Phimosis (Foreskin Problems)

When boys are first born, their foreskin is tight. Over time it gradually loosens until it can be easily pulled back over the penis head (glans). Phimosis occurs when the foreskin remains unusually tight and cannot be drawn back. Some men can have phimosis throughout their life and are still able to have intercourse, although most would probably find it more comfortable without this condition.

Not being able to pull back the foreskin also means that it is difficult to clean the penis. This increases the chance of infection. Phimosis may also develop later in life, after puberty. It can be caused by thrush infections, which lead to scarring of the penis, or another condition (balanitis xerotica obliterans) that makes the foreskin stick to the penis.

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Phimosis (Foreskin Problems) symptoms

The main symptoms are not being able to pull back the foreskin to expose the head of your penis, and if the foreskin is very tight, erections may be painful. You may also have pain on urinating.

Try not to force the foreskin back yourself, as this can lead to painful cracks on the inside of the foreskin. As these cracks heal, they will form scars, which could make your condition worse.

Phimosis (Foreskin Problems) diagnosis

If you have difficulty pulling your foreskin back, or have observed that this is a problem in your son, you should consult your GP. Your GP will carry out a physical examination and discuss treatment options.

Phimosis (Foreskin Problems) treatment

If the cause is balanitis xerotica obliterans (a hardening of the tissue), you may be prescribed a steroid cream to apply to the top of the penis. If the steroid cream does not improve the phimosis, or there is a different underlying cause, surgery may be offered.

Performed under a general anaesthetic, sometimes a small cut in the foreskin may be enough to loosen it up so that it can be pulled back. However, in adults, the foreskin is usually so scarred and thickened a circumcision may be needed. This is when the foreskin is removed completely.

After a circumcision the top of the penis may be feel exposed and sensitive. It is therefore advisable to wear loose boxer shorts and use a condom during sex for the first two months after the operation to reduce any irritation.

Need more information?

Speak to your GP or consultant if you notice any symptoms or to discuss phimosis treatment options.

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