What causes phimosis?
What are the symptoms of phimosis?
How is phimosis treated?
Circumcision for the treatment of phimosis
Procedure outcomes
Phimosis is a condition affecting the foreskin of the penis. In phimosis, the foreskin is either too tight, or the tip of the foreskin has become narrowed and therefore it cannot be pulled back over the head of the penis (glans).
Phimosis can affect uncircumcised children and adults.
What causes phimosis?
Phimosis can occur:
- Naturally; the patient may be born this way
- As a result of trauma; where the foreskin has been pulled back forcibly before it has become naturally retractable, creating scar tissue
- As a result of infection or inflammatory conditions, such as balanitis.
Phimosis is considered normal in babies and toddlers. At around the age of 2, the foreskin starts to separate naturally from the head of the penis, allowing it to retract. As the boy grows, the foreskin continues to detach and eventually the foreskin can be fully retracted. In adults phimosis may be due to chronic inflammation, recurrent infection and scaring.
What are the symptoms of phimosis?
In cases where phimosis is causing problems for the patient, symptoms may include:
- Inability to retract the foreskin to expose the head of the penis
- ‘Ballooning’ (swelling) of the foreskin with urination
- Pain with urination
- Retention of urine (the bladder is not fully emptied out during urination)
- Urinary tract infections, which can become frequent
- Infection of the skin of the penis
- Pain with erections or during intercourse
- Injury of the foreskin, which can lead to bleeding or infection.
How is phimosis treated?
Phimosis is generally treated either with topical steroid cream or more definitively with surgical circumcision. The type of treatment recommended will depend on the age of the patient and severity of the condition.
Circumcision for the treatment of phimosis
Circumcision is a definitive and effective surgical treatment for phimosis. It alleviates the painful symptoms and complication associated with phimosis.
- Performed under general or spinal anaesthesia
- Relatively fast procedure of around 45 minutes duration
- The foreskin is removed surgically
- Fast recovery, with most normal activities able to be resumed in the next few days.
Procedure outcomes
Circumcision improves the quality of life of sufferers of symptomatic phimosis. Following a period of recovery most patients are satisfied with the outcome.
Written by Dr. Shekib Shahbaz and Dr. Tony de Sousa
McPhee, A. S., Stormont, G., McKay, A. C., (2020), Phimosis, StatPearls, online pubication, [https://www.ncbi.nlm.nih.gov/books/NBK525972/], accessed 19/02/21.