Phimosis: Causes, Symptoms, Treatment and Prevention

  • Symptoms of Phimosis
  • Types of Phimosis
  • Diagnosis of Phimosis
  • Treatment of Phimosis 
  • Surgery
  • Complications of phimosis
  • Prevention of Phimosis 

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Overview

Phimosis is a condition in males in which the foreskin doesn’t pull back from the tip of the penis.

In normal conditions, a boy is born with a tight foreskin. With age, the foreskin starts to retract and by the time they turn 3, this no longer remains a problem as the foreskin completely loosens up.

This is a common problem in young boys which usually gets cured on its own. But in severe cases, when urination becomes difficult or pain is severe, treatment becomes essential. 

Facts on phimosis

  • Men with tight foreskin are twice at risk of developing penile cancer than those who have been circumcised. Several studies indicate that countries with a higher incidence of circumcision have lower rates of penis-related diseases such as phimosis, balanitis, penile cancer, etc. 

  • The risk of penile cancer is higher in men who are above 60 years of age. 

  • Phimosis and paraphimosis are completely different. Phimosis is the inability of the foreskin to retract from the penis opening while paraphimosis is the condition in which the foreskin is retracted but can’t move back up. 

Causes of phimosis

Although this is a normal condition in uncircumcised babies and toddlers, this can create problems for children over 8 years and teenagers between 16 and 18. Young boys are more prone to suffering from phimosis. Older boys are more likely to suffer from phimosis if they suffer from-

  • Repeated urinary tract infections

  • Infection in the foreskin

  • Rough handling of the foreskin

  • Trauma or injury to the foreskin 

The primary risk factor for phimosis in adults include sexually transmitted infections (STIs) as well as certain skin conditions. Some infections that can result in the tightness of foreskin include-

  • Genital herpes

  • Gonorrhea 

  • Syphilis 

Some skin conditions that can worsen or contribute to the symptoms of phimosis are-

  • Eczema- A skin condition in which patches of the skin becomes dry and scaly.  

  • Lichen planus- This is a type of rash with shiny, flat bumps.

  • Lichen sclerosus- People suffering from this condition develop white patches on the foreskin and glans. 

  • Psoriasis- This is a chronic condition in which patches of skin become crusty and dry. 

Symptoms of Phimosis

In normal circumstances, phimosis doesn’t cause any symptoms. But when the problem is severe, people complain of the following signs and symptoms-

  • Pain while urinating

  • Traces of blood in the urine

  • Inability to empty the bladder properly

  • Pain in the penis while erection 

  • Redness, soreness, or swelling of the penis

When phimosis is left untreated for long, it leads to the inflammation of the penis known as balanitis. Furthermore, when this inflammation spreads to the glans and foreskin, this is called balanoposthitis. Apart from the above signs, the symptoms of both balanitis and balanoposthitis are mentioned below-

  • Soreness and itchiness of the penis

  • Swelling and redness of the penis

  • A buildup of thick fluid

In addition to all the above symptoms, a person suffering from phimosis may experience pain or a lack of sensitivity while having sex. The skin might even split in severe cases.

Types of Phimosis

Depending on the causes of phimosis, it can be broadly categorized into two-

  • Physiologic phimosis-

    It is a normal condition of a newborn male. Male babies are born with tight foreskin since birth. With age, the foreskin retracts. The retraction is usually completed by the age of 7. Although, it can take a few more years for some. The symptoms of this type of phimosis are visible around 3 years. Symptoms include the inability of the foreskin to retract while cleaning/bathing or inflating of the foreskin while urinating. This type of phimosis is more common in children. Physiological phimosis gets cured on its own unless there are no signs or symptoms. 

  • Pathologic phimosis-

    As the name suggests, this type of phimosis develops due to pathologic reasons. This type of phimosis occurs more in males who have hit their puberty. The main reasons for pathologic phimosis include- continuous swelling of the foreskin and penis glans, scarring of the foreskin and the most common, lack of hygiene. 

Diagnosis of Phimosis

The diagnosis of phimosis is a simple one. The urologist makes note of the full medical history of the patient by asking questions regarding any prior infection or injuries to the penis. There can be some questioning pertaining to any impact that might have occurred during sexual activity. 

