Phimosis
Phimosis is when a foreskin is too tight to be pulled over the head of the penis. This can have an extremely negative effect on a man’s quality of life and sex life.
What is phimosis (a tight foreskin)?
Phimosis is a condition where the foreskin, the skin covering the head of the penis (glans), is too tight to be retracted or pulled back. This can severely compromise a man’s quality of life, profoundly affecting both his physical comfort and sex life.
At The Urology Partnership our consultants understand the discomfort and difficulties a tight foreskin can present, and offer expert diagnosis and treatment in the comfort of our private clinic.
Types and causes of phimosis
Treatment for a tight foreskin is typically recommended based on the type of phimosis in question, and the severity of the symptoms being experienced.
Physiological phimosis is normal in newborns and young boys. The foreskin is naturally tight at birth and most boys’ foreskins cannot be retracted (fully pulled back) before the age of 5. This usually resolves as boys get older and the foreskin typically becomes looser and retractable by the age of 10.
Pathological phimosis can develop in older boys and men often as a result of scarring from infections, inflammation or injuries, including:
- Forced retraction: attempting to forcefully retract a tight foreskin causing tears and subsequent scarring.
- Infections: viral infections like genital warts or genital herpes simplex, and bacterial infections like syphilis or chancroid.
- Balanitis Xerotica Obliterans: a form of lichen sclerosus which is a chronic inflammatory condition affecting the foreskin and glans penis.
- Skin disorders: such as eczema, psoriasis, and lichen planus.
- Poor hygiene: that leads to infections and inflammation.
- Precancerous conditions: such as giant genital warts, Bowen’s disease, erythroplasia, Bowenoid papulosis.
- Penile cancer: squamous carcinoma
Paraphimosis occurs when a tight foreskin has been retracted over the glans but can’t return to its natural position, causing the glans to swell. This is a medical emergency requiring immediate treatment to avoid serious complications like restricted blood flow to the penis.
Symptoms of Phimosis
In most cases phimosis is just uncomfortable and has the common symptoms of:
- Tight/sore frenulum (banjo string).
- Difficulty retracting the foreskin to clean the head of the penis.
- Difficulty bringing the foreskin back over the glans if it’s pulled back.
- A balloon-like swelling under the foreskin during urination.
However, more severe phimosis symptoms can develop requiring medical attention. These include:
- Sore/itchy/red foreskin or glans penis.
- White discolouration of foreskin.
- Painful erections which make sex uncomfortable or difficult.
- Cracking or fissuring of foreskin which can bleed after sex.
- Bleeding, unusual discharge or an unpleasant smell from under the foreskin.
- Swelling and tenderness
- Difficulty urinating or frequent urinary tract infections (UTIs)
- Blood in the urine (haematuria)
Treatments for Phimosis
In most cases, treating phimosis starts with conservative measures to help stretch and loosen the foreskin. This will move to the surgical options of frenulaplasty or circumcision in more severe cases, or when conservative measures aren’t proving effective.
Conservative (non-surgical) measures
Conservative treatment aims to manage phimosis through a combination of:
- Applying steroid creams (Dermovate for short periods).
- Changes to cleaning and caring for the area (E45 aqueous cream wash, Vaseline, trim pubic hair).
- Foreskin stretching exercises.
Frenuloplasty
Frenuloplasty is a simple operation performed under either local or general anaesthetic. It’s used to address a short or tight penile frenulum by making precise cut across the tight part of the frenulum, which is then expertly closed in a manner which then lengthens the frenulum, helping to relieve pain and improve sexual function.
Circumcision
Circumcision under local anaesthetic is used to remove a tight foreskin.
It’s a day case surgery taking around 30-45 minutes. During surgery the foreskin is removed and sent for pathological review. The wound on the penis is then closed with absorbable stitches and an antibiotic impregnated bandage applied.
In this video, our consultant Mr Paul Hadway explains the causes of phimosis in adults and provides an overview of circumcision under local anaesthetic at The Urology Partnership.
Fast access to help for a tight foreskin
To arrange a private consultation with one of our highly experienced urology consultants please contact us on 0118 920 7041.
At The Urology Partnership, we understand the importance of timely and expert urological care. Our team of specialists is dedicated to providing you with an excellent, patient-centred service, using the latest treatments and technology.
Next Steps
Get fast access to leading specialists for the swift diagnosis and treatment of urological conditions in a private clinic environment.
If you would like more information or wish to arrange a consultation with one of our specialist consultant urological surgeons then please either Call 0118 920 7040 or complete the form below.
Insured patients
Contact your GP and ask for a referral to the Urology Partnership.
All consultations, investigations and treatments are covered by major insurance companies (depending on policy).
Funding your own treatment
Self-funding initial consultation fee is £205. Follow up fees are £165.
Consultation charges are exclusive of any tests and other investigations that the consultant may wish to carry out.