Phimosis – What is it? causes, symptoms and treatments

What is Phimosis?

Phimosis is a condition that causes difficulty in retracting the penile skin or prepuce. This condition is common among children and men. This will make the penis appear as if it has rings around the tip and gives an unusual appearance.

Phimosis condition is not considered to be a problem. However, they may cause certain difficulties. Phimosis is commonly seen in infants and toddlers because their foreskin can remain intact and will not be able to pull back.

This condition is common in children aged between 2-4, and as they age, it becomes easy, and the foreskin can be pulled back.

Phimosis does not really cause any problems. It should be monitored when the condition causes any symptoms. Phimosis can lead to a small pinhole size opening, and during this condition, it will require medical attention.

Causes of Phimosis

Phimosis is common among boys when compared to men. The opening of Phimosis skin can occur for up to ten years.

The common causes of Phimosis in boys are

• Urinary tract infections,
• Foreskin trauma,
• Rough handling of foreskin and
• Foreskin infection.

The causes of phimosis in adults can occur due to sexually transmitted diseases. The other causes of phimosis are due to certain skin conditions like eczema, lichen planus, psoriasis and lichen  sclerosus.

Eczema is a common condition that causes the skin to appear red, dry and cracked. Psoriasis causes the skin to become flaky, red and crusty.

Lichen planus causes swelling and irritation in the skin, which can appear as purplish, itchy and flat bumps on the penal skin.

Lichen sclerosus is a condition that is observed by patchy, discoloured, thin skin. This condition commonly affects the genital areas. This condition is not contagious.

Types of Phimosis

Physiological Phimosis

During birth, the foreskin remains non-retractile for a variable length of time. As the infant grows, the foreskin that encases the glans will become retractile.

When there is adhesion between the prepuce and glans, physiological phimosis occurs. This adhesion can occur naturally due to narrow skin and frenulum breve (a form of penile disorder).

As the baby grows, the skin becomes retractile after some time. The variable time can be from birth to 18 years of age. The physiological phimosis can also be aided by erections and keratinisation of the inner epithelium.

According to NCBI data titled “Phimosis in Children”, stated that 2% of normal males continue to have non-retractile skin throughout their life even though they appear to be normal.

Pathological Phimosis

Pathological phimosis occurs due to balanitis xerotica obliterans (BXO). BXO is a chronic disease that can lead to phimosis and urethral stenosis. This condition will affect both sexual and urinary functions.

The BXO condition causes scarring in the urethra, which leads to narrowing and slowing of the urine flow. According to NCBI, it states that BXO can lead to lichen sclerosis, a chronic skin condition which can be evident in autoimmune aetiology.

Phimosis symptoms

In most cases, phimosis does not indicate any symptoms. If phimosis indicates any type of symptom, it will require medical attention.

Foreskin pain

When the foreskin becomes non-retractile, it can lead to pain. This can be caused by poor hygiene too.

Infections

Infections can lead to inflammation like posthitis and balanitis. It can be mainly caused when dirty nappies or bubble baths are used.

Painful intercourse

During intercourse, when you try to pull your foreskin, it can be painful. The foreskin can also get trapped. This leads to painful intercourse. Pain can also be caused due to an erection.

White ring

The foreskin can appear to be a white ring that will look like scar tissue.

Painful urination

If the opening gets blocked, it can lead to painful urination.

Risk factors for Phimosis

Phimosis, in most cases, will not be painful, but when the symptoms show up, it will require medical attention.

STDs

Sexually transmitted diseases (STDs) can also lead to phimosis. When there is inflammation or infection in the head of the penis or the foreskin, it can cause phimosis.

STDs can occur as a result of poor hygiene or an infection that hides in the penal skin. These bacterial infections can hide under the skin and lead to infections which can be painful.

Scarring

Scarring on the foreskin can lead to phimosis. Scarring can occur when there is inflammation or other skin conditions. Other causes of scarring can be injuries.

Skin conditions

Certain skin conditions like psoriasis, lichen planus, eczema and lichen sclerosus. These skin conditions can cause the foreskin to appear red and inflamed with flaky skin.

Diagnosing Phimosis

Phimosis usually represents pain in the penis. You can visit the urologist when you feel pain during urination.

Sometimes, phimosis can be caused due to infection, and the doctor will ask you about the history of your infection.

The symptoms exhibited will have an impact on your sexual life. This will also be monitored by your doctor.

The doctor will ask for a urine test and swab test from the foreskin. If there is any infection in the foreskin, the swab test will help diagnose it.

Treatment for Phimosis

The treatment of phimosis will depend on the type of symptoms that are exhibited. If the person exhibits severe symptoms, surgery will be required.

Medication

Medications can work for phimosis if the symptoms are less. The first medication for phimosis will be steroid creams. These steroid creams for the foreskin will help to reduce the stiffness of the skin and loosens the skin.

Circumcision surgery

Circumcision surgery will remove the foreskin that covers the penis. It is common that after the birth of the infant, circumcision surgery will be carried out to remove the foreskin.

In earlier days, circumcision was started as a religious rite, and now it is performed for cultural reasons.

In most cases, young and teen boys get circumcision surgery, and for men, it is less common. But now, circumcision surgery is also common among men.

How to prevent Phimosis?

Phimosis can be prevented if good hygiene is followed. Sometimes, rough handling can also lead to phimosis. So, the foreskin should not be rough-handled.

Cleaning the penis with warm water will help avoid infections getting under the skin. This will also help to loosen the foreskin and avoid infections.

Conclusion

Phimosis can lead to uncomfortable symptoms. This can also affect the quality of life and lead to pain. Phimosis is not a life-threatening condition. However, it requires certain medications to bring the symptoms under control.

In some cases, phimosis might require surgery. Infections can spread to STDs and cause phimosis. So proper precautions should be taken to avoid contracting such infections.

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