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Phimosis: everything you need to know

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The foreskin is a sheath of skin that covers the head (glans) of the penis. It's a normal, natural body part—just like your eyelids, earlobes, or nipples. The purpose of the foreskin is to protect the glans from irritation and injury that can occur with clothing, friction, and other contact.

Most foreskins can be pulled back (retracted) from the head of the penis. This process is called foreskin retraction. It usually happens during puberty, but it can happen earlier or later in life, too. The ability to retract the foreskin varies from person to person, but it's generally not a problem.

If the foreskin can't be retracted, it's called phimosis. Phimosis is normal in infants and toddlers. In older children and adults, it can be the result of an infection or scarring from an injury. Phimosis can also be caused by sexual activity that's too rough, which can lead to scarring.

Phimosis is not a medical emergency, but it can be a problem if it's not treated. Phimosis can cause pain, difficulty urinating, and problems with sexual activity. Let's take a look at everything you need to know about phimosis, including its causes, symptoms, and treatment options.

What Is Phimosis?

Phimosis is a medical condition in which the foreskin of the penis is so tight that it cannot be retracted (pulled back) from the head of the penis. This can cause pain, difficulty urinating, and other problems. Phimosis is relatively common in newborns and young boys, but it usually goes away on its own as the child gets older. In some cases, phimosis may persist into adulthood and require medical treatment.

How Do You Know If You Have Phimosis?

If you have phimosis, you will be unable to retract your foreskin from the head of your penis. This may cause pain, difficulty urinating, and other problems. If you are unsure whether you have phimosis, you should see a doctor for an evaluation.

Most cases of phimosis resolve on their own without treatment. If phimosis persists into adulthood, medical treatment may be necessary. By the age of 17, most boys will be able to retract their foreskin without difficulty. If you cannot retract your foreskin by this age, you may have phimosis.

Symptoms include:

  • Inability to retract the foreskin past age 17
  • Pain during erection or intercourse
  • Difficulty urinating
  • Paraphimosis (in which the foreskin becomes stuck behind the head of the penis and cannot be pulled back into place)

If you have any of these symptoms, you should see a doctor for an evaluation.

What Causes Phimosis, and How Are They Treated?

Phimosis can simply be a natural variation in how tight the foreskin is. It's not clear as to why this occurs. However, there are a few different treatment options available for phimosis, depending on the underlying cause.

Some possible causes and treatments include:

Congenital (present at birth): Congenital phimosis is the most common type of phimosis. It is simply a variation in how tight the foreskin is and is not due to any underlying medical condition.

Developmental (occurs during childhood): Developmental phimosis is caused by the foreskin not separating from the glans (head) of the penis during childhood. This can be due to a variety of factors, including:

  • Inadequate cleaning of the foreskin
  • Tightness of the foreskin
  • Infection

Scarring from injury or infection: Scarring of the foreskin can occur from injury or infection. This can lead to phimosis by making the foreskin tighter and less able to be retracted.

If phimosis is due to scarring from injury or infection, then treatment will depend on the underlying cause. In some cases, surgery may be necessary to remove the scar tissue.

Surgical complications: Phimosis can also be caused by complications from surgery, such as circumcision.

If phimosis is due to complications from surgery, then treatment will depend on the underlying cause. In some cases, revision surgery may be necessary.

Balanitis xerotica obliterans (BXO): A rare condition that results in the inflammation and scarring of the foreskin, that's usually the result of poor hygiene.

If phimosis is due to BXO, then treatment will usually involve the use of topical steroids to reduce inflammation. In some cases, surgery may be necessary to remove the affected tissue.

Lichen sclerosus: A chronic skin condition that results in the thinning and inflammation of the skin.

If phimosis is due to lichen sclerosus, then treatment will usually involve the use of topical steroids to reduce inflammation. In some cases, surgery may be necessary to remove the affected tissue.

Allergic reaction: Allergies to latex or other substances can cause inflammation and scarring of the foreskin, leading to temporary phimosis.

If phimosis is due to allergies, then avoiding the trigger substance can help to resolve the issue. In some cases, antihistamines or other medications may be necessary to control the allergic reaction.

Further Treatments for Phimosis

If phimosis is due to a lack of cleaning under the foreskin, then simply improving hygiene can help to resolve the issue. This includes gently washing the area with soap and water every day.

If phimosis is due to tightness of the foreskin, then stretching exercises may help. These exercises involve gently pulling back the foreskin and holding it in place for a few minutes at a time. This should be done several times a day, but do not force the foreskin back if it is painful without a doctor's guidance.

If phimosis is due to an infection, then treating the infection will usually resolve the issue. This may involve the use of antibiotics or antifungal medications.

When To See a Doctor

If you have phimosis, you should see a doctor if:

  • You have pain or difficulty urinating
  • You have difficulty retracting your foreskin
  • You have swelling or redness of the foreskin
  • You have discharge from your penis
  • You have blood in your urine
  • You have difficulty having sex

If you have any of these symptoms, you should see a doctor to rule out any underlying medical conditions.

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This blog post is for educational purposes only and does not constitute medical or other professional advice. Your specific circumstances should be discussed with a healthcare provider. All statements of opinion represent the writers' judgement at the time of publication and are subject to change. Phoenix and its affiliates provide no express or implied endorsements of third parties or their advice, opinions, information, products, or services.

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