Refers to a condition in which the foreskin of the penis cannot be pulled back past the glans.
It result in pain during an erection, but is otherwise not painful.
Associated with greater risk of inflammation of the glans, known as balanitis
With urination, a balloon-like swelling under the foreskin may occur.
Normally present at birth, and tyically resolves by 3 years of age.
In young children, it is normal to not be able to pull back the foreskin.
In more than 90% of cases, this inability resolves by the age of seven, and in 99% of cases by age 16.
The foreskin is usually non-retractable in early childhood, and some males may reach the age of 18 before their foreskin can be fully retracted.
Occasionally, it may be caused by scarring due to balanitis
A potential complication of phimosis is paraphimosis, where the tight foreskin becomes trapped behind the glans.
Phimosis is over-diagnosed due to failure to distinguish between normal developmental non-retractability and a pathological condition.
Pathological phimosis may arise from balanitis, and Lichen sclerosus et atrophicus.
May occur after other types of chronic inflammation, repeated catheterization, or forcible foreskin retraction.
May also arise in untreated diabetics due to the presence of glucose in their urine giving rise to infection in the foreskin.
Can vary in severity, with some able to retract their foreskin partially, while others are completely unable to retract their foreskin.
Topical steroid creams are effective treatment phimosis and is an alternative to circumcision.
Steroids may work by reducing inflammation decrease immune responses, and also by thinning the skin.
Stretching of the foreskin can be accomplished manually.
Surgical remedies range from the complete removal of the foreskin to more minor operations to relieve foreskin tightness.
A dorsal slit is a single incision along the upper length of the foreskin from the tip to the corona, exposing the glans without removing any tissue.
Ventral slit, an incision along the lower length of the foreskin from the tip of the frenulum to the base of the glans, removing the frenulum in the process.
Preputioplasty, refers to a limited dorsal slit with transverse closure is made along the constricting band of skin, and is an effective alternative to circumcision.
Circumcision is sometimes performed for phimosis, and is an effective treatment
Circumcision prevents phimosis.
The most acute complication of phimosis is paraphimosis, when the glans is swollen and painful, and the foreskin is immobilized by the swelling in a partially retracted position.
Some studies suggest phimosis to be a risk factor for urinary retention and carcinoma of the penis.
The incidence for pathological phimosis is 1% of uncircumcised males.
When phimosis definition is nonretractility of the foreskin after age 3 years, considerably higher incidence rates have been reported.
A non-retractile prepuce in adolescence is normal, common, and usually resolves with increasing maturity.