Phimosis

CAUSES AND TREATMENT OF PHIMOSIS

STEROIDS, PREPUTIOPLASTY, FULL or PARTIAL CIRCUMCISION

What is Phimosis?

In this condition, 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 unable to pull back over the glans when the penis is erect.

Usually, the tight foreskin does not remain the same as with each erection; there is repeated minor trauma to the foreskin. This leads to loss of elasticity due to scarring. In adults, sexually transmitted infections (STIs) or other infections (balanitis) can be associated with Phimosis.

Skin conditions can also cause phimosis:

1. Lichen sclerosus or Balanitis Xerotica Obliterans (BXO) - scarring skin condition which may involve the foreskin and glans (head) of the penis caused by progressive tight foreskin
2. Lichen planus - a non-infectious skin condition which may affect the foreskin
3. Eczema- long-term skin problems with itchy, cracks and dry skin which is predisposing to BXO
4. Genital warts: When there are large or multiple warts on the foreskin, circumcision and biopsy are the best options.

Foreskin cleaning is essential to avoid infection. She gently washed the foreskin with mild soap or warm water with sea salt while bathing or showering.

How to cure Phimosis

Treatment of tight foreskin depends on the patient's age and the severity of Phimosis.

• A tight foreskin can be treated with a topical steroid cream like hydrocortisone or stretching exercises in the early stages. Studies showed that both steroids and stretching might improve the tight foreskin in the early stages.
• Phimosis stretching of a scarred foreskin may produce further tearing and scarring. There is no scientific evidence that stretching the scarring has a cure for diseased foreskin.
• Phimosis creams are sometimes used with limited success in adult tight freoskin.
• If tight foreskin symptoms become worse with time, BXO and diabetes should be excluded in adults.
• Some adults use a condom and lubricants during sexual activities in the presence of mild cases.

Sex with phimosis can be painful and require urgent treatment. Phimosis home treatment is possible without a diseased foreskin by daily washing, stretching exercises and clearing the smegma along with steroid creams. Tight foreskin gives balanitis, which requires treatment in the form of antibiotics. Incidence of Circumcision is more in patients with BXO and diabestes in older adults.  

Fungal infection causing mild phimosis is treated with antifungal drugs, and early BXO is treated with steroid cream. In adults with diabetes with a tight foreskin, circumcision is the preferred treatment due to recurrent fungal and bacterial infections.

There are alternatives to full circumcision, such as topical steroid cream, the "pull and burn" method for the frenulum, frenulum excision, V-Y preputioplasty, frenuloplasty, partial circumcision or other medical treatments. These are personal preferences and foreskin conditions and can be discussed further with our specialist- Dr Khan, or Consultant Urologists at a dedicated adult circumcision clinic in London, UK.

When surgery may be needed

A tight foreskin can be stuck behind the head of the penis (glans) due to the presence of a phimotic ring. This is called paraphimosis, which requires urgent treatment.

Phimosis cure in adulthood can be done with steroids, preputioplasty and circumcision. Phimosis surgery can retain the foreskin by preputioplasty.

Circumcision remains the standard surgical option for tight foreskin, especially BXO phimosis. We take all patients with tight foreskin from the UK and abroad.

Where can circumcision be done?

We have two clinics where procedures can be done : 

PS: This information is for guidance only and does not replace professional medical advice. Please call Dr Khan for free telephone advice at +447527314081 without any obligation.

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