Phimosis was defined as a inability to retract the skin (foreskin or prepuce) which covers the head (glans) of the penis. Phimosis can appear as a tight ring or “rubber band” on foreskin surrounding the tip of the penis, prevents full retraction.
Phimosis is classified into two forms:
Physiologic phimosis: Children who were born with tight foreskin at the time of birth and separation occur naturally over the time. Phimosis was normal for uncircumcised infant or child and generally resolves at 5-7 years of age, even though the child may be older.
Pathological phimosis: Phimosis that occurs due to scarring, infection or inflammation.
Bleeding, scarring and psychological trauma for the child and parent because of forceful foreskin retraction. If there is ballooning of the foreskin during urination, difficulty with urination, or infection, then treatment may be warranted.
Phimosis in older children and adults can be vary in severity, with able to retract the foreskin incompletely (relative phimosis), and some completely not capable to retract their foreskin even when penis was in flaccid state that is full phimosis.
Pathological phimosis was a rare condition and the causes are been varied. Some cases can arise from balanitis (inflammation of glans penis).
Lichen sclerosus et atrophicus was regarded as a usual (or even the main) cause of pathological phimosis. In this skin condition of unknown origin that may cause a white color ring of indurated tissue to develop at near of the tip of prepuce. This inelastic tissue may prevents from retraction.
Phimosis can develop after other kinds of forcible foreskin retraction, chronic inflammation or repeated catheterization.
Phimosis can also arise in untreated diabetics because of the presence of glucose in the urine that give rise to infection in the foreskin.
Doctor can diagnose phimosis depends on a thorough observation of history and physical examination. Additional tests are generally not necessary.
Physiologic phimosis, was frequent in males that may affect from 10 years of age and younger, it is normal, and won’t require any intervention. Non-retractile foreskin generally becomes retractable when the course of puberty. If phimosis was in older children or adults it won’t cause any acute and severe problems, nonsurgical measures can be effective. Surgical procedures may range from complete removal of foreskin to minor operations to get relieve foreskin tightness