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Phimosis

A condition in which the foreskin cannot be retracted to reveal the glans penis. It is due to tightness or narrowing of the foreskin opening.

PubMed Health Glossary
(Source: NIH - National Library of Medicine)

About Phimosis

Many parents feel concerned if their newborn or young boy's foreskin cannot be pulled back. They may think his foreskin is too tight and that he might need an operation. But it is a little known fact that about 9 out of 10 boys' foreskins are tight or stuck to the head of their penis when they are born.

This is known as phimosis, and it is completely normal. It protects the sensitive head of the penis from rubbing against things, becoming too dry and coming into contact with germs like viruses or bacteria.

Within the first three years of life, the stuck skin (adhesion) usually detaches, and tight foreskin usually loosens enough to be able to pull it back without any problems or pain. Treatment is only needed if the foreskin still can't be pulled back in older boys or adult men.

Symptoms

If someone has phimosis, it is not possible to pull (retract) their foreskin back over the head of their penis, or doing so hurts. In teenagers and adults, having a non-retractable foreskin can cause pain during an erection or sex. It might also occasionally lead to a balloon-like swelling under the foreskin if the opening is so small that urine cannot flow out properly.

It is difficult for teenagers and adults with phimosis to clean the head of their penis and the area under their foreskin. This makes bacterial or fungal infections on the glans or foreskin more likely...

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What works? Research summarized

Evidence reviews

Topical corticosteroids for treating phimosis in boys

Phimosis is a condition where the foreskin cannot be fully drawn back (retracted) over the penis. Phimosis is normal at birth and often self‐corrects without needing treatment during the first three to four years of life; only 10% of three year old boys have phimosis. This is known as congenital phimosis. Phimosis can also be caused by scarring of the skin protecting the head of the penis that is caused when the foreskin cannot be retracted. Phimosis caused by scarring is estimated to occur among 0.6% to 1.5% of boys less than 18 years of age, but this type of phimosis seldom occurs among boys under five years of age. Making a distinction between types of phimosis can sometimes be difficult.

Assessment of topical steroid treatment for childhood phimosis: review of the literature

OBJECTIVES: Questions concerning nonretractile foreskin are frequently asked by parents in infant consultations. Topical steroid treatment could be a less expensive and less traumatizing alternative to surgery.

Shang Ring circumcision versus conventional circumcision for redundant prepuce or phimosis: a meta analysis

OBJECTIVE: To compare the effect and safety of Shang Ring circumcision with those of conventional circumcision in the treatment of redundant prepuce or phimosis.

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Summaries for consumers

Topical corticosteroids for treating phimosis in boys

Phimosis is a condition where the foreskin cannot be fully drawn back (retracted) over the penis. Phimosis is normal at birth and often self‐corrects without needing treatment during the first three to four years of life; only 10% of three year old boys have phimosis. This is known as congenital phimosis. Phimosis can also be caused by scarring of the skin protecting the head of the penis that is caused when the foreskin cannot be retracted. Phimosis caused by scarring is estimated to occur among 0.6% to 1.5% of boys less than 18 years of age, but this type of phimosis seldom occurs among boys under five years of age. Making a distinction between types of phimosis can sometimes be difficult.

Phimosis: Overview

Almost all boys are born with "natural" phimosis. During the first few months, it protects the sensitive head of the penis from rubbing against things, becoming too dry and coming into contact with germs like viruses or bacteria. Treatment is only needed if the foreskin still can’t be pulled back in older boys or adult men.

What are the treatment options for phimosis?

Most boys no longer have problems pulling their foreskin back (phimosis) by the time they reach the age of three. If this is still an issue in older boys or adult men, it may have to be treated. Using a special cream is often enough. Surgery is only rarely needed. If parents notice that their son’s foreskin cannot be pulled back, there is no need for them to worry. It is normal for the foreskin of baby boys and toddlers to be tight or stuck to the head of their penis (glans): About 96% of all boys are born with this kind of natural “physiological” phimosis. It protects the glans beneath the foreskin and the urethra (urine tube) from things like germs. Areas of stuck skin (adhesions) usually detach and tight foreskins usually loosen on their own within the first few years of life. Only about 10 out of 100 three-year-old boys still have phimosis, and by the age of seven only about 7 out of 100 boys are still affected. So it is best to wait a while before seeking medical advice. But you should see a doctor if the child is in pain, his foreskin is inflamed, swells like a balloon when urinating, or if urine cannot flow out properly.

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Terms to know

Foreskin
The loose skin that covers the head of the penis.
Glans Penis
The rounded, gland-like head of the penis.
Paraphimosis
A condition in which the foreskin, once retracted, cannot return to its original position. If this condition persists, it can lead to painful constriction of glans penis, swelling, and impaired blood flow to the penis.
Penis
An external male reproductive organ. It contains a tube called the urethra, which carries semen and urine to the outside of the body.
Retract
To pull back.

More about Phimosis

Photo of a baby

Other terms to know: See all 5
Foreskin, Glans Penis, Paraphimosis

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