Table Of Index

Phimosis

What is Phimosis?

Phimosis is a common foreskin problem in uncircumcised males in which the foreskin of the penis becomes too tight and cannot be pulled over the head (glans) of the penis. Phimosis in adults often causes painful symptoms and requires treatment. In adults, this condition is usually not the result of a natural development but instead, there is an underlying cause that needs to be addressed.

If not accompanied by painful symptoms, phimosis is normal in children and young. In infants and young boys, the foreskin is usually attached to the head of the penis. In 99% of cases, this resolves itself completely but if it does not, treatment might be necessary. But if the child is experiencing symptoms like painful urination, phimosis treatment should be considered. 

formation of Phimosis

What does phimosis look like?

With phimosis, there may appear a tight ring or “a rubber band” of foreskin around the glans(tip of the penis), which often prevents full retraction. 

Types of phimosis

Physiologic phimosis

Physiologic phimosis

Pathologic phimosis

Pathologic phimosis

Causes

  • Infection of the foreskin
  • Forceful retraction of the foreskin
  • Urinary tract infections (UTIs)
  • Foreskin or injury
  • Eczema
  • Psoriasis
  • Lichen sclerosus
  • Diabetes

Signs and symptoms

  • Inability to pull back foreskin
  • Redness
  • Swelling
  • Soreness
  • Itchiness
  • Difficulty or pain while urinating
  • Painful intercourse and erections
  • Foul-smelling odor
  • Lack of sensation

Diagnosis

Diagnosis of phimosis begins with a simple, routine physical examination. Your urologist may ask questions about your medical history, symptoms, sexual activity, and any injury to the penis. The doctor may also examine the penis for signs of infection,  tight foreskin and related symptoms of phimosis. 

The first thing that the urologist will do is ask about your symptoms and physically diagnose the condition. The urologist will try nonsurgical treatments to reduce the foreskin swelling such as pressing the penis with a hand or wrapping the penis in a tight bandage. After the swelling has been reduced, your urologist should be able to pull the foreskin back to its regular position. If the foreskin remains stuck there, the urologist might need to perform a circumcision to treat phimosis.

Diagnosis of Phimosis

Risks and Complications

  • Paraphimosis- Paraphimosis is a urology condition that occurs in uncircumcised males, in which the foreskin of the penis can be pulled back behind the head of the penis but cannot be returned to its regular position. When the foreskin is  stuck behind the head of the penis, the blood flow to the penis is restricted. Lack of blood flow to the penis may result in an immediate medical emergency requiring prompt medical attention. 
  • Balanitis- It is the inflammation of the head of penis and is often a complication of untreated phimosis. 
  • Balanoposthitis- Balanoposthitis occurs when both the foreskin and the head of the penis are inflamed. The condition may make the penis sore.

When to consult a doctor ?

You should call a doctor right away if you suspect the following signs of paraphimosis- 

  • Unable to pull back the foreskin
  • Foreskin stuck behind the glans 
  • Swollen and painful penis
  • Unable to clean under the foreskin 
  • Infections under the foreskin 

Phimosis should be taken seriously and treated promptly. The need for phimosis treatment will depend on the patient’s age, the severity of the problem and the underlying cause. For patients with severe or recurrent phimosis, doctors suggest circumcision to permanently treat the condition. If you are suffering from paraphimosis, consult a doctor to undergo circumcision.  


Questions to ask your doctor before circumcision

Which is the best technique for phimosis treatment?
Are there any alternative treatment options available?
Will I feel any pain during circumcision?
What signs of infection should I look for during the recovery period?
What is the success rate of the phimosis surgery?
Can I have sex with phimosis?
When can I have sex/ mastrubate / drive after circumcision?
How long is the recovery period after circumcision?
What are the possible risks and complications of the procedure?
How can I take care of myself at home after the procedure?
Will I need medications after the procedure?

Treatment options

Your doctor will do a detailed and careful diagnosis to check for any other infections or complications. If there are no infections or other conditions that might be causing phimosis, several nonsurgical treatment options are available for effectively treating this condition. For mild cases of phimosis, treatments including usage of phimosis steroid creams, manual stretching exercises can be used. In more serious cases, surgery may be the option.  

Phimosis detected in infants and young boys does not always need treatment. If your child has phimosis, it is important that a pediatrician evaluates the condition to determine the need of treatment. If phimosis persists or occurs in adulthood or later in life, treatment would be necessary.

Phimosis creams- Doctors may recommend topical steroid phimosis ointment application for patients with phimosis These phimosis creams can help soften the tight foreskin around the penis, which may be easily retracted. Your doctor will demonstrate how to apply the phimosis cream to the tight foreskin and how often to apply that. The ointment should be massaged into the affected areas 2 times daily for 6 to 8 weeks along with manual stretching or retraction exercise twice daily. Phimosis steroid creams have shown a success rate of more than 70%. 

