Phimosis is a condition in which the foreskin of the penis cannot be retracted (pulled back) over the glans. This condition may be present from birth or develop later in life for acquired reasons. In children, normal phimosis often resolves on its own as they grow older. However, in some cases, a tight foreskin may persist and require medical intervention or circumcision.
Phimosis can be categorised into two types:
- Physiological Phimosis: This is a normal condition in infants and young boys where the foreskin is still attached to the glans. It usually resolves naturally as the child grows.
- Pathological Phimosis: This develops when the foreskin cannot be retracted and is tight due to scarring, inflammation, infection or other foreskin conditions like Balanitis Xerotica Obliterans (BXO).
Phimosis should not be confused with paraphimosis, which is a medical emergency in which the foreskin is retracted behind the glans and cannot be returned to its original position, cutting off blood flow.
Causes of Phimosis
The causes of phimosis vary depending on the type. Physiological phimosis is a regular part of a child’s development. Pathological phimosis can result from several factors:
- Infections: Recurrent infections of the foreskin (balanitis) or glans (posthitis) can lead to scarring.
- Inflammation: Skin conditions such as contact dermatitis, lichen planus, or BXO can cause inflammation and tightening of the foreskin.
- Diabetes: Repeated fungal or bacterial infection may contribute to the development of phimosis.
- Trauma: Forceful retraction of the foreskin or ring stretching can cause injury and subsequent scarring.
Identifying the underlying cause is crucial for determining the most effective treatment plan.
If phimosis persists or causes discomfort, medical intervention or circumcision may be necessary.
Symptoms of Phimosis
The symptoms of phimosis can vary in severity and may include:
- Inability to retract the foreskin: The most common symptom is when the foreskin cannot be pulled back over the glans.
- Pain or discomfort: Especially during erections or sexual activity, due to the tightness of the foreskin.
- Difficulty with hygiene: The inability to retract the foreskin can make it harder to clean the area properly, potentially leading to scarring or infection.
- Redness or swelling: Inflammation of the foreskin or glans may occur.
- Ballooning during urination: In children and adults, the foreskin may swell during urination, which can be uncomfortable.
- Difficulty urinating: In severe cases, phimosis can make it difficult to urinate.
- Tearing or bleeding: The foreskin may tear or bleed, particularly during sexual activity or attempted retraction.
If you experience any of these symptoms, it is essential to consult our skilled surgeon/urologist for an accurate diagnosis and suitable treatment or circumcision.
How is Phimosis Diagnosed?
Phimosis is typically diagnosed through a combination of a physical examination and medical history, and the physical examination.
Our doctor will:
- Inspect the foreskin and glans for signs of redness, swelling, or infection.
- Attempt to retract the foreskin to assess the degree of tightness gently.
- Check for any associated skin conditions or abnormalities.
Our Specialist will also ask about:
- The onset and duration of symptoms.
- Any history of infections or previous treatments?
- The impact of the condition on daily activities, such as urination, hygiene, and sexual activity.
- Are you taking any medication or suffering from medical conditions
In certain cases, further tests might be advised to eliminate underlying conditions, such as:
- Swab tests: To check for bacterial or fungal infections.
- Biopsy: In rare cases, a foreskin may be sent for microscopic examination if BXO or another skin condition is suspected, with additional charges.
Treatment Options for Phimosis
Treatment for phimosis depends on the severity of the condition and the underlying cause. Standard treatment options include:
1. Topical Steroids
- What they do: Reduce inflammation and soften the foreskin, making it easier to retract.
- How to use them: Apply directly to the foreskin as prescribed by our doctors.
- Effectiveness: Often effective for the early stages of tight foreskin, mainly when used consistently.
2. Manual Stretching
- What it involves: Gently stretching the foreskin over time to increase flexibility gradually.
- Guidance: Should be done gently to avoid injury.
- Combination therapy: Often used alongside topical steroids for better results.
3. Circumcision
- What it involves: Surgical removal of the foreskin.
- When recommended: For severe or persistent cases of phimosis where other treatments have failed.
- Benefits: Provides a permanent solution and prevents the recurrence of phimosis.
4. Preputioplasty
- What it involves: A surgical procedure to widen the foreskin without removing it.
- When recommended: For individuals who wish to retain their foreskin but need it loosened in some cases.
- Benefits: Preserves the foreskin while addressing the tight foreskin.
5. Addressing Underlying Conditions
- Infections: Treating any bacterial or fungal infections with appropriate medications.
- Inflammation: Managing conditions like BXO with circumcision.
- Diabetes: Good control of diabetes is important and monitoring HbA1c blood result.
6. Hygiene Measures
- Importance: Maintaining good hygiene to prevent infections and reduce inflammation.
- Practices: Gentle cleaning of the area as advised by a healthcare professional.
When to Seek Medical Advice
If you or your child experiences any symptoms of phimosis, it is important to consult our doctor for an accurate diagnosis and appropriate treatment.
Seek medical advice if you notice:
- Persistent difficulty retracting the foreskin
- Pain or discomfort during erections or sexual activity
- Signs of infection, such as redness, swelling, or discharge
- Difficulty urinating
- Blood or pus in urine
- Foreskin that remains retracted behind the glans (paraphimosis), which is a medical emergency
Why Choose Our Clinic for Phimosis Treatment?
Our clinic specialises in treating phimosis and offers a range of treatment options tailored to your specific needs. Our experienced urologists and healthcare professionals provide:
- Comprehensive assessments to determine the most suitable treatment plan
- State-of-the-art facilities for Circumcision or surgical procedures, ensuring minimal discomfort and quick recovery
- Personalised care with a focus on your condition of the foreskin
- Follow-up appointment to discuss your biopsy result with further treatment and address any concerns
If you or your child or adult is experiencing symptoms of phimosis, contact us today to make an appointment for assessment. Early medical or surgical intervention can prevent complications and improve quality of life.
Our team provides you with the best possible care and treatment options, including circumcision.
Early diagnosis and treatment are important to prevent complications and improve quality of life. If you suspect that you or your child may have phimosis, it is advisable to consult a healthcare professional without delay.