Phimosis (tight foreskin)

Phimosis is a condition where the foreskin is tight and cannot be pulled back to expose the head of the penis.

Image from SM 1000/Adobe Stock

Causes

Physiological (natural)  – It is normal for a baby to have a tight foreskin; most of the time the foreskin naturally separates from the head of the penis as the child grows up. In some men,  the foreskin fails to separate from the head of the penis and remains tight.

Pathological (disease) – A tight foreskin may be the result of scarring from foreskin infection (balanoposthitis) or less commonly, a severe inflammatory condition called BXO (balanitis xerotica obliterans).

Consequences of phimosis

A tight foreskin may not cause any problem, on the other hand it can cause discomfort and tearing of the skin, especially during erection or sexual intercourse.

Paraphimosis

Rarely, a tight foreskin may become stuck behind the head of the penis, if the foreskin is forcefully pulled back. This is a condition called paraphimosis, and it is an emergency situation which requires immediate release of the tight foreskin, and a circumcision later on.

Treatment for phimosis

Circumcision – The most effective treatment for phimosis is circumcision. This can be performed as a day surgery procedure.

Steroid cream – application of steroid cream to the foreskin, and daily gentle retraction of the foreskin may help the foreskin to open up. In our experience with adults, this method is not as effective as surgery.