Recurrent vaginitis is caused by the foreskin; male hygiene affects women's health.

**Article 22**

**Recurrent vaginitis is caused by the foreskin.**

**Case Study**

**Name: Liu Li (pseudonym), 43 years old**

**Region: Guangzhou, Guangdong**

**Occupation: Accounting Supervisor at a Listed Company**

One day, Liu Li, who was sitting in the passenger seat, was taking a ride home with a male colleague after working late. Suddenly, she experienced waves of itching in her lower body. Unable to do anything, she could only try her best to endure it. When she couldn't bear it any longer, she rubbed against the seat, attracting the attention of her colleague. When she got home, she discovered that she had flared up with vaginitis again. She had been experiencing this frequently lately, and many medications had not been effective.

She noticed that her vaginitis symptoms worsened after intimacy with her husband. During a doctor's visit, she casually mentioned this, and the doctor immediately asked if her husband had phimosis (tight foreskin) and didn't like to clean it. The doctor suggested that her recurrent vaginitis might be related to her husband. This embarrassed and surprised Liu Li. How did the doctor know her family secret? And how could her vaginitis be related to her husband's infrequent foreskin cleaning?

Wang Chuanhang, Department of Andrology, China-Japan Friendship Hospital: This female patient's case is quite common in urology and andrology clinics. Many men only realize the problem of their foreskin after their wives have recurring gynecological problems.

Having a long foreskin seems normal. Generally, boys under 7 years old have a relatively long foreskin, covering the entire glans penis and urethral opening. Around age 13, during puberty, the foreskin and glans will separate naturally, making it easier to retract the foreskin behind the glans. However, some men still have a long foreskin in adulthood, and if they neglect cleaning, it can negatively impact their sexual satisfaction.

If the foreskin can be easily retracted to fully expose the glans penis, it is called phimosis. If the foreskin opening is too tight and cannot be retracted to fully expose the glans penis, it is called paraphimosis. In cases of paraphimosis, the glans penis may be affected in its development due to the foreskin being constantly constricted. During sexual intercourse, the foreskin may be pulled back, causing pain and affecting the quality of sexual life. If the intercourse is vigorous, the foreskin may be forcibly retracted to the coronal sulcus and cannot return to its original position, resulting in paraphimosis. Paraphimosis is an emergency; patients will experience penile edema and swelling of the glans penis. Due to severe impairment of local blood supply, delayed treatment can lead to severe ischemia and even necrosis of the glans penis. In cases of phimosis or redundant foreskin, the secretions from the sebaceous glands under the foreskin cannot be discharged. If not cleaned regularly, this will gradually form foul-smelling smegma. Smegma provides a suitable environment for bacterial growth, which can cause inflammation of the glans penis and foreskin.

Therefore, if a person still has phimosis by puberty, they should undergo circumcision in a timely manner.

Adults who don't have the habit of cleaning themselves are not only prone to inflammation, but they can also cause their partners to develop bacterial or viral infections such as Candida, leading to vaginitis, cervicitis, and other more serious gynecological diseases.

How can we effectively prevent balanitis and balanitis? Regularly retract the foreskin to expose the glans; thoroughly retract the foreskin and clean it daily during rinsing. This can effectively prevent infection and balanitis. Circumcision is one of the smallest urological surgeries, but it is crucial to a man's lifelong sexual well-being. Some patients, tempted by lower prices, choose illegal clinics or small hospitals for circumcision, often leading to irreversible consequences.