Phimosis occurs when the foreskin is tight and cannot be pulled back to expose the head of the penis (glans). Sometimes, it is retractable when the penis is flaccid but cannot retract when the penis is erect. Repeated minor trauma or infection, mainly due to diabetes, can lead to a loss of elastic fibres in the foreskin due to scarring. This may result in Balanitis Xerotica Obliterans (BXO). A tight foreskin can become stuck behind the head of the penis, leading to paraphimosis.
1. Balanitis Xerotica Obliterans (BXO), also called Lichen sclerosus (Read more about BXO)
2. Lichen planus - a non-infectious skin condition which may affect the foreskin
3. Eczema- long-term skin problems
Cleaning the inside of the foreskin is essential for preventing infection. It is advisable to wash the foreskin with mild soap or warm salty water during your shower or bath. This will help keep the foreskin clean.
Phimosis is categorised into six distinct grades, each indicating the degree of tightness and retraction capability of the foreskin:
Notably, grades 4 and 5 often necessitate surgical intervention for effective resolution.
The appearance of the phimosis provides further insights into the condition:
Scores 2 and 3 could indicate the presence of BXO phimosis, a more severe form of phimosis.
Treatment for phimosis depends on factors such as age and the severity of the condition. Here are some available options:
1. Steroid Cream or Ointment: Applying steroid-based creams or ointments can help alleviate tightness and promote gradual foreskin retraction.
2. Stretching Exercises: In the early stages, gentle stretching exercises may aid in loosening the foreskin.
It's important to note that attempting to stretch a scarred foreskin could result in further tearing and scarring. Additionally, various phimosis creams might be utilised with limited success.
For grades 4 and 5 phimosis, as well as cases involving complications like BXO, surgical solutions become crucial. Some options include:
- Circumcision: This standard procedure involves removing the foreskin entirely. It's particularly recommended for adults with recurrent fungal infections, diabetes-related issues, or severe BXO phimosis. There are different methods of circumcision
- Alternative Surgical Procedures: Options like preputioplasty, frenuloplasty, and partial circumcision offer alternatives to full circumcision. These procedures can be discussed with urologists at specialized clinics.
It's important to remember that this information is a guide and not a substitute for professional medical advice. If you're experiencing any problem , consider consulting a medical specialist. Video consultations are available for personalized guidance.
Understanding phimosis is crucial for effectively managing this condition. Whether through non-surgical methods or surgical interventions, seeking our urologist's opinion and personalised solutions can solve the problem.