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Phimosis

What is Phimosis?

Phimosis is a common urology health condition 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, consulting a urologist for phimosis treatment is vital.

formation of phimosis

What does phimosis look like?

A phimosis penis may look like it has rings around the tip of the penis. 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.

Phimosis Types

Physiologic phimosis type

Physiologic Phimosis

Pathologic phimosis type

Pathologic Phimosis

Phimosis Causes

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

Phimosis 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 of Phimosis

Phimosis is usually diagnosed and treated by a urologist. In the diagnosis procedure, the doctor analyzes the various phimosis symptoms you might have and then proceeds to determine the best phimosis treatment for you.

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, to understand your phimosis symptoms.. The doctor may also examine the penis for signs of foreskin infection, tight foreskin and other phimosis symptoms. 

The first thing that the urologist will do is ask about your symptoms and physically diagnose the condition. The urologist may first try nonsurgical approaches for phimosis treatment or to reduce the foreskin swelling. 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 circumcision surgery for phimosis treatment.

Diagnosis of Phimosis

Risks and Complications Associated with Phimosis

  • Paraphimosis Paraphimosis is a condition 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. 
  • BalanoposthitisBalanoposthitis occurs when both the foreskin and the head of the penis are inflamed. The condition may make the phimosis penis sore.
risk factor of phimosis

  • Prevention of phimosis

    Preventions of Phimosis

    Prevention of phimosis

    Good hygiene of the penis can lower the chances of phimosis or other foreskin-related health conditions. Some easy tips for phimosis penis hygiene are:

    • Undergo circumcision – Men suffering from chronic or severe phimosis/ paraphimosis or other foreskin issues can find permanent relief and prevention from the condition by undergoing circumcision. 
    • Wash the foreskin 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.
    • Wear comfortable undergarmentsWear loose, breathable underwear so that excessive moisture doesn’t build up under the foreskin.
    • Clean pubic hair – Unhygienic pubic hair is one of the lesser known phimosis causes. It is important for adult men to maintain cleanliness of their pubic hair to prevent bacterial/fungal infections in the foreskin that can lead to phimosis.

When to consult a doctor for phimosis treatment?

You should call a doctor right away if you witness any of the following phimosis symptoms: 

  • 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 phimosis surgery:

Which is the best technique for phimosis surgery?
Are there any alternative methods available for phimosis treatment?
Will I feel any pain during phimosis surgery?
What signs of infection should I look for during the recovery period?
What is the success rate of the phimosis surgery/ circumcision?
Can I have sex after phimosis surgery?
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

Phimosis treatment may vary from medicines to surgical and non-surgical methods. For mild phimosis treatment, phimosis steroid creams can be used and manual stretching exercises can be done. In severe cases of phimosis, surgery may be the best option.  

Phimosis 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. 

Different types of phimosis treatment are:

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

Phimosis retraction exercises – Retraction exercise is the best non-surgical phimosis treatment. Boys older than 5 years  might be recommended some foreskin stretching exercises to try and get relief from phimosis symptoms. However, these exercises should not cause pain and should not be done forcefully.

To do these exercises, apply any phimosis 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 or worsen the existing phimosis symptoms.

Circumcision Surgery or Phimosis surgery – 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 (sometimes, known as phimosis surgery). 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. Leveraging advanced technology, urologists can perform phimosis surgery through minimally invasive techniques (laser circumcision and stapler circumcision) in less than 30 minutes. 

At Pristyn Care, We offer advanced laser and laparoscopic surgical treatment including laser circumcision, stapler circumcision and frenuloplasty surgery.

phimosis surgery cover under insurance

Is phimosis surgery covered by medical insurance?

Circumcision is recommended by a urologist when other conservative treatment options have failed to treat the phimosis symptoms and removal of the foreskin becomes inevitable. In such cases, where the doctor states that phimosis 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. 

phimosis surgery cover under insurance

Video testimonial - by patient

Video on the disease and treatment - by Pristyn Care doctor

Latest Research

  • Latest Research on phimosis

    It is estimated that more than 1 in 2 uncircumcised males will experience an adverse foreskin-related medical condition over their lifetime.”

     

  • Latest Research on phimosis

    “Over the lifetime 1 in 12 circumcised males experience a UTI compared with 1 in 3 uncircumcised males.”

  • Latest Research on phimosis

    “Uncircumcised Men May Have Higher HIV Risks”

  • Latest Research on phimosis

    “Circumcision of males also partially protects their female sexual partners from oncogenic types of HPV.”

     

  • Latest Research on phimosis

    “Over the lifetime, up to 80% of uncircumcised males may be affected by a medical condition related to the presence of their foreskin.”

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. Stapler 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. Medically, 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.

Can phimosis cause inflammation of the penis?

Yes, inability to retract the foreskin can make it even more difficult to maintain proper hygiene of the penis. Microbes can thus thrive in the dark and moist area under the foreskin and cause infections, which can result in inflammation of the glans penis.

Does phimosis occur in children as well?

Yes, phimosis does occur in children. In fact, infant phimosis is very common and occurs due to adhesions between the foreskin and the glans penis. The problem is nothing to worry about and it usually resolves on its own by the time the child reaches 5-7 years of age.

Why do adults get phimosis?

Sexually transmitted infections, improper hygiene and skin conditions like eczema and psoriasis are the major causes of sudden phimosis in adult men.

Can I rely on self-medication and home remedies for phimosis?

No, you should not rely on self-medication and home remedies for phimosis. Home remedies can certainly help alleviate the discomforts of phimosis only temporarily. However, it is not a good idea to rely completely on home remedies. And self-medication is just not an option. Delay in medical treatment for phimosis can result in the worsening of the problem and the symptoms can aggravate.

Can I have sex with phimosis?

Yes, you can have sex with phimosis. But you may experience pain and discomfort during sexual intercourse. The tight foreskin also affects the chances of achieving orgasm pleasurably. You will also have to be cautious to prevent any tearing or scarring of the foreskin. It is better to consult a doctor for a permanent solution for phimosis.

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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