Phimosis

Specialty of Urology

What is phimosis?

Phimosis is a condition that inhibits the foreskin from being able to be pulled over the head of the penis (the glans) because the skin of the foreskin is too tight. It can be congenital (primary) or acquired (secondary). Having a tight foreskin is normal for baby boys who are not circumcised, but this normally stops being a problem by the age of 3. If phimosis is acquired, it happens as a result of scarring.

What are the symptoms of phimosis?

The main symptom of phimosis is the narrowness of the foreskin and difficulty in retracting it. Another associated symptom, although less frequent, is pain during urination, or swelling of the foreskin when urinating. If the phimosis is not treated, complications such as infection in the glans or paraphimosis can appear. Paraphimosis is when the foreskin gets stuck behind the head of the penis, which can result in circulation being cut off, and as such, it should be treated as an emergency. Additionally, if the glans becomes sore and inflamed, it is likely that the patient is suffering from balanitis (inflammation of the head of the penis).

What causes phimosis?

Congenital phimosis is naturally occurring, but it is not clear why some boys have this but not others. On the contrary, acquired phimosis can be caused due to repeated infections or tears. It can occur, for example, when the skin is violently and prematurely pulled back on babies. Also, when the foreskin or glans become inflamed and scars, the scar tissue contracts and hardens slightly, which causes phimosis. In addition, conditions can increase your risk of developing balanitis, such as diabetes.

Can it be prevented?

There is no way to prevent phimosis of congenital origin, but in other cases it is possible to prevent it by practising good penis hygiene (i.e. gently washing it with warm water using mild or non-perfumed soap, taking care to gently pull the foreskin back and wash underneath it). It can also help to do daily, gentle retraction of the foreskin, to help loosen the skin.

What is the treatment for phimosis?

Phimosis is common in children under 10 years old and, therefore, in those cases no treatment is required. If phimosis is causing complications, such as balanitis, antibiotics may be necessary to overcome the infection. Along with gentle daily retraction of the foreskin, topical steroid cream can help to soften the foreskin, making retraction easier. In more severe cases, circumcision may be recommended, which removes the foreskin.

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