About the disease

Phimosis is a condition, whereby the tight ring of scarred tissue forms around the head of penis, also known as glans. Normally, the skin over the penis is loose and it can slide over the head of penis covering and uncovering it. In phimosis the foreskin is not loose, therefore it can not move. The head of penis, also known as glans, is covered by the foreskin and can not be seen by moving the foreskin as the scar tissue formed around it.

Overall, the severity of phimosis depends whether the foreskin can retract the glans, head of the penis, or not. In mild cases, the foreskin is half retractable, in severe cases - the head of penis is completely closed, as the foreskin cannot retract.

According to AboutKidsHealth.ca, around 10% of newborn boys are born with phimosis. Even more boys are born with partial cases of phimosis. Normally, this condition resolves on its own by the time a boy reaches 16 years of age. By that time he is supposed to be able to freely retract the head of penis. Nonetheless, there is a small percentage of boys for whom this condition does not resolve on its own.

If a boy is born with phimosis, it is considered natural. During prenatal development the glans can become attached to the foreskin. By the age of 3, the head of the penis needs to be able to retract normally, at least partially.

In some cases boys develop phimosis already after they reached puberty. Then this is not natural. Acquired phimosis can develop due to poor hygiene habits or constant swelling of the foreskin.      

Symptoms

• Inability to retract the head of penis from the foreskin normally
• The foreskin is not movable
• The foreskin created tight ring around the head of penis
• Swelling of the foreskin
• Pain during erection
• Foreskin pain and discomfort in some cases
• Difficulty urinating freely

Diagnosis

• During a general examination a doctor will examine the testicles of a boy and will determine if the foreskin of a penis is tractable. He will also examine the penis and determine if it develops and functions normally. In teenagers a doctor will also ask about erection and whether there is a problem when urinating. Usually, simple general examination is enough to diagnose phimosis.

Treatment

• Conservative treatment uses topical steroids, which need to be applied to the foreskin for 4 to 6 weeks to make it tractable.
• Circumcision is used to remove the foreskin, which creates the tight ring around the penis. In future, a boy will need to take care of the head of penis to avoid infection or bleeding.

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed