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Phimosis (Tight Foreskin): Causes, Symptoms, and Treatments

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Phimosis (Tight Foreskin): Causes, Symptoms, and Treatments

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Phimosis is caused when the foreskin is too small and it becomes difficult to pull it over. Get immediate help if you have pain and difficulty urinating.

Medically reviewed by

Dr. Sneha Kannan

Published At December 5, 2017
Reviewed AtDecember 28, 2022

The prepuce (foreskin) is a double-layered tissue that forms the anatomical covering of the glans penis in males. In certain conditions, the prepuce is too tight and does not slide over the glans. It is stuck in one place, either over the tip or behind. If a male is circumcised, then the condition of phimosis does not occur. However, the act of circumcision has its own disadvantages.

What are the Advantages of Foreskin?

The presence of foreskin might have many advantages.

  • The foreskin gives a bulky appearance to the penis when it is in flaccid condition. The bulkier appearance seems to be more attractive to women.

  • Many men admit that the foreskin is the most sensitive part of the skin. It is known to enhance the sensual stimulus.

  • For a satisfactory sexual experience, natural lubrication is necessary. A cut foreskin might lack that natural lubrication. People who have circumcised their foreskin might require help from additional lubricants.

  • It does not have any effect on the fertility rate.

What Are the Disadvantages of a Foreskin?

Having a foreskin might need extra care for your private parts. There is an increased chance for more dead cells and bacteria to stay in the penis. It can occur as a process of self-cleaning. It is white in color with a thick consistency. This whitish build-up is known as smegma. It can lead to a dry condition accompanied by itching.

What Are Phimosis and Paraphimosis?

When the opening of the foreskin is too small for it to be retracted behind, the condition is known as phimosis.

When the prepuce has retracted back and cannot be brought forward again, it is known as paraphimosis.

Physiological: Almost all boys are naturally born with a tight foreskin, and separation occurs naturally over time. It is essential for parents and caregivers to understand that phimosis is normal in an uncircumcised infant and resolves during adolescence.

Pathological: Pathological phimosis can occur in any male as a result of scarring, inflammation, or infection of the foreskin. It is usually seen in uncircumcised adult men.

What Causes Phimosis?

  • Repeated urinary tract infection

  • Inflammation due to other conditions.

  • Foreskin trauma during sex.

  • Repeated rough masturbation.

  • Sexually transmitted diseases.

  • Lack of foreskin hygiene.

  • Certain dermatological conditions.

  • Genital. If the person’s father had the condition of phimosis, then there is a higher possibility of getting transmitted to it.

  • Congenital. It might occur as a birth defect.

Does Balanitis Cause Phimosis?

Balanitis is an inflammation of the head of the penis. It might be accompanied by pain and swelling in the penis. This pathological condition might make it hard for the male to pull the foreskin forward and backward. Balanitis can be caused by sexually transmitted diseases also. Gonorrhea and syphilis are known to contribute to phimosis.

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Does Balanoposthitis Cause Phimosis?

Balanoposthitis is a condition in which the glans and foreskin become inflamed. This inflamed condition might make it harder for the foreskin to be moved. Bacterial and fungal infections can also cause balanoposthitis.

The least common causes of phimosis are:

Lichen Planus: It is an itchy skin disorder. It cannot be transmitted to others. The bumps that appear on the penis look shiny.

Lichen Sclerosus: This condition might cause white patches on the foreskin and glans.

Eczema: Eczema causes the formation of dry patches on the skin. Soaps and other creams might aggravate the condition of eczema.

Psoriasis: Psoriasis can cause crusty formation on the skin.

What Are the Symptoms of Phimosis?

  • Pain, discharge, and swelling.

  • Ballooning of foreskin while urinating.

  • Difficulty in urination

  • Painful erection.

  • Repeated infections.

  • It can also lead to inflammation of the glans (balanitis) or inflammation of the glans as well as foreskin (balanoposthitis).

How to Treat Phimosis?

The treatment depends on the age, severity, and cause of phimosis.

In very mild cases, gentle stretching of the penis during bathing and cleansing will suffice.

In a few others, a short course of topical steroid ointments and creams can help in loosening the skin.

In some instances, partial or complete circumcision is recommended by the doctor.

