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What is Phimosis and how is it treated?

Phimosis is a common condition in males in which the foreskin of the penis is too tight, making it difficult or impossible to retract the foreskin. This condition can cause discomfort, pain, and difficulty maintaining proper hygiene. While it is common in infants and young children, it can also occur in adult men.

What are the causes of Phimosis?

  1. Balanitis

Balanitis is a condition where the head of the penis becomes inflamed and swollen. It can be caused by a bacterial or fungal infection, poor hygiene, or an allergic reaction. Balanitis can lead to scarring, which can cause the foreskin to become tight and difficult to retract.

  • Scarring

Scarring of the foreskin can be caused by injury, infection, or inflammation. Scarring can cause the foreskin to become less flexible and difficult to retract, leading to phimosis.

  • Congenital Phimosis

Some infants are born with a tight foreskin that cannot be retracted. This is known as congenital phimosis and usually resolves on its own as the child grows older. However, in some cases, it can persist into adulthood and cause problems.

  • Poor Hygiene

Poor hygiene can cause a buildup of smegma, a substance made up of dead skin cells and oils, under the foreskin. This buildup can lead to inflammation and infection, which can cause the foreskin to become tight and difficult to retract.

  • Medical Conditions

Certain medical conditions, such as diabetes, can increase the risk of developing phimosis. Diabetes can lead to a buildup of sugar in the urine, which can cause infections and inflammation in the foreskin.

What are the symptoms of Phimosis?

The symptoms of phimosis may vary from person to person. Some common symptoms include:

Difficulty Urinating 

Phimosis can cause difficulty urinating, especially if the opening of the foreskin is very narrow. This can lead to a weak stream, incomplete emptying of the bladder, and a frequent need to urinate.

Pain During Intercourse 

Phimosis can cause pain during intercourse, as the foreskin can become trapped behind the head of the penis, causing discomfort and pain. This can lead to a decreased desire for sex and affect a man’s quality of life.

Redness and Swelling 

Phimosis can cause redness and swelling of the penis as the foreskin becomes trapped and unable to retract fully. This can lead to irritation and discomfort, and in some cases, infection.


In some cases, phimosis can cause a discharge from the penis. This is usually a sign of infection and requires immediate medical attention.

Pain and Discomfort 

Phimosis can cause pain and discomfort in the penis, especially during erections. This can affect a man’s ability to engage in sexual activity and can cause anxiety and stress.

How is Phimosis diagnosed?

A doctor can diagnose phimosis by physically examining the penis. The doctor may also recommend additional tests, such as a urine test or swabs, to rule out any underlying infections.

How is Phimosis treated?

The treatment for phimosis may depend on the severity of the condition. In some cases, the condition may resolve on its own without any treatment. However, if the phimosis is causing discomfort or difficulty retracting the foreskin, the doctor may recommend one of the following treatments:

Topical Steroids 

Topical steroids are a common treatment for phimosis. Steroid creams can be applied to the foreskin to reduce inflammation and soften the skin, making it easier to retract the foreskin. Topical steroids can take several weeks to work, and the foreskin may need to be gently stretched to achieve the desired results.


Circumcision is a surgical procedure where the foreskin is removed. It is a permanent solution to phimosis and can be an effective treatment option for severe cases. The procedure is typically performed under local anaesthesia and can take several weeks to heal.


Preputioplasty is a surgical procedure that involves making a small incision in the foreskin and then stitching it back together. This procedure can help to loosen the foreskin and make it easier to retract. It is a less invasive alternative to circumcision and can be an effective treatment option for milder cases of phimosis.

Stretching Exercises 

Stretching exercises can help to loosen the foreskin and make it easier to retract. The exercises involve gently stretching the foreskin over the head of the penis and holding it in place for several minutes. This should be done several times a day for several weeks to achieve the desired results.


In cases where phimosis is caused by an infection, antibiotics may be prescribed to help clear the infection. Antibiotics can be taken orally or applied topically and can help to reduce inflammation and discomfort.

Preventing a Phimosis

Preventive measures for phimosis include maintaining good hygiene by cleaning the penis regularly. Parents should also teach their children how to properly clean the penis during bath time. It is also essential to treat any infections or inflammation promptly.


Phimosis is a common condition that can cause discomfort and difficulty retracting the foreskin. It is essential to seek medical attention if you experience any symptoms. With proper diagnosis and treatment, phimosis can be effectively managed, and complications can be avoided. 

Author: Mr Neil A Haldar MBBS MD FRCS

Consultant Urological Surgeon

The Pelvic Specialists

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