Phimosis is when the foreskin is tight and unable to pull back to see the head of the penis (glans). Sometimes it is retractable when the penis is flaccid. But never able to retract when the penis is erect. Usually, phimosis does not remain the same as with each erection. There is minor trauma to the foreskin. This leads to loss of elasticity fibres due to scarring. This can lead to Balanitis Xerotica Obliterans (BXO). Phimosis can lead to paraphimosis.
1. Balanitis Xerotica Obliterans (BXO), also called Lichen sclerosus (Read more about BXO)
2. Lichen planus - a non-infectious skin condition which may affect the foreskin
3. Eczema- long-term skin problems
Cleaning inside of the foreskin is essential to prevent infection. It is a good idea to wash the foreskin with mild soap or warm salty water when you take a shower or bath. This will help to keep the foreskin clean.
Phimosis is categorised into six distinct grades, each indicating the degree of tightness and retraction capability of the foreskin:
Notably, grades 4 and 5 often necessitate surgical intervention for effective resolution.
The appearance of the phimosis provides further insights into the condition:
Scores 2 and 3 could indicate the presence of BXO phimosis, a more severe form of the phimosis .
Treatment for phimosis depends on factors such as age and the severity of the condition. Here are some available options:
1. Steroid Cream or Ointment: Application of steroid-based creams or ointments can help alleviate tightness and promote gradual retraction of the foreskin.
2. Stretching Exercises: In the early stages, gentle stretching exercises may aid in loosening the foreskin.
It's important to note that attempting to stretch a scarred foreskin could result in further tearing and scarring. Additionally, various phimosis creams might be utilised with limited success in certain cases.
For grades 4 and 5 phimosis, as well as cases involving complications like BXO, surgical solution become crucial. Some options include:
- Circumcision:This standard procedure involves removing the foreskin entirely. It's particularly recommended for adults with recurrent fungal infections, diabetes-related issues, or severe BXO phimosis.
- Alternative Surgical Procedures: Options like preputioplasty, frenuloplasty, and partial circumcision offer alternatives to full circumcision. These procedures can be discussed with urologists at specialized clinics.
It's important to remember that this information serves as a guide and not a substitute for professional medical advice. If you're experiencing symptoms of phimosis or related issues, consider consulting a medical specialist. Video consultations are available for personalized guidance.
Understanding the grading, appearance, and treatment options for phimosis is essential for managing this condition effectively. Whether through non-surgical approaches or surgical interventions, seeking timely medical advice and tailored solutions can lead to improved comfort and overall well-being.