About 0.5% to 13% of men above the age of 18 had been diagnosed with phimosis. Apart from it, a random effects model discovered that the risk in men of phimosis was 3.4%. Most experts also believe that phimosis is not necessarily a problem unless it causes any symptoms. However, for treating phimosis, it is essential to contact a healthcare professional if it starts showing symptoms and difficulties. 

To know more about phimosis, continue reading!

Phimosis is a term that is used to define the difficulty in retracting the penile prepuce. This can occur naturally or might result from scarring.

Phimosis can be differentiated into two forms, namely physiological and pathological phimosis. The physiological form is common in children from 2 to 4 years of age and is self-limiting, and might not require medical treatment for phimosis. This type is often self-limiting and resolves on its own when the penile prepuce becomes more retractile.

On the other hand, Balanitis xerotica obliterans (BXO), a cicatrizing skin disorder histologically similar to lichen sclerosis, is frequently cited as the cause of the pathogenic form. It has an insidious onset and might be associated with dysuria, local infection, irritation, and bleeding, leading to meatal stenosis and atrophy.

A few of the symptoms of phimosis include – 

• Skin inflammation 
• Redness or discolouration 
• Dysuria
• Presence of blood during urination 
• Soreness
• Inability to retract the penile prepuce completely
• Preputial pain
• Local infections
• Pain during sexual activity
• Tissue in front of the penile prepuce is fibrotic and white

Although having any of these symptoms of phimosis in adults might be a clear indication, it is always essential to seek the help of a medical professional to determine its severity.

Various things can lead to phimosis in adults. However, a few of the assorted causes of phimosis include – 

• Lichen sclerosus and Balanitis xerotica obliterans (BXO)
• Other skin conditions such as psoriasis and eczema
• Infections, including STIs (Sexually Transmitted Infections)
• Loss of skin elasticity and rare erections in elderly adults 
• Poor hygiene 
• Balanoposthitis
• Preputial adhesions

Usually, there are six grades of severity of phimosis. The stages are – 

• 0 Grade - Full retractability
• 1st Grade - Full retraction but tight behind glans
• 2nd Grade - Partial exposure of glans
• 3rd Grade - Partial retraction with meatus just visible
• 4th Grade - Slight retraction but neither meatus nor glans visible
• 5th Grade - No retraction

Although there are multiple risk factors for phimosis, the most significant ones are – 

• Trauma
• Diabetes
• Poor hygiene
• Frequent diaper rash of infants 
• Bacterial infections such as Balanitis
• Being uncircumcised 

Effects of untreated phimosis can be serious and might be threatening in a few cases. To minimise this risk, individuals must treat it fast and should seek medical help to diagnose it properly, and they must also refrain from self-treatment unless advised by a medical professional. Nevertheless, a few of the potential risks of phimosis include –

• Gangrene
• Difficulty during urinating 
• Difficulty in ejaculation 
• Infertility 
• Pain during coitus 
• Recurrent infections
• Posthitis
• Scarring in penile opening 

If you have self-diagnosed phimosis or have symptoms of phimosis, it is always advisable to seek the help of a doctor before self-treating the problem. Surgical treatments are available to treat phimosis, such as circumcision and preputioplasty, which are strictly performed under the supervision of a physician.

However, if you prefer non-surgical treatment for phimosis, a doctor might prescribe a steroid cream or can suggest manual stretching, depending on its severity. However, if it is caused by BXO, steroid creams might not work. But, as mentioned above, you should always seek the help of a medical professional to diagnose it properly to detect the stage of your problem because if it becomes worse, there might be a chance of cancer.

Although phimosis can’t be prevented, especially in newborns, you might do that if you are an adult. First of all, it is essential to keep your genitals clean, and parents or adults must provide proper directions for cleaning genitals to a child. Besides this, some of the other measures include –

• Gently retracting the penile prepuce when bathing or urinating 
• Circumcision 

Hence, it is evident that phimosis is primarily seen in young boys but can create significant problems in adults. Although there is nothing much you can do to prevent it, maintaining proper hygiene in the genitals is always encouraged. In case you already have phimosis consult a doctor immediately and know its severity to decide on a surgical or non-surgical treatment for phimosis.