What is Phimosis?

Phimosis is a condition where the foreskin (prepuce) cannot be fully retracted back over the head of the penis (glans).

It is common in young boys and is usually a normal developmental condition. In adults, phimosis may develop due to scarring, infection, inflammation, or skin conditions.

Phimosis can vary from mild tightness to complete inability to retract the foreskin.

Phimosis

Person in a light blue long-sleeve shirt and dark jeans covering their crotch with their hands, standing against a light blue background.

Types of Phimosis

Physiological Phimosis

This is a normal condition in children, where the foreskin is naturally tight and not yet retractable.

In most boys, the foreskin gradually becomes retractable during childhood or adolescence without treatment.

Pathological Phimosis

This occurs when the foreskin becomes tight due to:

  • Repeated infections

  • Inflammation

  • Scarring of the foreskin

  • Skin conditions such as lichen sclerosus (balanitis xerotica obliterans)

  • Poor hygiene

  • Diabetes

Pathological phimosis is more common in adults.

Symptoms

Symptoms of phimosis may include:

  • Inability to retract the foreskin

  • Pain when retracting the foreskin

  • Redness or swelling of the foreskin

  • Difficulty with hygiene

  • Pain during erections

  • Pain during sexual activity

  • Ballooning of the foreskin when passing urine

In some cases, infections may occur.

Possible Complications

Untreated phimosis may lead to:

Recurrent Infections

  • Balanitis – inflammation of the glans penis

  • Posthitis – inflammation of the foreskin

  • Balanoposthitis – inflammation of both

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Urinary Problems

Severe phimosis may cause difficulty passing urine.

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Paraphimosis

This occurs when a tight foreskin becomes trapped behind the head of the penis and cannot be returned to its normal position. This is a medical emergency requiring urgent treatment.

How is Phimosis Diagnosed?

Phimosis is usually diagnosed through a physical examination by a doctor.

Your doctor may also ask about symptoms such as:

  • Pain or discomfort

  • Urinary problems

  • Recurrent infections

Further tests are usually not required.

Treatment Options

Treatment depends on the severity of symptoms and underlying cause.

Conservative Treatment

For mild cases, treatment may include:

Topical steroid creams

A steroid cream applied to the foreskin for several weeks may help soften the skin and improve retractability.

Gentle stretching exercises may also be recommended.

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Circumcision

Circumcision involves surgical removal of the foreskin and is the most definitive treatment for persistent or severe phimosis.

The procedure is usually performed under local or general anaesthetic.

Circumcision completely eliminates phimosis and reduces the risk of recurrent infections.

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Preputioplasty

In some cases, a foreskin-preserving surgical procedure may be performed to widen the tight foreskin rather than remove it completely.

Recovery After Treatment

Recovery depends on the treatment performed.

After circumcision:

  • Mild swelling or discomfort is common

  • Healing usually takes 2–3 weeks

  • Sexual activity should be avoided for about 4–6 weeks

Your doctor will provide instructions for wound care and recovery.

When to Seek Medical Advice

You should see a doctor if you experience:

  • Inability to retract the foreskin

  • Painful erections

  • Recurrent infections of the foreskin or glans

  • Difficulty passing urine

  • Swelling or redness of the penis

Urgent medical attention is required if the foreskin becomes trapped behind the head of the penis (paraphimosis).