Phimosis is a condition wherein the foreskin of the penis is too tight and cannot be pulled back to show the head of the penis. It usually manifests as difficulty while urinating or sometimes discomfort and pain while you pass urine, erection may occasionally be painful, and there may be paraphimosis as well.
Physiologic phimosis is a normal condition wherein a child is born with a constricted foreskin and it cannot be pulled back over the glans penis, i.e. the head of the penis; however, separation customarily happens during late childhood or early adolescence.
Pathologic phimosis is known to develop because of inflammation and swelling, infection, or scarring and is typically seen in uncircumcised adult men.
What Are The Causes Of Phimosis?
Phimosis, by and large, seen in children, is usually present at birth. It may be caused by an infection, or by scar tissue that could have formed as a consequence to trauma or long drawn out inflammation. Physiologic phimosis is present at birth and it tends to resolve without any kind of intermediation.
At birth, most children won’t have a completely retractable foreskin, but as the child gets older, it will develop, with a majority having a completely retractable foreskin by adolescence.
Another significant etiological factor for phimosis is balanitis, which leads to tightness of the foreskin. Speedy medical aid is very necessary in case the condition makes urination difficult, excruciating or impossible.
Signs And Symptoms Of Phimosis
The signs and symptoms of phimosis include:
- The chief presenting feature of the condition is an inability of the foreskin to retract over the glans penis; and this can lead to difficulty in cleaning of the area and maintaining hygiene which further triggers balanitis.
- Difficulty to pass urine and occasionally painful urination.
- Painful erection of the penis may be seen sometimes.
- Your health care provider / paediatrician will diagnose phimosis based on a thorough history of the individual; and a physical examination. Additional investigations / tests are habitually not required.
Treatment Options For Phimosis
The following guidelines and recommendations will help you deal with your condition better:
- The treatment for phimosis depends upon the age of the male, the symptoms and their severity.
- Treatment of phimosis may consist of mild, manual stretching of the foreskin over an interval of time. Confer with your health care provider about how exactly you have to do this.
- The first choice of treatment is usually a steroid cram that is applied locally. At times, the foreskin can be made loose with medication applied to the penis. Steroidal application has shown a success rate of approximately 70 %. Steroidal ointment will soften the foreskin and help retract it easily; the cream needs to be applied for 5 to 6 weeks. Once you can fully retract the foreskin, your health care provider will ask you to discontinue the steroid cream. Keep following up regularly with your doctor.
- In case steroid application is not effective, your doctor may recommend circumcision. This depends on the symptoms and their intensity. Circumcision is the surgical excision of the foreskin, and is very often used to treat phimosis.
- Preputioplasty, another effective surgical procedure involves separating the foreskin from the head of the penis. The procedure preserves the foreskin and is less distressing than circumcision.