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Phimosis – Tight Foreskin

Phimosis is a condition where the foreskin on the penis does not retract properly, typically due to adhesions or scarring.

Phimosis, also known as tight foreskin, can cause hygiene problems, pain during urination and if left untreated, contribute to painful erections. Phimosis only affects boys or men who have not been circumcised.

The Symptoms of Phimosis

Phimosis occurs when the foreskin remains adhered to the shaft or glans of the penis and cannot be retracted.

A very tight foreskin, left untreated, can result in problems during intercourse and urination.
Symptoms of phimosis can include:

  • Difficulty urinating
  • Painful urination
  • Inflammation of the glans
  • Painful erections
  • Pain during sexual intercourse

It is important not to force the foreskin to retract. If it is injured or torn, the foreskin can form a phimotic ring – a tight band of tissue that encircles the shaft right below the glans.

A secondary condition called paraphimosis occurs when the foreskin is so tight that once it is pulled off the glans, it cannot be put back to the original position.

Causes of Tight Foreskin

It is unclear why this occurs in some but not others. Other factors that can cause phimosis include:

  • Injury or tearing that forms scar tissue
  • Balanitis (inflammation or infection often caused by poor hygiene)

Though the condition be recognized early in a boy’s life, it frequently becomes a larger issue when they reach puberty. Tight foreskin can make erections difficult or painful. Adolescence is a time when a boy’s testosterone is high and have a high occurrence of erections.

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Treatment for Phimosis

Treatment for phimosis is dictated by the severity of the condition – ranging from topical cremes to circumcision.

Medication

When the patient arrives, the doctor will conduct an examination of the penis. He may take cultures to check for infection. If infection is present, the appropriate antibiotics will be prescribed.

Steroid creams are typically prescribed to improve elasticity of the foreskin.

Circumcision Surgery

Circumcision is the surgical response to severe phimosis. Circumcision removes the foreskin entirely and can be performed on boy, teens and adult men. Symptoms that may prompt your doctor to suggest surgery can include:

  • Scars at on the head of the foreskin
  • Episodes of paraphimosis
  • Chronic balanitis (swelling and inflammation)
  • Symptoms of urinary retention
  • Erection is difficult or painful
  • Circumcision is performed in-office and does not require hospitalization. The procedure typically takes under an hour, requiring only local anaethesia, with minimal risk or complication.
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Phimosis Treatment for Children, Adolescents, and Adult Men

Phimosis can require intervention at any age.

Phimosis in Children

It is normal for young boys to have a foreskin that does not fully retract. This will normally become fully retractable as the child grows and matures. When parents observe that the normal process is slow or not occurring it is recommended to consult with a doctor to assess whether any intervention is appropriate.

There is no need to rush to treatment if the situation is not painful or otherwise problematic for the boy. Consult with your doctor, especially if there is any discomfort or if your son reports other issues. While it is important to correct an un-retractable foreskin, serious long-term health problems due to phimosis are very rare. The best approach to this very personal issue is a very calm and measured one. An experienced doctor will help you make a good decision for your son’s health.

Adult Phimosis

Adult phimosis treatment can provide an important relief to men suffering from the difficulties of an overly tight foreskin. Symptoms of phimosis can include pain during urination and painful erections.

In some cases, a locally applied steroid ointment can be effective at treating phimosis over a period of two months. The ointment softens the foreskin and can eventually permit full retraction. In other cases, the recommended treatment is the surgical removal of the foreskin, generally known as circumcision.

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