Phimosis

Phimosis

Article
Kids' Zone
Men's Health
+4
Contributed byMaulik P. Purohit MD MPHDec 20, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Preputial Stenosis
  • Pathologic Phimosis
  • Physiologic Phimosis in Children

What is Phimosis? (Definition/Background Information)

  • Phimosis may be defined as the inability to retract the foreskin (prepuce), which covers the glans penis (or penis head)
  • There are 2 types of Phimosis and these include:
    • Physiologic Phimosis: This condition is completely normal in an uncircumcised boy less than 10 years old. Approximately around or after 10 years of age, the child may be able to retract the foreskin of the penis. Nevertheless, this condition can cause considerable stress and anxiety in parents
    • Pathologic Phimosis: It is a common condition that may affect males of any age. Pathologic Phimosis occurs due to abnormal causes such as infections, scarring, or other malignant conditions
  • Phimosis (in adults and children) may require treatment if it causes significant signs and symptoms, such as urination difficulties, frequent infections, or ballooning of the foreskin during urination
  • Phimosis may be diagnosed through physical examination, medical history evaluation, and tests to rule out underlying conditions
  • The prognosis of Physiologic Phimosis in Children is generally excellent; the prognosis of Pathologic Phimosis is good with suitable treatment, but also depends upon the underlying cause

Who gets Phimosis? (Age and Sex Distribution)

  • Phimosis is a common condition that affects both boys and men (all age groups); however, it is normal in boys less than 10
  • The condition can occur worldwide and no geographical preference is seen. Males of all racial and ethnic background may be affected

What are the Risk Factors for Phimosis? (Predisposing Factors)

The risk factors for Phimosis may include the following:

  • Physiologic Phimosis is a normal occurrence in children, but it may also occur due to congenital defects, infections, or cancers
  • Pathologic Phimosis in teens and adults may be influenced by a variety of factors such as:
    • Chronic bacterial infections
    • Lichen planus and lichen sclerosis
    • Scarring due to skin conditions or surgery         
    • Malignant tumors (invasive or in situ squamous cell carcinomas)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Phimosis? (Etiology)

  • Pathologic Phimosis may be caused by a set of several factors affecting the penis that includes skin conditions, infections, cancers, and scarring of the skin
  • Physiologic Phimosis is benign condition that may be normally observed in boys younger than 10 years

What are the Signs and Symptoms of Phimosis?

Physiologic Phimosis may not present any signs and symptoms in most cases. The signs and symptoms of Pathologic Phimosis may include:

  • The foreskin is too tight to be retracted backwards to expose the glans penis
  • Difficulty in urinating
  • Frequent or recurrent infections
  • During urination, the prepuce may balloon up

How is Phimosis Diagnosed?

The following are the diagnostic methods that may be helpful for Phimosis:

  • A thorough physical examination and a complete medical history is very important
  • Blood tests and urine tests
  • Tests and examinations as required for underlying conditions or infections

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Phimosis?

The complications due to Phimosis may include:

  • Individuals may have severe stress and anxiety issues
  • Forcible retraction of the skin can cause bleeding, pain, and scarring of the tissue, which makes the condition worse
  • Discomfort and pain during sex
  • Serious complications can lead to a condition called paraphimosis, which is the fixed retraction of the penile foreskin. This can potentially be a medical emergency

How is Phimosis Treated?

In a majority of cases, no treatment may be required for Physiologic Phimosis, if the condition is asymptomatic. The condition resolves automatically on its own, when the child reaches the age of 10 years. The treatment course of action may include observation and support.

However, in case of Pathologic Phimosis with significant signs and symptoms, the following treatment measures may be considered:

  • Treatment of the underlying condition that caused Phimosis
  • Application of topical steroids
  • Circumcision
  • Prepucioplasty surgical procedure: It is the partial removal of the prepuce, which makes it easier for the prepuce to retract over the glans penis
  • Providing reassurance and helping with anxiety feelings, since the condition is harmless and has an excellent outcome
  • Some individuals may consult healthcare professionals to rule out a sexually-transmitted infection

How can Phimosis be Prevented?

Currently, there are no specific methods or guidelines to prevent Phimosis. However, the following factors may be considered:

  • Early medical care and treatment of any infection, condition (especially those that affect the penis), or penile lesions
  • The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse
  • Avoid forcible retraction of the foreskin; for this may cause additional complications

What is the Prognosis of Phimosis? (Outcomes/Resolutions)

  • Physiologic Phimosis is a condition that may not require any treatment. The condition may have to be monitored and follow-up maintained. Nevertheless, it has an excellent prognosis with or without appropriate treatment (as the case may be)
  • Pathologic Phimosis usually requires treatment and the prognosis is good, if the underlying conditions may also be successfully treated. The prognosis may be guarded if Phimosis occurs due to squamous cell carcinoma

Additional and Relevant Useful Information for Phimosis:

  • Circumcision is the surgical removal of skin around the tip of the penis, which is also known as the foreskin or prepuce

The following article link will help you understand circumcision:

http://www.dovemed.com/common-procedures/procedures-surgical/circumcision/

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On the Article

Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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