Phimosis

What Is It ?

Phimosis is tightness of the prepuce (foreskin) of the penis that prevents the retraction of the foreskin over the glans.The condition is usually congenital but it may be the result of an infection.

True phimosis - that is, not just non-retractability - may rarely be a primary and congenital anomaly, but is much more commonly secondary to repeated attacks of infection that cause scarring and narrowing of the preputial ring.

Symptoms

The foreskin may be red, swollen, and tender. Diagnosis is made by a physical examination.

How It's Done

Phimosis begins with an infection of the foreskin. If untreated, the infection spreads and the foreskin swells up. Eventually, the foreskin becomes so large that it cannot retract. It is swollen and tight, and cannot be moved back away from the glans.

Phimosis is the result of repeated foreskin infections such as balanitis. It is linked to neglected hygiene. Germs breed under the foreskin with its enclosed glans. The delicate tissues undergo a process of partial healing/partial flare-up/partial healing again. Scar tissue keeps building up and breaking down. Eventually, the scar tissue becomes fibrous - hard, tough and inelastic. It contracts the meatus, pulling the infected foreskin tightly inwards. At the same time, nearby healthy tissue strives to form new scabs and becomes infected. This adds to the spread of germs.

When To Call A Professional

Difficulty with voiding and ballooning of the prepuce are the commonest reasons for patients seeking treatment, though recurrent bacterial infections (balano-posthitis) may also occur.

Treatment

Some men accept the chronic irritation and the red, swollen foreskin. They sometimes complain of phimosis and visit the doctor only when there is pain or an odorous discharge. Antibiotics may control the infection. Hot soaks may help separate the foreskin from the glans. If they fail, a small incision is made to release it. Circumcision is generally advised when the inflammation clears.