What Is Phimosis?
Phimosis is a condition in which the foreskin (prepuce) of the penis cannot be fully retracted over the glans (head) of the penis. It can be a normal developmental stage in young boys or a medical issue in adolescents and adults, depending on the cause and severity.
There are two main types:
- Physiological Phimosis – Naturally occurring in infants and young boys; usually resolves on its own with age.
- Pathological Phimosis – Caused by scarring, infection, inflammation, or trauma. It is more likely to cause symptoms and may require treatment.
Diagnosis
Phimosis is typically diagnosed through a physical examination. No imaging or laboratory tests are usually required unless there are signs of infection or other complications.
Your doctor may also assess:
- Urinary symptoms
- Signs of infection or inflammation
- History of diabetes, as this can contribute to recurrent infections and poor skin healing
Symptoms of Phimosis
Many cases are asymptomatic. However, when symptoms do occur, they may include:
- Difficulty retracting the foreskin
- Pain during urination or erections
- Swelling or ballooning of the foreskin during urination
- Recurrent infections (e.g. balanitis or balanoposthitis)
- Redness, cracking, or thickened foreskin
- Painful intercourse (in adults)
Treatment Options
Treatment depends on age, severity, and symptoms:
- Topical corticosteroids: Applied to the foreskin daily to reduce inflammation and promote gentle stretching.
- Gentle manual stretching: Done over time, often in combination with creams.
- Improved hygiene: Especially important in boys and adults prone to infections.
- Circumcision: Complete removal of the foreskin. Often recommended for recurrent or severe cases.
- Preputioplasty: A less invasive surgical procedure that preserves the foreskin by making small incisions to widen it.
- Dorsal slit procedure: Sometimes performed in emergency situations (e.g. severe infection or paraphimosis).
When to Seek Medical Advice
You should consult a GP or urologist if:
- The foreskin is painful or impossible to retract after age 7–10
- There are recurrent infections
- Urination is painful or obstructed
- There is scarring, cracking, or bleeding of the foreskin
- The condition affects sexual function or quality of life