What Is Phimosis?
Phimosis is a condition where the foreskin can't be pulled back (retracted) from the head of the penis. It only happens if you're uncircumcised.
The foreskin is a piece of tissue that covers the head of the penis. Babies are born with a tight foreskin that's often removed in a procedure called a circumcision. If it's left in place, the foreskin gradually loosens as the child grows. Usually by about age 6 it can be pulled back completely to pee and to clean underneath it. Rarely, the foreskin can stay tight into the teenage years. Phimosis can also appear later in life.
Phimosis vs. paraphimosis
Phimosis can sometimes lead to a dangerous condition called paraphimosis. That's when the foreskin gets stuck behind the head of the penis and can't be pushed back into place. It can happen when the foreskin is tight and you force it to retract. It can cut off the flow of blood to your penis and needs to be treated right away.
Phimosis in adults
Phimosis is natural in young children. In older children or adults, it can be caused by an infection, inflammation, or a skin condition.
In babies and young children, phimosis is something they're born with, and they usually grow out of it. That's called physiologic phimosis. Pathologic phimosis is caused by something else, such as:
Scar tissue. Infections can scar the foreskin, which might make the skin less stretchy. The tough tissue can be hard to pull back.
Skin conditions. A skin condition called penile lichen sclerosus or balanitis xerotic obliterans is a leading cause of phimosis in adults. It can also be caused by eczema and psoriasis.
Medical conditions. If you have diabetes, you're more likely to have balanitis, an infection of the tip of penis. Talk to your doctor about your complete medical history so they can treat you properly.
When you have phimosis, your foreskin will be stuck over the head of your penis. You might also have the following signs:
In the bathroom. Your foreskin will expand when you pee, like a balloon. It can be painful. You might see blood in the stream or in the toilet. The stream might seem weaker than normal.
When you have sex. You might have pain with an erection or while having sex.
Infections. You may get urinary tract infections. Symptoms include blood in your urine, pain or burning when you pee, the urge to go even when your bladder is empty, and pain or pressure in your lower abdomen or back.
Foreskin pain. You may notice that your foreskin hurts. It might have discharge, too.
White ring. The opening of your foreskin may have a white ring that looks like scar tissue.
Your doctor can usually figure out if you have phimosis by listening to you describe your symptoms and with an exam. They have probably seen cases like yours many times, so there's no need to be embarrassed or shy.
You can get treatment in an outpatient setting by a urologist. How they treat you depends on how serious your condition is and what symptoms you're having. They'll also consider the cause of the problem and ask what kind of solutions you prefer.
Phimosis treatment without surgery
For a young child, treatment usually isn't needed. Phimosis will go away on its own as the child grows and the foreskin loosens naturally. That process can be helped along if they work on gently retracting and stretching their foreskin a few times day, only as far as it can be moved without pain. Bath time is a good opportunity.
Another option is a medicated cream or ointment that you apply to your foreskin several times a day for several weeks. It usually contains a steroid, like betamethasone, fluticasone propionate, hydrocortisone, or triamcinolone. This can soften and loosen the skin, and is often combined with stretching exercises.
If other treatments don't work, phimosis can be fixed with surgery. In one procedure, a surgeon makes small cuts in the foreskin that make it easier to pull it back. Another procedure, called circumcision, removes the foreskin entirely.
Circumcision may be the best option if you get infections often, if you have a lot of scar tissue, or if the phimosis is caused by balanitis xerotic obliterans.
Phimosis can lead to a number of complications, including:
- Infections in your foreskin and urinary tract
- Paraphimosis, when the foreskin gets stuck behind the head of the penis
- Tears in your foreskin. Be gentle when you try to pull it back, and use a condom and plenty of lubrication when you have sex.
If you have phimosis, you're also more likely to get penile cancer.
Getting circumcised will keep phimosis from happening.
You can also prevent infections that cause phimosis by keeping your penis clean and taking steps to prevent sexually transmitted infections.
The penis head and the foreskin need to be washed and dried regularly. Be gentle with the skin when you pull it back, and put it back in place when you finish.
Phimosis is a condition where the foreskin can't be pulled back from the head of the penis. It's normal in babies and small children, and they usually grow out of it. It can also be caused by infections, scar tissue, and skin diseases, and may need to be treated with steroid cream or surgery.
How do you fix phimosis?
Phimosis usually goes away as a child grows and the foreskin loosens naturally. It can also be treated with stretching exercises, steroid cream, or a combination of the two. Surgery to remove the foreskin, called circumcision, can prevent or fix it.
What is the main cause of phimosis?
Babies are born with tight foreskin that becomes easier to retract over time. In older children and adults, phimosis is often caused by a skin condition called balanitis xerotic obliterans.
Does phimosis ever go away?
Phimosis that happens naturally, called physiologic phimosis, usually goes away on its own. Pathologic phimosis, which is caused by something else like an infection, scar tissue, or a skin condition, needs to be treated.
Is phimosis a serious problem?
Most of the time, phimosis is a natural part of a child's growth. It becomes a problem if it causes infection or trouble peeing. It can also lead to more serious conditions.