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Definition

Phimosis is a condition where it is difficult to retract the foreskin over the tip of the penis. This may be caused by the opening of the foreskin of the penis being too small, or the foreskin being too tight or stuck to the head of the penis.

Foreskin of the Penis

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Causes

The foreskin is connected to a newborn’s penis at birth. This called physiologic phimosis. As a child grows, the foreskin naturally separates from the head of the penis. In some boys, the foreskin does not separate. The reason why is not known.

In other cases, called pathologic phimosis, it may happen due to:

  • Infection
  • Scarring
  • Adhesions
  • Repeated forceful retraction of the foreskin
  • Inflammation and swelling

Risk Factors

Phimosis is more common in young boys. It may also occur in older boys and men.

Risk factors for phimosis may include:

  • Trauma
  • Bacterial infections such as balanitis
  • Poor hygiene

Symptoms

Symptoms may include:

  • Inability to retract the foreskin
  • Pain
  • Swelling and redness
  • Scarring

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. It will include a genital exam. The diagnosis is made based on the ability of the foreskin to retract.

Treatment

Phimosis may improve with time. If treatment is needed it will be chosen depending on the cause of your phimosis. Talk with your doctor about the best treatment plan for you.

Your doctor may advise medication that is applied to the area. Medication can help decrease swelling and loosen the skin.

If medication is not successful, a surgical procedure may be done. The foreskin may need to be partially or totally removed. This can be done with circumcision. Occasionally, small strands connecting the foreskin to the penis, called adhesions, can be removed.

Prevention

There are ways to reduce your chances of getting phimosis. These may include:

  • When able to do so, gently retract the foreskin when urinating and bathing
  • Maintain good hygiene of the penis and foreskin
  • Circumcision to remove the foreskin
RESOURCES:

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org

CANADIAN RESOURCES:

Canadian Paediatric Society
http://www.cps.ca

Health Canada
https://www.canada.ca

REFERENCES:

McGregor T, Pike J, et al. Pathologic and physiologic phimosis. Can Fam Physician. 2007 March;53(3):445-448.

Phimosis and paraphimosis. EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T114116/Phimosis-and-paraphimosis. Accessed January 29, 2021.

Phimosis. University of California, San Francisco website. Available at: http://urology.ucsf.edu/patient-care/children/phimosis. Accessed March 6, 2018.

Phimosis and paraphimosis. Patient UK website. Available at: http://www.patient.co.uk/doctor/phimosis-and-paraphimosis. Accessed January 29, 2021.

Phimosis (tight foreskin). NHS Choices website. Available at: http://www.nhs.uk/conditions/phimosis/Pages/Introduction.aspx. Accessed January 29, 2021.

Tight foreskin (phimosis). The British Association of Urological Surgeons website. Available at: http://www.baus.org.uk/patients/symptoms/phimosis. Accessed January 29, 2021.

Tight foreskin (phimosis). NetDoctor website. Available at: http://www.netdoctor.co.uk/diseases/facts/phimosis.htm. Accessed January 29, 2021.

Last reviewed March 2020 by EBSCO Medical Review Board David L. Horn, MD, FACP  Last Updated: 1/29/2021