Phimosis is a condition of an uncircumcised penis where the foreskin is unable to fully retract from the head of the penis. Phimosis is normal in the neonatal period and sometimes through adolescence. It usually corrects itself. As the penis grows and erections occur, this condition becomes painful and if still present in adulthood it needs to be corrected- usually with preputioplasty or circumcision. Phimosis can sometimes be corrected by stretching, done gradually and with lubricants and does not require any removal of the foreskin.
What Causes Phimosis?
Pathological Phimosis is phimosis that has not corrected on its own (most uncircumcised children experience some level of phimosis and it usually corrects itself by adolescence). Pathological Phimosis can be caused by a few things. First, phimosis can be caused by balanitis, or a swelling of the tip of the penis. If the glans is swollen it will be harder for the foreskin to allow it through. A second cause of phimosis is preputial stenosis, or narrowing of the foreskin. If the foreskin is too tight, the penis will not be able to expand through it. The third known cause of phimosis is balanitis xerotica obliterans (BXO), which is a skin condition where a ring of whitish skin (scar tissue) forms around the tip of the foreskin. This disallows the foreskin to be able to stretch when trying to retract.
Solutions to Phimosis
- Applying a topical steroid cream, such as betamethasone, for four to six weeks.
- Stretching to help generate cell growth and therefore widening the foreskin. This is done gradually and with the aid of lubricants.
- Preputioplasty is less dramatic than circumcision and involves a limited dorsal slit. Pain is minimal in this procedure and recovery time is much quicker.
- Dorsal Slit is an incision of the foreskin along the upper length, exposing the glans but not removing any skin tissue.
- Circumcision is the most dramatic and painful for an adult male to correct pathological phimosis, but it is also effective and results in the total removal of the foreskin.
When it comes to phimosis, it is important to consult a doctor on what treatment is best for your penis. Phimosis can often times be misdiagnosed, especially in younger males, and second opinions should be sought after to be sure you choose the right method of correction.