Phimosis, or preputial stenosis, refers to any condition where the foreskin of the penis cannot be retracted. Most infants are born with a foreskin that cannot be retracted and the prepuce may be tight until after puberty.
Causes
Phimosis can be caused by the failure of foreskin to loosen during growth, infections such as balanitis, deformities caused by trauma, and diseases of the genitals.
Symptoms
Phimosis is usually a painless condition. Infection may result from an inability to carry out effective cleaning of the area, in which case swelling, redness, and discharge may all be present, making the area tender and painful. A very tight foreskin can cause problems during intercourse and urination.
Treatment
Medical opinion differs on the condition and on the treatment of phimosis. It has been suggested that any radical or surgical treatments for phimosis should not be done until after puberty. This is partly due to a perception of the overuse of circumcision as a mainstream treatment for phimosis. It has also been reported that significant numbers of doctors are unable to recognize developmentally normal tight prepuce from pathological phimosis. It is believed that many unnecessary circumcisions are performed because of current medical practice and misdiagnosis of phimosis.
Balanitis xeroticia obliterans has been cited as one of the only causes of phimosis that should lead to a surgical circumcision.
If treatment is required there are three main types:
- Tropical creams, steroidal and non-steroidal, applied to the prepuce.
- Gradual stretching of the opening of the prepuce to widen it.
- Surgical reshaping of the prepuce to make it wider.
All these treatments tend to avoid the side effects associated with surgical circumcision, trauma, pain, side effects of the removal of the foreskin such as friction and interference of the erogenous and sexual functions
