Phimosis means that it is difficult to pull back the foreskin from the tip of your penis. As a tight ring or “rubber band” of the foreskin around the tip of the penis, which prevents full retraction. A tight foreskin is prevalent in infant boys who are not circumcised, although it normally resolves by the age of three. Young boys may not require phimosis treatment unless they have difficulty urinating or have other symptoms.
Phimosis becomes an issue when it creates symptoms such as a pinhole-sized opening or the inability to draw back your foreskin sufficiently to clean the region beneath. As these boys develop, their requirement for treatment may rise.
Phimosis and paraphimosis are two conditions that affect the foreskin. However, paraphimosis is a medical emergency that must be treated immediately. Phimosis is not an emergency.
Physiological- Which is connected in young age.
Pathological- which developed in adulthood due to unhygienic condition and skin infection. This can be treated with application of steroids ointment.
The last resort of correction is advising the man to get circumcision.
Phimosis has both physiological and pathological manifestations.
Physiologic Phimosis
● Physiological phimosis. Physiologic phimosis is more common in young children. It normally resolves as they become older.
● Common in children between 2 and 4 years of age is a self-limiting condition that disappears as the foreskin becomes more retractile.
Pathologic Phimosis
● Pathologic phimosis is caused by infection, inflammation, or scarring which developed in adulthood due to unhygienic condition and skin infection. Lichen sclerosis is a prevalent cause.
● Balanitis xerotica obliterans (BXO) is a cicatrising skin disorder that has histological characteristics with lichen sclerosis. BXO has an insidious start and may be linked with discomfort, local infection, dysuria, and bleeding, which can lead to atrophy and meatal stenosis.
● The most prevalent causes of pathologic phimosis in children are infection, which includes sexually transmitted infections (STIs) and scarring.
● Other causes include skin disorders such as eczema, psoriasis, lichen planus, and lichen sclerosis.
● Penile adhesions, also known as scar tissue, are what keep the foreskin attached to the tip of your penis.
● Injuries.
The major sign of phimosis is the inability to draw the foreskin back from the head of the penis. However, other phimosis symptoms may include:
● Discolouration (red, purple, dark brown, or black) may develop due to irritation or illness
● Swelling can occur as a result of irritation or an illness
● Pain or soreness
● Dysuria (pain during urination)
● Weak pee stream
● Blood in your urine (hematuria)
● Smegma (fluid, sweat, and skin cells accumulate around genitals)
● Pain when getting an erection or having sexual intercourse
Treatments for phimosis differ based on the kid and the severity of the condition. Treatment options include mild daily manual retraction, topical corticosteroid ointment administration, or circumcision.
A healthcare physician can diagnose phimosis after analysing your symptoms and doing a physical examination. They might recommend tests to see if you are infected. Tests can include:
● Urine analysis
● Urinary discharge culture.
Physiologic phimosis seldom requires treatment. In most circumstances, young children will eventually outgrow it. The primary treatment option for pathologic phimosis is commonly a topical corticosteroid cream or gel. This cream helps stretch the foreskin. They will also prescribe medications if you have an infection in your foreskin or glans. If a corticosteroid cream is ineffective, you may require phimosis surgery. This typically involves a circumcision. During a circumcision, the foreskin is removed to expose the glans fully. Circumcision is the treatment for pathological phimosis, and it is the only definitive reason for the surgery in kids.
Preputioplasty is an alternative surgical method to circumcision that preserves the foreskin. Initially, postoperative looks resemble a dorsal slit surgery, but with consistent foreskin retraction following the treatment, this transforms into a normal retractile prepuce (foreskin).
It's crucial to remember that phimosis affects practically all newborns; most children outgrow it, and there's often no cause to treat it. It can be induced by infections, scar tissue, and skin diseases; treatment usually involves the use of a potent steroid cream or surgery. Keep their genital area clean and dry all the time, and teach them from a young age while they are bathing themselves how to take care of that part.
A healthcare physician can diagnose phimosis after analysing your symptoms and performing a physical examination. They might recommend urine analysis and culture to determine whether you are infected.
Phimosis surgery is a simple treatment often performed under local or general anesthesia and is generally not considered painful.
Phimosis, or tight foreskin, in adults, can be treated with several treatments, including steroid creams, stretching, antibiotics, and surgery.
