PhimosisPhimosis is a tightening of the foreskin over the head of the penis that prevents the foreskin from being pulled back. Phimosis is a medical indication for circumcision. It is defined as "stenosis of the preputial ring with resultant inability to retract a fully differentiated foreskin." In other words, phimosis is present if the foreskin cannot be retracted at an age when it
should normally be retractable.
There are different degrees from phimosis, from most extreme in the one than the opening is so narrow that it only lets pass the urine, until most benign than he can to discover it in flaccidity, and with difficulty in erection, but with annoyance or pain by the tautness of the skin.
Phimosis is defined as a condition in which the foreskin cannot be pulled back behind the head of the penis (ie, inability to retract the foreskin). Two types of phimosis exist: physiologic and pathologic. Physiologic or congenital phimosis refers to a foreskin (prepuce) that is adherent to the glans at birth but disappears as the infant ages, usually by age 5 years. Pathologic phimosis causes a medical problem when the patient is either a child or an adult. Buried penis, otherwise known as concealed penis, is a condition in which a phimotic penis is hidden or buried within the suprapubic fat pad. This condition is most often encountered in children who are obese. Phimosis is one of the risk factors that predispose patients to a dangerous condition known as paraphimosis. Paraphimosis is defined as a condition in which the foreskin is trapped behind the glans penis and cannot be pulled down to cover the head of the penis (inability to pull down the foreskin).
It is entirely normal for the prepuce to be adherent to the glans in babies, and for the prepuce to not fully retract in young boys. Premature retraction, which is extremely painful, can cause permanent damage to the glans and ridged band, and is also the primary cause of infection in this area. As a boy grows to sexual maturity the prepuce normally becomes retractable. About 44 percent of boys have a fully retractile foreskin by age 10.
In acquired phimosis there is chronic inflammation of the tip of the penis and prepuce (fore skin) or there are adhesions between Glans & prepuce or due to malignancy. In congenital causes it is present since birth. Phimosis is usually caused by thickening and repeated inflammation of the foreskin. Once this happens the foreskin fails to retract over the glans.
Stretching is an effective method for primary "simple" phimosis. This must be understood as a temporary measure, however the daily stretching may become an enjoyable pastime and it becomes easier to stretch. Various methods are reported. Please see Stretching - Please note, for children stretching exercises and experiments with creams and steroids can be far more disturbing than surgery.
Circumcision remains largely unquestioned as the treatment for phimosis. Circumcision is the oldest routine operation (trepanning discontinued). This operation is the foundation stone of surgical history and its tradition in Western medicine. However, in the modern world a full circumcision is usually performed, the origional traditional operation was a partial circumcision.
For some men full circumcision is an attractive choice of treatment. A full circumcision is also the least problematic form of treatment simply because it is easily available and doctors are familiar and experienced with a number of successful methods. For the treatment of a phimotic ring a partial circumcision (so called "loose circumcision") is all that is necessary and thus an important option. This will involve a little persuasions talent with most doctors, takes around ten stitches, and will provide a satisfying answer for most men. For variations on this theme, please see circumcision.