Phimosis Phimosis


Are you unable to retract the foreskin behind the head of the penis? Do you have painful urination or erection?

Visit Steinberg Urology for a consultation with our urologists to address your concerns, perform diagnosis and provide you on advice as to what treatments are likely to fit your individual circumstances.


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

Most uncircumcised babies and toddlers will have phimosis, meaning the foreskin cannot be retracted. This is because the glans and the foreskin remain connected for the first few years of life.

Phimosis can cause hygiene problems, pain during urination and if left untreated, contribute to painful erections.

This penis disorder usually is divided into physiologic and pathologic phimosis.

  • Physiologic phimosis is the normal condition in which children are born with a tight foreskin, and separation occurs during late childhood and early adolescence.
  • Pathologic phimosis happens because of an infection, inflammation, or scarring.

Phimosis can require intervention at any age.

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

A very tight foreskin, left untreated, can result in problems during intercourse and urination.

Symptoms of phimosis may include:

  • Difficulty urinating
  • Painful urination
  • Inflammation of the glans
  • Painful erections
  • Pain during sexual intercourse
  • Paraphimosis (A medical emergency where the foreskin can’t return to it’s normal location once retracted.)

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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.


Physiologic phimosis is present at birth and resolves without intervention. Most children will not have a fully retractable foreskin at birth, but do so as they get older with the majority having a fully retractable foreskin by early adolescence.

Pathologic phimosis is caused by scarring, balanitis, and underlying medical risk factors.

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.


The foreskin can be pulled back behind the glans in about 50 percent of 1-year-old boys, and almost 90 percent of 3-year-olds. Phimosis will occur in less than 1 percent of teenagers between 16 and 18.

It is most likely to occur in older boys with:

  • Repeated urinary tract infections
  • Foreskin infection
  • Repeated rough handling of the foreskin
  • Foreskin trauma

In adults, risk factors for phimosis include sexually transmitted infections.

Phimosis is a risk factor for type 2 diabetes. Adults presenting with a tight foreskin may be given blood and urine tests to check their blood sugar levels, as a result.


Your doctor can diagnose phimosis based on a physical examination, asking about any previous penis infection or injuries they might have had. History and physical examination is the primary diagnosis. They may also inquire about the impact of any symptoms on sexual activity. A physical examination will include them looking at the penis and foreskin.

Additional tests are usually not necessary. The doctor may order urine tests to check for urine infections or take a swab from the foreskin area to check for bacteria.

Ballooning of the foreskin and splaying of the urinary stream are not reliable symptoms of pathologic phimosis. Significant aspects of symptomatic phimosis include recurrent urinary tract infections, infections of the foreskin or penis or trips to the emergency room as the child is unable to pee.


Treatment depends on the age of the male, severity, and resulting symptoms. Treatment for phimosis is dictated by the severity of the condition – ranging from topical cremes to circumcision.


The first choice of treatment is usually a steroid ointment that is locally applied. The ointment softens the foreskin and is applied for 4 to 6 weeks. Once full retraction is possible the ointment is discontinued. The doctor may take cultures to check for infection. If infection is present, the appropriate antibiotics will be prescribed.


Circumcision is the surgical response to severe phimosis and it removes the foreskin entirely and can be performed on boy, teens and adult men. 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.

The images and/or videos are not presented as a guarantee of result. The results may vary. Patients gave their consent for the publication of images and/or videos.


At Steinberg Urology we pride ourselves on our compassionate care we offer to those facing challenges that affect their quality of life. Our urologists have years of experience and a commitment to excellence.

If you need to discuss this sensitive medical concern, schedule a consultation at our clinic in a safe confidential environment. Let us help you achieve optimal health and wellness in a professional setting.


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