Phimosis treatment

Phimosis is a narrowing of the foreskin that makes it difficult to retract and expose the head of the penis. In childhood, this condition is natural and occurs in most boys, but if it persists beyond adolescence, medical correction is necessary. Treatment includes both conservative and surgical methods.

There are several types of phimosis:

• Physiological – the foreskin is narrowed but the skin remains elastic (mostly seen in children and usually resolves with age);

• Atrophic – the skin becomes thinned, leading to frequent tears;

• Cicatricial – the skin becomes scarred and hardened (usually a complication of inflammatory diseases);

• Hypertrophic – excessive foreskin tissue prevents the head from being exposed.

In children, all types of phimosis except cicatricial can be treated conservatively and do not require surgical intervention.

Phimosis can present with varying severity and cause discomfort and pain during urination and erection.

There are 4 degrees of phimosis:

1. First degree – the glans is easily exposed when flaccid, but discomfort occurs during erection;

2. Second degree – retraction causes discomfort when flaccid and pain during erection;

3. Third degree – the glans cannot be retracted at all;

4. Fourth degree – the foreskin is swollen and inflamed, with urination difficulties.

The main symptom of phimosis is the inability to retract the foreskin and expose the head of the penis. In the early stages, this occurs only during erection, but in the third and fourth stages, it happens even when flaccid. Discomfort and pain may also be present.

In cases of complications, the foreskin often becomes swollen and inflamed, leading to problems with urination.

Phimosis of the first and second degree typically does not interfere with urination or reproductive function. Third and fourth-degree phimosis are considered severe and require treatment based on medical indications.

Main complications include:

• Urination issues (retention, intermittent stream);

• Pain during sexual intercourse;

• Inflammation of the urethra, bladder, and kidneys;

• Balanitis and balanoposthitis;

• Paraphimosis – constriction of the glans by the retracted foreskin, leading to impaired blood flow and risk of necrosis (requires emergency medical attention);

• Adhesions between the glans and the foreskin.

Diagnosis and treatment of all male urogenital disorders are carried out by urologists and andrologists. During the consultation, the specialist will listen to complaints and perform an external examination. In most cases, this is sufficient for diagnosing phimosis. If other symptoms are present, such as itching, unusual discharge, etc., laboratory tests may be required.

Depending on the type and severity of foreskin narrowing, the patient may be prescribed:

• Medication therapy;

• Physiotherapy;

• Surgical correction.

Today, doctors prioritize conservative treatments and recommend surgery only in cases of significant narrowing or when complications develop.

Medication therapy includes the use of creams and ointments that soften the skin and improve its elasticity. After application, the foreskin is gently stretched. This procedure should only be done under a doctor’s supervision using their recommended technique. The therapy progresses gradually to prevent injury and tearing. On average, several months are required.

In adults, phimosis is usually treated surgically. The operation involves circumcision (removal of the foreskin). The extent of tissue removal is determined individually based on the degree of narrowing.

The operation is minimally invasive and typically performed on an outpatient basis, meaning the patient can leave the clinic a few hours later. Local anesthesia is used, but sedation (medicated sleep) may be recommended for children.

Before surgery, the patient may undergo tests and examinations to rule out contraindications and reduce the risk of complications.

After surgery, patients are advised to abstain from sexual activity, avoid saunas and pools, refrain from intense physical activity, and follow all other medical recommendations.

Phimosis is common in young boys and is usually a physiological feature that resolves by puberty. However, children should be regularly examined by a urologist and follow all medical advice.

To prevent pathological phimosis and complications, it is recommended to:

• Maintain good intimate hygiene;

• Have a urological exam at least once a year;

• Follow all medical instructions;

• Treat urogenital diseases in a timely manner.

At Oxford Medical, you can receive a consultation with a highly qualified urologist-andrologist with many years of experience. The specialist will carry out diagnostics and select the necessary treatment. The clinic also offers lab tests, instrumental examinations, physiotherapy procedures, and, if needed, surgical treatment.

Advantages of treatment at Oxford Medical:

• Experienced specialists;

• State-of-the-art equipment from leading brands;

• Lab tests, diagnostics, and procedures performed in one clinic;

• High-tech surgical inpatient facilities;

• Medical and surgical treatment of phimosis.

To schedule an appointment, call the clinic's contact center or send a message via the website chat.