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Phimosis is a condition where the foreskin on the penis is so tight that it cannot be pulled back. Usually, this is quite normal among baby boys and would be present for some years. There are rare cases where the foreskin remains tight throughout and result in permanent phimosis.

Causes of Phimosis

Phimosis is considered to be a congenital condition. Usually, it would change as the child grows. The condition can also occur if the foreskin is forcibly pulled back before it is ready. This would cause scarring and make it difficult to pull back later on.

Inflammation or an infection of the foreskin or on the tip of the penis also causes phimosis in men. Balanitis is considered to be an inflammation of the glans. Poor hygiene or an infection of the foreskin can lead to balanitis, which in turn leads to phimosis. Lichen sclerosis is one of the infections that causes balanitis. It is a skin condition that will be triggered by an abnormal immune response or a hormone imbalance. There would be white spots or patches on the foreskin, plus there could be itchiness of the skin.

Treatment of Phimosis

Generally, phimosis would change as the child grows. However, if there is trouble in urinating or any other obstruction, then the doctor would suggest treatment. If the phimosis is mild, then the doctor would recommend non-surgical measures as it will be effective. Whereas, for severe conditions, surgical measures would be suggested.

Non-surgical methods - usually, doctors provide topical steroid cream such as betamethasone for a few weeks. This is highly effective and has replaced circumcision as the preferred treatment method for a few physicians. Stretching of the foreskin can be performed manually, as this would help tissue expansion. The tissue expansion would help promote the growth of new skin cells to permanently expand the narrow preputial ring that prevents pulling back the foreskin.

Surgical methods - the methods would either be complete removal of the foreskin or minor surgeries to relieve the tightness of the foreskin. At times, circumcision will be performed for pathological phimosis that is considered to be effective.

Dorsal slit or superincision is considered to be a single incision that is along with the upper length of the foreskin from the tip to the corona that exposes the glans without removing any other tissue.

Frenuloplasty is performed for the short frenulum that prevents the prepuce retraction or pulling back of the foreskin. Frenulum will be cut horizontally and sutured vertically.

Preputioplasty is an alternative to circumcision. A limited dorsal slit with transverse closure will be made along with the constricting band of skin. This has minimal pain and recovery period.

At Urologist Bangalore, the doctor and team promptly provide the necessary treatment to avoid unnecessary complications. Simple surgery could help prevent a lot of difficulties.

Authored By : Dr. Mahendra Jain