskin. The best-known 6 surgical techniques of preputioplasty are triple incision plasty, preputial plasty, ventral V-plasty, Y-V plasty, trident plasty, and Z-plasty. They are explained in this article.

 

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​Non Surgical Options - Stretching Devices

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At the time of writing this I have found 8 branded foreskin stretching solutions that fall into 5 different categories of expansion method:

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1. thread-adjusted arms and tubes x 1 type

2. silicone tubes x 1 type

3. silicone rings x 3 types (other similar products may be available)

4. air-filled balloon x 1 types

5. modified forceps x 2 types

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In the following section, I take a look at the 6 of the most prominent foreskin stretching tools available to purchase right now starting with the PC4 available to purchase on Etsy. For the PC4 there is a description of how it works plus other relevant points. For the other 5 products I provide only a summary of the information provided by the manufacturer and a link to where the product is sold. The features  of other stretching devices are not evaluated and neither is their effectiveness.

 

The purpose is to list and describe the main non-surgical phimosis treatment solutions currently available to purchase in 2024. If you decide to stretch your foreskin you need to decide which product will meet your needs best. This summary may help by showing the features of the main stretching tools that could be found when searching in English on the UK version of Google.

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