Phimosis retraction exercises- Boys older than the age of 5 might be recommended some foreskin stretching exercises to try and reduce phimosis. However, these exercises should not cause pain and should not be done forcefully.

To do these exercises, apply the ointment and pull the foreskin back slowly, for about 1 minute, 3-4 times a day. These exercises should not cause discomfort or pain but should loosen the foreskin little by little.  If these phimosis exercises are not done correctly, it may cause complications like pain, scars, new adhesions, and paraphimosis.

Circumcision Surgery for Phimosis treatment- Typically, after non-surgical treatment options have proven unsuccessful in reducing the tightness of the foreskin and the foreskin cannot be pulled back to the normal position, the doctor may recommend circumcision. During the circumcision procedure, the surgeon will cut the foreskin to expose the head of the penis. Many men choose to undergo circumcision surgery in order to get permanent relief from foreskin problems and penile infections. Urologists can now perform circumcision using minimally invasive techniques (laser circumcision and stapler circumcision) in less than 30 minutes.  

Is circumcision covered by medical insurance?

Circumcision is recommended by a urologist or specialist doctor when other conservative treatment options have failed to cure the underlying condition and removal of the foreskin is necessary. In such cases, where the doctor states that circumcision surgery is medically necessary to cure the underlying condition or prevent its recurrence, circumcision can be covered under insurance. Most leading healthcare providers in India such as Max Bhupa, New India,  Religare, United India Insurance, Care Health, etc cover the cost of circumcision when it is a medical necessity. 

Video testimonial - by patient

Video on the disease and treatment - by Pristyn Care doctor

Case Study

In March 2020, Laxman, a 31 year old software developer got in touch with our team regarding chronic phimosis. He first started experiencing phimosis when he was about 17 but at that time, home remedies provided temporary relief. In the following years, he had recurrent episodes of phimosis but thinking that the condition would resolve on its own, he did not consult a doctor for the same. However, in January 2020, the problem became worse and a lot more painful.

He tried home remedies but they failed to provide any relief. Phimosis started creating problems in his personal life and the embarrassment and stress started affecting his job-life as well. He googled the problem and realized that it is a common medical condition. After a number of google searches, he booked his appointment with one of our urologists for phimosis treatment. 

After proper diagnosis, the urologist told Laxman that as phimosis in his case was prolonged and severe, he needed circumcision surgery for the same. At first, Laxman was naturally unsure but the doctor made him understand why surgery is necessary for him. Eventually, he agreed and underwent a successful laser circumcision surgery in March 2020. 

After his surgery, Laxman recovered well and found permanent relief from phimosis.

Latest Research

Cities Where We Treat Phimosis

FAQ’s

Is phimosis curable?

Yes, phimosis is curable. Circumcision is the procedure to treat phimosis once and for all. Laser circumcision is the safest way to remove the tight foreskin from the penis. ZSR circumcision is a modern painless technique of circumcision that is minimally invasive in nature. It is better to undergo any of these advanced circumcision procedures than complex open circumcision surgery.

Will forcible retraction help resolve the problem of phimosis?

If you have a tight foreskin, do not retract it forcibly. This can result in tearing of the foreskin tissues and can aggravate your problem. Also, the foreskin may get stuck and form a ring around the penis. This condition is called paraphimosis and is an emergency medical condition.

What is the permanent treatment for phimosis?

Although phimosis can be treated with ointments and medications, the only permanent treatment for the condition is the surgical procedure called circumcision. In circumcision, the surgeon removes the layer of foreskin from the penis, which resolves the problem of phimosis. At present, the most effective and modern circumcision procedure is laser circumcision.

Can you leave phimosis to resolve on its own?

Phimosis in infants usually goes away on its own by the time the boy turns 7 years of age. However, cases of adult phimosis do not resolve on their own without medical treatment. If left untreated, they can cause a number of complications. Therefore, it is better to seek medical consultation for the problem.

Facts and statistics around Phimosis

Why is it important to choose the best surgeons for circumcision?

Circumcision is a relatively minor and complication-free procedure. But it is still very important to choose the best surgeons to undergo circumcision surgery. You should choose an expert surgeon who specialises in performing advanced circumcision procedures such as stapler or laser circumcision, which is different from conventional circumcision in many ways. The benefits of advanced circumcision are:

  • Gives a natural and aesthetically appealing look
  • Performed under great magnification to prevent any complications
  • Expert precision which bypasses minor complications that may arise during surgery 
  • Procedure completed in under 30 minutes
  • Minimal postoperative pain or discomfort with no downtime from regular life.

If you have any doubts or concerns regarding circumcision surgery, it would be best to consult an expert surgeon. 

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