What is Phimosis?
Phimosis is a penile condition in which the foreskin, a retractable fold of skin at the top of the penis, cannot be pulled back or retracted over the head, or the glans, of the penis.
Phimosis itself is usually not a problem. As long as it does not cause you any pain or discomfort or affect your daily life, it does not require any surgical intervention. However, severe cases of phimosis may require surgical procedures such as circumcision or foreskin removal.
Phimosis usually occurs naturally and is found in almost all newborn babies and young boys. With time, however, the foreskin starts to loosen up on its own and resolves itself before adolescence. But in some cases, it can last into adulthood as well.
While non-surgical options such as steroid creams may give you temporary relief from its phimosis symptoms, surgery is generally considered to be an effective and safe solution to phimosis in adults.
What Are the Types of Phimosis?
There are primarily two types of phimosis: Physiological phimosis and pathological phimosis.
- Physiological phimosis: Physiological phimosis, sometimes called primary phimosis, occurs naturally at birth. As mentioned before, almost all newborns are born with a tight foreskin that loosens up on its own over time.This type of phimosis generally does not require any surgical intervention. If the condition seems to persist until teenage, non-surgical methods such as steroid creams may be effective in treating physiological phimosis. If the condition does not improve thereafter, the doctor might suggest foreskin removal surgery.
- Pathological phimosis: Unlike physiological phimosis, pathological phimosis occurs due to scarring, infection or inflammation on the penis caused by an injury or forcefully trying to retract the foreskin.Pathological phimosis can occur irrespective of age and usually requires surgical intervention for treatment. Your urologist may also refer to pathological phimosis as secondary phimosis. Some of the common phimosis causes in adults include:
- Poor hygiene
- Skin conditions
- Formation of scar tissue
- Balanitis
- Balanoposthitis
- Injuries
Diagnosis for Phimosis
Prior to phimosis surgery, your healthcare provider will likely perform some simple tests and diagnostics to not only assess your overall health but also uncover any underlying medical conditions you may have that could require additional care and precautions either during or after surgery.
In case of phimosis, diagnosis generally begins with a simple, routine physical examination. Your urologist will try to gently retract the skin that covers the penile glans manually. If the foreskin is not retractable or the penile glans are not completely visible, it indicates phimosis.
Alongside, your urologist will likely ask you about your medical and surgical history, the symptoms you’re facing, any injury that may have occurred on your penis or questions regarding your sexual activity to further understand your condition. Your urologist may also examine the penis to check for signs of any infection or injuries.
Depending on the severity of your condition, your urologist may try some non-surgical approaches such as steroid creams and ointments but if they fail to have any significant effect, a surgery may be the only solution.
Surgical Treatment for Phimosis – Circumcision
Circumcision is a urological procedure that is generally performed as a safe and effective treatment for various foreskin related conditions including phimosis.
In a circumcision procedure, the foreskin is cut and removed from the penis. There are primarily 3 methods of performing a circumcision surgery:
Laser circumcision
Laser circumcision or laser phimosis treatment is one of the most advanced and minimally invasive surgical procedures that are commonly performed and recommended by most urologists for patients seeking to undergo circumcision surgery.
In a laser circumcision, the urologist uses a highly focused beam of laser to precisely cut and remove any excess foreskin from your penis without the risk of any deep cuts.
Due to its high operating temperature, the incision wound is also cauterized, minimizing chances of any excessive bleeding as well.
Stapler circumcision
Compared to laser circumcision, stapler circumcision is generally considered to be a more conventional form of performing circumcision in which the surgeon uses a stapler device, an advanced and disposable surgical tool that is specially designed to perform circumcisions, to cut and remove the foreskin.
In a stapler circumcision, the surgeon places the stapler device over the head of the penis and removes the foreskin in a quick motion. Once the foreskin is removed, the stapler device leaves behind a silicone ring around the incision wound to close it off and minimize bleeding.
The silicone ring falls off on its own once the incision wound has healed completely, which generally takes 7-10 days.
Open circumcision
Open circumcision, often referred to as the dorsal slit technique, is a conventional method of performing circumcision in which the surgeon makes an incision along the upper length of the foreskin from the tip of the corona to expose the penile glans using a scalpel or surgical scissors.
Compared to laser or stapler circumcision, open circumcision is more invasive in nature and requires more recovery time. Due to its invasive nature, it also carries a significant risk of complications and infection as well.
