Abstract

Abstract Introduction Phimosis can be associated with sexual dysfunction since it often causes discomfort or pain on erection or during sexual intercourse. While circumcision is routinely advocated in patients with phimosis, many males would prefer conservative treatment and are keen to preserve their foreskins. Novoglan foreskin tissue expander is a non-surgical device that uses a balloon to produce gradual stretching of the phimotic foreskin. Objective To assess the impact of phimosis and Novoglan treatment on sexual health and psychological domains. Methods Following Institutional Ethics Board approval (HREC/2020/QMS/66682), 20 males with phimosis were recruited across two Australian sites. Inclusion criteria include male aged ≥ 18 years, who has phimosis and normal erectile function, while those with balanoposthitis and/or recurrent UTIs were excluded. All participants received informed consent and completed questionnaires before and after the Novoglan treatment. The questionnaires included questions on pain or discomfort during sexual activity and levels of anxiety or depression. Circumcision was offered to all patients at the start and end of the study period. Results Nineteen (95%) patients with phimosis recruited in the Novoglan trial reported pain or discomfort during sexual activity, with one (5%) participant reporting pain or discomfort as severe, while moderate or mild levels were reported by ten (50%) and eight (40%) participants, respectively. The level of pain or discomfort during sexual activity improved significantly after the Novoglan treatment with no patients reporting severe level of pain or discomfort, with most males reporting mild or no pain or discomfort (80%). While all participants documented mild to moderate levels of anxiety or depression prior to treatment, 17 participants (85%) reported no anxiety or depression and only three (15%) men reported a mild degree of psychological distress. None of the participants elected for circumcision. Conclusions The Novoglan foreskin tissue expander device significantly improves the psychological outcomes and sexual function in males with phimosis. All patients reported minimal or no pain or discomfort during sexual activity, had minimal or no anxiety or depression related to foreskin issues, and declined circumcision at the end of the study period. Disclosure Yes, this is sponsored by industry/sponsor: Novoglan device company. Clarification: Industry funding only - investigator initiated and executed study.

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