What phimosis is
The foreskin is the fold of skin that covers the glans. In young boys, a foreskin that does not retract is normal and usually resolves with time. In teenagers and adults, phimosis that persists or develops later (for example after repeated inflammation or with some skin conditions) can cause problems.
Symptoms
- inability or difficulty pulling back the foreskin;
- pain during erection or intercourse;
- repeated inflammation of the glans (balanitis) and foreskin;
- difficulty with hygiene and sometimes with passing urine.
Paraphimosis is an emergency
If a tight foreskin is forced back and cannot be returned to its normal position, it can constrict the glans (paraphimosis). This is an emergency and needs immediate medical attention.
Treatment
In some mild cases, corticosteroid creams can help. When phimosis is significant or keeps coming back, treatment is surgical:
- circumcision, which removes the foreskin;
- preputioplasty, which widens the tight ring while keeping the foreskin, when possible.
The operation is done under local or general anaesthesia and takes 30–60 minutes. The stitches dissolve on their own.
Recovery
- discomfort and swelling for a few days;
- careful hygiene, as instructed;
- back to normal activities after a few days;
- sexual activity after 4–6 weeks.
Risks and things to know
- bleeding or haematoma;
- infection;
- an uneven cosmetic result, which is rare;
- temporary changes in sensation.
