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Although it is in generally regarded as a common condition, not too many people have heard about phimosis. What exactly is this condition?
Phimosis is defined as the inability of the prepuce, also called the foreskin, to be retracted behind the glans. Of course, we are talking about uncircumcised males.
What is also interesting, a great majority of all males are born with congenital phimosis, but this represents a benign condition that does not need any treatment and resolves on its own in the majority of infants in their early childhood. Phimosis in infants is termed pathologic when nonretractability is associated with local or urinary complaints attributed to the phimotic prepuce. It is also extremely important to point out that the phimosis in most infants is physiological rather than pathological, whereas phimosis in older children and adults is more often pathological than physiological.[1] Although it is mostly a condition that affects the males, women can also suffer from a similar condition called clitoral phimosis
As already mentioned phimosis in male babies is completely normal — in this case, phimosis protects the sensitive head of the penis from rubbing against things, becoming too dry and coming into contact with germs like viruses or bacteria. 90% of male babies are born with their foreskins tight or stuck to the head of their penis. This normal condition resolves within the first three years of their life. However, phimosis demands treatment when the foreskin can’t be pulled back in older boys or adult men.[2]
  • About one-half of one-year-old boys are affected by phimosis.
  • About one in 10 three-year-old boys still have phimosis.
  • And by the age of 16, only 1 out of 100 teenage boys are still affected.

The most common symptoms of phimosis are [2]:

  • inability to retract a foreskin
  • straining during urination
  • a thin stream of urine
  • recurrent urinary infections
Uncomplicated pathologic phimosis is usually responsive to conservative medical treatment, but patients should know that every failure of medical treatment leaves only surgical intervention as the alternative, usually in the traditional form of a circumcision, or preputioplasty, where a narrow non-retractile foreskin is widened.[2] 

Relevant anatomy

The foreskin or prepuce is an integral part of the penis. It normally forms an anatomical covering over the glans. It is interesting that the sensory receptors of the ridged band of the preputial mucosa may form part of the afferent limb of the ejaculatory reflex, and that’s why it is important that all of these structures remain fully functional. As said earlier, development of the prepuce is incomplete in the newborn male child. Separation from the glans, and consequently foreskin retractability, usually occurs by the age of three or by the teenage years.

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