What is phimosis and how is it treated?


Jojo Ming (Image: Urology Care Toowoomba)

Phimosis is a medical condition characterized by the tightness or constriction of the foreskin, the retractable skin covering the head (glans) of the penis. In individuals with phimosis, the foreskin cannot be easily pulled back over the glans, leading to potential complications and discomfort. Understanding the causes, symptoms, and treatment options for phimosis is essential for those affected by this condition.

Causes of Phimosis: Phimosis can be classified into two main types: physiological and pathological. Physiological phimosis is considered a normal condition in infants and young boys, where the foreskin is naturally tight and non-retractable. This often resolves on its own as the child grows, and the foreskin becomes more flexible.

Pathological phimosis, on the other hand, occurs later in life and can be caused by various factors. Scarring due to repeated infections, inflammation, or trauma to the foreskin may lead to a tightening of the skin. Additionally, conditions such as balanitis (inflammation of the glans) and lichen sclerosus (a chronic skin condition) can contribute to the development of phimosis.

Symptoms of Phimosis: The symptoms of phimosis can vary in severity. Common signs include difficulty retracting the foreskin, pain or discomfort during urination, and potential issues with hygiene. In more severe cases, phimosis can lead to complications such as inflammation, infections, and discomfort during sexual activity.

Treatment Options: The treatment of phimosis depends on the severity of the condition and the presence of symptoms. There are both conservative and surgical approaches to address this issue.

  1. Topical Steroid Creams: Mild cases of phimosis may respond well to the application of topical steroid creams. These creams work by reducing inflammation and promoting the stretching of the foreskin. Application is usually done under the supervision of a healthcare professional, and progress is monitored to ensure effectiveness.
  2. Stretching Exercises: Stretching exercises involve gently pulling back the foreskin to gradually increase its flexibility. This method is often recommended for mild to moderate cases of phimosis. It is crucial to perform these exercises carefully to avoid injury, and consultation with a healthcare provider is advisable to determine the appropriateness of this approach.
  3. Surgical Intervention: In cases where conservative measures prove ineffective or when phimosis is severe, surgical intervention may be considered. There are two main surgical procedures for treating phimosis:
    • Circumcision: This involves the removal of the foreskin through a surgical procedure. While circumcision is a definitive solution to phimosis, it is a more invasive option and is usually considered after other methods have been exhausted.
    • Dorsal Slit: A dorsal slit is a less extensive procedure than circumcision. It involves making a small incision on the dorsal side of the foreskin to relieve the tightness. This allows for improved retraction without removing the entire foreskin.

Consulting with a Healthcare Professional: Regardless of the chosen treatment option, it is essential for individuals experiencing symptoms of phimosis to consult with a healthcare professional. A thorough examination will help determine the severity of the condition and guide the selection of the most appropriate treatment plan.

Preventing Complications: Proper hygiene is crucial for individuals with phimosis to prevent complications such as infections. Keeping the genital area clean and dry can help minimize the risk of inflammation and discomfort. Additionally, individuals should seek prompt medical attention if they experience persistent pain, swelling, or signs of infection.