Trauma (trapping the foreskin in a zipper). Apply mineral oil to the zipper, so that it simply slips off (Pediatr Emerg Care, 1993; 9: 90-1) or break the zipper with a pair of bone-cutting pliers (J Urol, 1977; 117: 671).
* Prepuceplasty. In this procedure, a short slit is made on the upper surface of the penis through both layers of the prepuce, or foreskin, which are then sutured together to create a permanently widened opening (Ann Roy Coll Surg Engl, 1994; 76: 257-8).
* Hygiene. Regular cleaning with the foreskin pulled back will prevent the recurrence of infection.
* Manual stretching. The skin has potentially unlimited 'plastic' capabilities and will respond to stretching by growing new skin cells. The simplest method of manual stretching is masturbation.
In his research, Dr Michel Beaug'e, a specialist into male sexual medicine, found that men aged 18 to 22 with a tight foreskin either never masturbate, or do so in a manner that differs from the usual way (that is to say, mimicking the forwards and backwards movement of sexual intercourse). When such patients practised conventional masturbation, the condition was corrected within a few weeks (Br J Sex Med, 1997; Sept/Oct: 26).
* Medical means of stretching. The foreskin can be stretched using devices such as an arterial forceps (Aust NZ J Surg, 1989; 59: 963).
* Steroids. Although not particularly welcome, short-term use (external applications of betamethasone 0.05 per cent cream every day over the length of the foreskin for four to six weeks) is preferable to irreversible surgery. Success rates range from 65 to 95 per cent.