Medications:

If there is an underlying inflammation, you can use Hydrocortisone or any other corticosteroids.

If there is any bacterial infection, then it might be necessary to use antibiotics. Erythromycin is an effective antibacterial agent. Miconazole is another drug that is very beneficial against fungal parasites.

If there are no conditions present, still, some doctors recommend the usage of topical steroids for making the foreskin become more flexible and supple.

Surgical Methods:

Circumcision involves surgically cutting off the foreskin that protects and lubricates the head of the penis. Apart from being indicated for religious, cultural, and social reasons, medically circumcision has been the traditional treatment for phimosis. People who are having circumcised foreskin are known to have very low reported cases of penile cancer.

Phimosis is experienced by children and men for different reasons. Surgical intervention is not necessary for all male infants with a non-retractile foreskin. In infants, phimosis is the norm as the foreskin and glans develop as one. With age, the foreskin becomes more pliable and resolves on its own by the time they are seven to 10 years of age. In some boys, it can settle even later. It is not a problem unless there are symptoms. So, there is no need for parents to get anxious and choose circumcision for their healthy baby boys. Maintaining penile hygiene will help with this.

If phimosis is due to an infection (pathological), and other treatments do not help, then it is advisable to consult a urologist who can tell the difference between a normal tight foreskin and true phimosis and accordingly advise you a treatment plan based on the severity.

Other Options:

Preputioplasty: It is a less invasive procedure than circumcision. It involves both cutting and stretching a part of the foreskin. This can be the best treatment option for men who still feel they need their foreskin.

Frenuloplasty: This procedure involves cutting off the foreskin only on the underpart of it. After frenuloplasty, the foreskin becomes easily movable and flexible.

The biggest disadvantage of surgery is that all of them have a higher risk of bleeding. Also, during the surgical procedure, there is a chance of infection too.

When Do You Need to See a Doctor?

In most people, the condition resolves by itself when the boy grows up to a man. If the condition of phimosis causes severe pain or discomfort during the process of erection or urination, then it is necessary to consult with your doctor as soon as possible. Many reports have shown that a large number of patients with phimosis go untreated.

If you have any doubts about phimosis, call a doctor online, and get help from our online platform.

Frequently Asked Questions

1.

Why does phimosis occur?

Phimosis is common in uncircumcised males. It can occur due to repeated urinary tract infection, foreskin infection, foreskin injury, and skin condition affecting the penis like eczema, psoriasis, lichen planus, and lichen sclerosus.

2.

What is phimosis surgery called?

In severe cases of phimosis, a surgery called as circumcision is done. It is the surgical removal of the foreskin. The foreskin is either completely or partially removed.

3.

What are the steroid creams used for phimosis?

Cream, gel, or ointment containing steroid like Clobetasol propionate is used to treat phimosis. Application of a steroid cream can make the skin soft, which makes it easier to retract the skin. Always use steroids under medical supervision.

4.

How do you treat phimosis at home?

Try pulling the foreskin gently back and forth while cleaning the penis every day. This should be started at a very early age and can be used to treat as well as prevent phimosis. But remember never to retract the foreskin forcefully.

5.

Is it necessary to treat phimosis?

Yes, you should get phimosis treated as early as possible. If left untreated, it can lead to balanitis, paraphimosis, posthitis, and penile cancer.

6.

How do you know if you have phimosis?

Difficulty retracting the foreskin of an uncircumcised penis is the characteristic sign of phimosis.

7.

How long does it take for phimosis to go away?

Once you start the treatment, you should see changes within a week. After a couple of weeks, you will be able to stretch the skin.

8.

Can tight foreskin prevent growth?

Tight foreskin preventing growth is a myth. The foreskin stretches and grows as your penis grow, and it will in no way prevent growth.

9.

Can phimosis cause UTI?

Phimosis can cause inflammation of both the penis and glans penis (balanoposthitis), which in turn can cause urinary tract infection.

10.

How do you cure a tight foreskin without surgery?

If your condition is not severe, then your doctor might suggest applying steroid creams and gently performing penile stretching exercises. But in severe cases, circumcision has to be done.
Source Article IclonSourcesSource Article Arrow
Dr. Vasantha. K. S
Dr. Vasantha. K. S

Dentistry

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