Phimosis is a condition in which the foreskin of the penis is abnormally tight or the tip of the foreskin has narrowed, which prevents it from retracting. Phimosis can cause severe pain during erections or sexual intercourse, sometimes leading to minor bleeding and infection. It can also contribute to a higher risk of infections such as balanitis, because washing under the foreskin is difficult. Phimosis is more common in children and young adults, usually before puberty, but can also affect adults with penises. Phimosis is the most common reason for circumcision after infancy.
Signs and symptoms
Symptoms can include:
- Inability to retract foreskin either partially or wholly
- Pain around foreskin associated with erections or sexual activity
- Pain when urinating
- Urinary tract infections
- Skin infection of the penis
Causes of Phimosis
Phimosis can occur naturally or develop after an infection or inflammation. Phimosis can also happen after an injury that causes the foreskin to tear. This is called secondary or acquired phimosis. As the tear heals, scar tissue can make it more difficult for the foreskin to stretch.
Treatment is with steroid creams, applied once or twice daily for a couple of weeks. A doctor may suggest stretching the foreskin by retracting it regularly, such as when showering and urinating. The stretching process may take a few weeks. If the foreskin remains tight, circumcision may be required. For people who are unable or unwilling to undergo circumcision, it may be possible to keep the foreskin but surgically widen it. The cut made along the topside of the foreskin is called a ‘dorsal slit’.