Phimosis is a condition where the foreskin does not pull back (retract) over the glans. This is common in young boys.
Facts and figures
- 1% of men aged 16-18 have had an incidence of phimosis
- By age 10, most boys will have a retractile foreskin
- 95% of boys will have a retractile foreskin by 16-17 years of age
- 8% of 6-7 year old boys will have an incidence of phimosis
Phimosis can occur at any age but particularly in young men after puberty. Phimosis is not a problem unless it causes difficulties such as urinary obstruction, haematuria or local pain. However, it can cause major discomfort. It can also cause severe pain and splitting of the foreskin on erection. You are more likely to develop balanitis (swelling of the foreskin or head of the penis) if you have phimosis,
as sweat, debris and urine may collect under the foreskin. This can irritate directly, or can encourage bacteria to thrive and cause infection. It is one of the most common problems and relatively minor.
Paraphimosis occurs when a tight prepuce is retracted and then unable to be replaced as the glans swells. A tight constricting band or scar in the skin of the foreskin may prevent the foreskin being retracted back over the head of the penis. This is a urological emergency. Always check there is no encircling foreign body constricting venous return, such as a ring, rubber band or hair.
Circumcision is the mainstay of treatment if the foreskin is scarred by balanitis xerotica obliterans.
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What are the treatments?
This is one of medicine’s oldest operations. If the band is not too established with scar tissue, it is possible to perform a preputioplasty in which the
foreskin is made looser through a skillful couple of ‘nip-tuck’ incisions and fine stitching and the foreskin is preserved. Your options will be discussed with you.