Cover image for phimosis in children

What is phimosis?

In normal conditions, the foreskin covers the penis’s head in a baby. By the age of 3, it starts to loosen from the penis’s head which allows the foreskin. The condition of phimosis can be explained as the inability of the foreskin to retract i.e slide back over the penis. 

Phimosis is a condition that occurs in babies and toddlers. The reason being that the glans and foreskin remain intact in the initial years of life. This is a common condition that occurs more in boys than men. 

The process of detachment starts between 2 and 6 years of age. But in some boys, the detachment occurs around the age of 10 years. 

Does that mean phimosis doesn’t occur in adults? This is not the case. Around one percent of teenagers between 16 and 18 tend to suffer from phimosis. 

There are two different types of phimosis that generally occurs in children-

  • Physiological phimosis- This is the type of phimosis that occurs naturally since birth. Hence, the name. The symptoms are most visible around three years of age. This includes the inability to retract the foreskin while cleaning/bathing or the foreskin getting inflated while urinating. Children usually suffer from this type of phimosis which gets cured on its own as the foreskin slowly detaches from the glans over time. 
  • Pathological phimosis- This develops around puberty when boys reach the age of twelve. The main causes of pathological phimosis are lack of hygiene, continuous swelling of the foreskin and penis glans or scarring of the foreskin. Symptoms of pathological phimosis are-

-Foreskin blocks the penis glans

-Pain while erections

-Bleeding

-Balanitis, inflammation of the penis glans

-Repeated urinary tract infections

-Difficulty while urinating or weak flow of urine  

How do I know that my child is suffering from phimosis?

There are no specific symptoms of phimosis. But children with phimosis often complain about redness, soreness or swelling. They even complain about having difficulty in urinating or emptying the bladder.

Balanitis is another condition that can arise from phimosis. The condition might aggravate to balanitis hence, children complain of the following symptoms-

  • Soreness
  • Urge to itch
  • Bad smell
  • Build up of thick fluid
  • Pain when you urinate 

What are the causes and risk factors of Phimosis?

Phimosis tends to get cured on its own. Although the biggest factor of phimosis in adults is sexually transmitted infections, in children the main cause is generally a skin condition such as-

  • Eczema – a chronic skin condition that makes the skin itchy, red, dry, and cracked
  • Psoriasis – a skin condition that makes the skin red, flaky and crusty
  • Lichen planus – a rash that develops in different parts of the body
  • Lichen sclerosus – a disease that causes scarring on the foreskin that can complicate the condition of phimosis. 

What is the treatment for Phimosis in Children?

Depending on the physiology of the child and the severity of phimosis, the treatment for phimosis is administered. The two types of treatment are-

Topical corticosteroid therapy

The first approach towards the treatment of phimosis in kids is topical steroid ointment. These ointments work by softening the tight foreskin around the penis. Urologists usually prescribe the following corticosteroids-

  • Hydrocortisone
  • Betamethasone
  • Triamcinolone 

In order to retract the foreskin over the penis, doctors recommend massaging the affected area twice a day for almost two months. This eventually cures the problem and manual retraction during warm baths and urination can prevent recurrence of phimosis. 

Circumcision 

This is the removal of the foreskin surgically. This is the most treatment that the urologist prescribes when all other types of treatment options fail. When compared with other traditional surgical procedure for circumcision, the laser is considered to be much safer because it offers minimum pain.  

Few More Words from Pristyn Care

Phimosis is a painful condition that can interfere with a child’s day to day life. We, at Pristyn Care, provide circumcision for phimosis in both children and adults through laser treatment. As discussed earlier, this is painless surgical removal of the foreskin which offers several benefits such as-

  • Almost no bleeding
  • Faster recovery
  • Performed on an outpatient basis
  • Lower chances of getting a UTI
  • Lower risk of STDs
  • Reduced risk of phimosis and paraphimosis

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