Phimosis is a Greek word to describe a condition where a person’s foreskin is too tight to be pulled back behind penile glans. This is mainly because the foreskin failed to stretch beyond the size of the penile gland. It can be presented as early as childhood. Children who had phimosis commonly present with ballooning of the foreskin when passing out urine. Adults typically come with painful erection as the skin is stretched and some may even tear the foreskin.
How did it happen?
Recurrent infection to the foreskin is one of the common causes of phimosis in adults. The infection leads to inflammation of the foreskin which results in scarring as well as thickening of part of the foreskin and will lose its elasticity. Other causes of phimosis include structural, i.e. The tip of the foreskin is too narrow to pass over the glans of penis or the foreskin adheres to the glans and skin condition which alter the elasticity of the foreskin.
The severity of the condition is graded into 5
Score 1: full retraction of foreskin, tight behind the glans.
Score 2: partial exposure of glans
Score 3: partial retraction, urinary opening just visible.
Score 4: only slight retraction, glans and urinary opening not visualised
Score 5: absolutely no retraction of the foreskin
What happens if we do not treat it?
Phimosis can also lead to recurrent infection of the penile glans which makes the phimosis worse and this vicious cycle may eventually develop even more severe complications such as Paraphimosis. It is a condition where the skin is retracted behind the glans and becomes painfully swollen and thus fails to reduce back the foreskin. This may compromise the blood flow towards the penile gland and need emergency treatment.
How to treat it?
Regardless of the severity, we recommend patients undergo circumcision for the best outcome. There are many ways to do circumcision, from the most conventional method using scissors and sutures to the more advanced method of using devices such as rings, clamps and staplers. You will have to talk to your doctor about which method is suitable for you. We prefer stapler circumcision as it is fast, good aesthetic outcome and fast recovery.
In adult patients, you will also benefit by reducing the risk of getting STDs as well as other usual urinary tract infections. This is because we eliminate the moist environment in between the foreskin and glans of penis which may favor bacterial viral growth. You will still have similar sexual satisfaction of slightly minimal changes after circumcision.