Overview
Phimosis is the non-retraction of the penile prepuce (foreskin). It is a penile condition that occurs in uncircumcised males. The foreskin may look like a ring around the penis tip and cannot be retracted or pulled back.
It is generally not a problem unless there are symptoms of pain, inflammation, infections, or urinary problems.
Phimosis is common in almost all newborns and the foreskin naturally loosens when the baby reaches the age of 2 years. The condition, however, can occur at a later stage even in adolescence or in adult men.
At what age should phimosis be treated?
Physiological (congenital) phimosis or primary phimosis is a natural condition that occurs at birth and does not need any treatment. Natural phimosis generally resolves within the first few years of the baby’s life. The foreskin loosens as the baby grows old and it is best to wait for some time before going for a treatment.
If there are complications like the baby has difficulty urinating or there are signs of infection, you can consult a physician. Usually, steroid cream application is enough to treat the condition, and surgery is rarely needed.
Parents should never try to aggressively pull the foreskin back as it can cause scarring and injuries. This can also lead to pathological phimosis.
The treatment generally depends on the age of the child and the symptoms.
Sometimes, the foreskin is too tight and forms a ring that gets stuck at the head of the penis. This can cause severe pain and even cut the blood flow and requires emergency medical intervention and even surgery.
In most cases, the doctor typically follows the “wait and see” treatment approach to see whether the phimosis resolves by itself.
Laser circumcision is a minimally invasive surgery that is effective and provides a definitive solution to treat phimosis in teenagers and adults.
How to diagnose phimosis?
During phimosis diagnosis, your doctor will ask questions regarding medical history, any trauma or injury to the penis, symptoms, sexual activities, etc. The doctor will examine the penis to verify the symptoms of phimosis.
Additional tests for phimosis include:
- Urine test for detecting UTIs (urinary tract infections)
- Swab test of the foreskin to detect bacterial infections
- Blood and urine tests for detecting blood sugar level
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How to treat phimosis in children?
Phimosis treatment depends on its type, the specific symptoms, causes, age, and recurrence.
For congenital or primary phimosis in newborns and babies, the doctor may ask the parents to wait for some time and see if the condition resolves on their own as the baby reaches a certain age.
Conservative or non-surgical treatment includes the application of steroid cream twice daily to stretch and loosen the foreskin.
Natural phimosis treatment at home can be helpful. Warm water baths or gentle coconut oil massage can help stretch the foreskin. Gentle stretching exercises can be done but precaution should be taken not to overstretch or irritate the foreskin.
Phimosis can be recurrent and the condition may return after treatment. Steroid cream treatment can be done multiple times. If there are complications or pain, the doctor may consider surgery. Partial circumcision once the child is 10 years old or older can be done if the foreskin is inflated like a balloon during urination.
In some cases, the pediatric urologist may recommend a circumcision if the baby is suffering from paraphimosis or pathologic phimosis where there are recurrent urinary tract infections or balanoposthitis.
How to treat phimosis in adults?
Treatment for tightened foreskin or phimosis in adults includes:
Maintain hygiene
Daily hygiene includes washing the penile area with clean, lukewarm water, and keeping the area dry. Avoid taking bubble baths, or applying strong shampoos or soaps in the area as it can irritate. After urination, dry the penile area to avoid infections.
Topical ointments
The doctor will prescribe steroid creams and antifungal ointments to treat bacterial infections and also to help stretch the foreskin.
Antibiotic medications
Antibiotic medications are prescribed for treating infections. The duration of oral medication depends on the severity of the disease.
Circumcision
Phimosis surgery or circumcision is done to remove the foreskin partially (partial circumcision) or complete removal of the foreskin (full circumcision).
Partial circumcision can sometimes lead to the recurrence of phimosis. In that case, the doctor will perform another surgery where the remaining foreskin will be removed.
