Phimosis: Symptoms, Causes, and Treatment Options - Urology

More Info

---

Phimosis is a condition characterized by the inability to retract the foreskin of the penis over the glans (the head of the penis). It can be classified into two types: physiological phimosis, which is common in infants and young boys and usually resolves naturally as they grow older, and pathological phimosis, which occurs due to scarring, inflammation, or other medical conditions.

In your case, where the foreskin can be retracted when the penis is not erect but cannot be fully retracted during an erection, it suggests a form of phimosis that may be classified as either a tight foreskin or a partial phimosis. The fact that you experience pain when attempting to forcibly retract the foreskin indicates that there may be some underlying issues, such as inflammation or scarring, which could be causing discomfort.


Symptoms of Phimosis
1. Inability to Retract Foreskin: As you described, the foreskin can be retracted when flaccid but not when erect.

2. Pain or Discomfort: Pain during attempts to retract the foreskin, especially during an erection.

3. Swelling or Redness: In some cases, the foreskin may appear swollen or red, indicating inflammation.

4. Difficulty with Hygiene: Inability to retract the foreskin can lead to hygiene issues, increasing the risk of infections.


Causes of Phimosis
- Congenital Factors: Some males are born with a naturally tight foreskin.

- Infections: Recurrent infections, such as balanitis (inflammation of the glans), can lead to scarring and tightening of the foreskin.

- Skin Conditions: Conditions like lichen sclerosus can cause skin changes that lead to phimosis.

- Trauma or Injury: Previous injuries to the area can result in scarring and tightening.


Treatment Options
1. Topical Steroids: Application of topical corticosteroids can help reduce inflammation and promote the stretching of the foreskin. This is often the first line of treatment for mild cases.

2. Gentle Stretching Exercises: Gradual and gentle stretching of the foreskin can help improve elasticity. This should be done carefully to avoid pain or injury.

3. Circumcision: In cases where phimosis is severe or does not respond to conservative treatments, circumcision (surgical removal of the foreskin) may be recommended. This is often considered when there are recurrent infections or significant discomfort.

4. Preputioplasty: This is a less invasive surgical option that involves widening the opening of the foreskin without complete removal. It may be suitable for some individuals with phimosis.


When to Seek Medical Attention
It is advisable to consult a healthcare provider, preferably a urologist, if you experience:
- Persistent pain or discomfort.

- Difficulty with urination or hygiene.

- Signs of infection, such as discharge, swelling, or fever.

In summary, your symptoms suggest a form of phimosis that may require medical evaluation and treatment. It is essential to address this condition not only for comfort but also to prevent potential complications such as infections or further scarring. A healthcare professional can provide a tailored treatment plan based on the severity of your condition and your overall health.