An explanation of Phimosis and treatment options

Phimosis

Phimosis is a condition in which the foreskin is too tight to pull all the way back.

Phimosis is normal in all baby boys and may be present for some years, until the foreskin has become supple enough and stretched enough to be pulled back, so that the head of the penis may be seen completely.

When is phimosis a concern?

In some cases, there may be scarring of the foreskin which may result in a permanent phimosis. The scarring may be caused by infection or inflammation of the foreskin, or forced stretching of the foreskin causing splitting, before it is ready to be stretched. Approximately 10% of boys develop scarring with phimosis.

When should the foreskin be able to retract?

Most boys are able to fully retract their own foreskins by 5 years of age. Some boys take longer than 5 years but if there is no evidence of significant scarring, then there should be no harm in waiting a few more years before becoming concerned.

Who needs a circumcision?

Boys who have either tight, normal phimosis or scarring with phimosis are unable to pull their foreskins back completely, and as a result of this there may be ballooning of the foreskin when it fills with urine. Those boys who have particularly tight foreskins, may experience pain when they have erections.

If there is a possibility of scarring causing the phimosis, the boy needs to be seen by a Paediatric Surgeon. If the Paediatric Surgeon believes that the phimosis will not resolve of its own accord, then circumcision will be recommended.

Are there any dangers?

Phimosis with scarring if left untreated, can result in further infections of the foreskin and even urinary infections. Once circumcision has been performed, there are not usually any ongoing problems.

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