Phimosis - also known as foreskin constriction - is a common disease of the penis. The foreskin cannot be pulled over the glans of the penis at all or only with pain. Typical symptoms and consequences of foreskin constriction are chronic inflammation of the tip of the penis and foreskin. In addition, difficulties urinating and pain during erection and sexual intercourse can occur.
Find more information and selected doctors for the treatment of phimosis here.
Phimosis is a common disease of the penis. It is usually congenital, but in rare cases can also develop in the course of life.
In this condition, there is a disproportion between the stretchable width of the foreskin and the diameter of the glans. The foreskin is too tight and cannot be pulled back over the glans of the penis at all or only with pain due to this disproportion.
Such pathological phimosis must be distinguished from the natural narrowing of the foreskin. This is perfectly normal in newborn boys and boys in infancy and toddlerhood.
Only if this congenital narrowing of the foreskin persists beyond the age of five is it a pathological phimosis.
Foreskin constriction can be divided into different forms, such as
Relative incomplete phimosis occurs when the foreskin cannot be pushed back only when the penis is erect. With complete phimosis, on the other hand, it is not possible to retract the foreskin even when the penis is flaccid.
Primary phimosis is congenital. A narrowing of the foreskin and adhesion of the foreskin and glans are very common in newborn boys and boys in infancy. Such physiological phimosis usually disappears on its own within the first two years of life.
If the foreskin cannot be retracted over the glans after the age of five, this is a primary phimosis.
Secondary phimosis is only acquired in the course of life.
This illustration shows different degrees of severity of phimosis © Bulgakova Kristina | AdobeStock
96 percent of all newborn boys are born with foreskin constriction.
By the age of seven, around 18 percent of all boys are affected by phimosis. In the age group of 16 to 18-year-old adolescents, the figure is only 1 percent.
Phimosis is caused by a congenital or acquired narrowing of the outer ring of foreskin.
Secondary phimosis is usually caused by recurring inflammation of the foreskin (posthitis) or inflammation of the glans (balanitis). They result in scarring and thus shrinkage of the foreskin.
Violent influences with
that heal with scarring can also cause acquired phimosis.
Other possible causes of acquired foreskin constriction are
Under certain circumstances, normal phimosis in the first years of life can also develop into secondary phimosis. If the parents try to pull back the foreskin of their young son by force. This can cause mucosal tears and scarring inflammation. As a result, a pathological phimosis can develop.
Those affected cannot pull their foreskin back over the glans completely or only with pain.
For this reason, their genital hygiene is severely restricted. As a result, the following accumulate under the foreskin
accumulate. These form whitish deposits, known as smegma. It can cause inflammation of the glans and foreskin. Chronic inflammation, which also increases the risk of penile cancer, is the result.
Under certain circumstances, the foreskin constriction may prevent urine from flowing freely. This can lead to discomfort during urination (micturition). This results in urinary disorders. These are usually manifested by a
This in turn can lead to inflammation in the genital area and repeated urinary tract infections.
Other possible symptoms include pain during erection and sexual intercourse. Sometimes sexual intercourse is only possible to a limited extent or not at all. During an erection, there may be a feeling of tension or tearing of the foreskin.
The diagnosis of foreskin constriction is usually made on the basis of a physical examination and a medical history interview.
During the physical examination, the treating doctor usually recognizes phimosis based on the typical symptoms. Phimosis can be clearly recognized by the fact that
During a medical history interview, the doctor will ask about other typical abnormalities and symptoms. Previous inflammation of the foreskin or glans is also relevant for the diagnosis.
To treat phimosis, the constricted foreskin is either widened or removed. This is possible either surgically, for example in the form of a circumcision, or conservatively with the help of cortisone ointments.
Conservative treatment is only possible in cases of mild foreskin constriction. Surgery is therefore necessary in most cases.
Conservative treatment of phimosis is carried out with cortisone ointments. These must be applied to the constricted foreskin twice a day for a period of four to eight weeks.
About two weeks after starting this conservative treatment, you can begin to carefully push the foreskin back as far as possible. In this way, the foreskin can gradually be stretched and widened. Tearing of the foreskin must be avoided at all costs.
In around 50 to 75 percent of cases, this type of conservative ointment treatment is successful.
If the phimosis cannot be successfully treated with conservative ointment treatment, surgery is necessary. The standard procedure is circumcision, i.e. the complete surgical removal of the foreskin.
Circumcision is performed under local anesthesia and usually only takes about 30 minutes. Careful wound treatment is required afterwards.
In addition to circumcision, other surgical methods are also available. If the phimosis is due to a shortening of the frenulum breve, a frenulotomy is an option. This involves cutting the frenulum.
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