Followed by the questioning round, the doctor does a physical examination in which he thoroughly looks at the penis and foreskin. To confirm, the doctor recommends a urinalysis to check for any urinary tract infections or perform a swab test by taking a sample from the foreskin area to check for bacteria. 

Treatment of Phimosis 

Ayurveda for phimosis

As discussed earlier, phimosis occurs when the foreskin is unable to retract from the tip of the penis. According to Ayurveda, the application of herbal oil can help in the retraction of the foreskin and strengthening the skin. This helps in the widening of the opening of the skin that covers the genitals thereby, the foreskin backs up over the penis’s tip. 

Homeopathy for Phimosis

When phimosis occurs due to balanitis, the doctor recommends the following homeopathic medicines-

  • For burning or extreme pain, doctors recommend Apis Mellifica. 

  • For marked redness of the glans penis, doctors prescribe Caladium.

  • To get relief from swelling and painful sensitivity, doctors recommend Merc Sol.

  • To get some relief from prolonged itching, Cinnabaris is recommended.

  • For getting relief from pain while urinating, doctors recommend Cantharis.

  • To get some relief from dark red swelling and pain in the groin, doctors recommend Rhus Tox.

  • For throbbing, shooting pain under Glans, doctors recommend Rhododendron. 

Allopathy for Phimosis

There are some allopathic medicines that can provide some relief from symptoms of phimosis. 

  • Hyaluronidase- It is an enzyme that is recommended for hydration, dispersion, and absorption of other injected drugs.

  • Hydrocortisone- It is a medicine that is recommended to get relief from severe allergies, arthritis, asthma, multiple sclerosis, and skin conditions. 

Home Remedies for Phimosis

The most-effective home remedy for curing phimosis is to practice stretching on the foreskin regularly. Here’s how to stretch the foreskin safely back in its place-

  • Gently apply a layer of steroid cream on and around the entire foreskin. Make sure to cover all the area- from the tip of the penis down to where the foreskin meets the skin lower in the penis shaft.

  • Gently massage the cream into the foreskin by rubbing it slowly until the cream is fully absorbed by the skin.

  • Pull your foreskin back carefully but stop as soon as you feel any discomfort or pain. 

Repeat the above steps twice or more on a daily basis until the foreskin fully retracts without any pain or discomfort. The foreskin might get loose within four to eight weeks if you stretch the skin on a daily basis. 

But remember the following tips before you stretch the foreskin-

  • Be gentle while pulling the foreskin. Stop pulling when it starts to pain, crack or bleed. 

  • Make sure that you use a topical steroid cream while massaging and softening the foreskin.

  • Don’t delay the treatment for seeking medical help. 

Surgery

The surgical removal of the foreskin is known as circumcision. In this procedure, the urologist frees the foreskin from the penis’s head and the extra skin is removed. The benefits of circumcision are discussed below-

  • Lower risk of urinary tract infections

  • Lower chances of sexually transmitted diseases in men

  • Decreasing the risk of penile cancer in males and cervical cancer in females

  • Preventing conditions such as balanitis and balanoposthitis

  • Preventing phimosis and paraphimosis 

Complications of phimosis

When a patient suffering from phimosis leaves it untreated, it can give rise to various complications such as-

  • Recurrence

  • Posthitis

  • Necrosis and gangrene of the glans

  • Autoamputation 

Prevention of Phimosis 

Good hygiene of the penis can lower the chances of phimosis or other related conditions. Some good penis hygiene tips are described below-

  • The foreskin should be washed regularly. The foreskin should be pulled back and gently rinsed with soap and water every time a bath is taken. This is done to prevent any buildup of urine, dirt, bacteria and other substances.

  • The entire penis- tip, shaft, base, and scrotum- should be washed thoroughly.

  • Loose, breathable underwear should be worn so that excessive moisture doesn’t buildup under the foreskin.

  • Pubic hair should be removed to prevent bacterial/fungal infections that can lead to phimosis. 

Frequently asked Questions

What happens if I choose to leave a phimosis untreated?

If you choose to leave a phimosis untreated, it can lead to inflammation or infection of the penis which is also known as balanitis. This is a very painful condition.

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Do you become impotent after a laser circumcision?

No. A person doesn’t become impotent following a laser circumcision. The only side effects after a circumcision that people face are exposed glans, that too for a few 3-5 days. That also will subside later as the glans get adapted.

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