Phimosis (pronounced ‘Fi Moze Is”) is the medical term used to describe when the male foreskin is unable to retract properly from the head of the penis (or glans) due to an unusually tight foreskin.

The causes of a tight foreskin can vary, but most commonly it is simply because males are born with it that way. Usually the condition resolves as the male develops into adult-hood. However, a proportion of men can have phimosis persist into later years, with a spectrum of presentations. Over time a tight foreskin can be exacerbated by tearing of the opening of the foreskin, which leaves scars. This can leave a fairly tight rim of scar tissue making the foreskin tighter.               

            Classic Phimosis    

Natural Development of the foreskin

At birth, the inner layer of the foreskin is sealed to the glans of the penis. This attachment forms early in fetal development and provides a protective layer for the delicate developing glans. The foreskin is usually non-retractable in infancy and early childhood. Studies have indicated that the foreskin becomes retractable in approximately 50% of cases at 1 year of age, 90% by 3 years of age, and 99% by age 17. Therefore it is considered perfectly normal that full retractability of the foreskin may not be achieved until late childhood or early adulthood.

Adult Phimosis

For some men, a tight foreskin may persist into adulthood or phimosis may develop in an uncircumcised adult who was previously able to retract his foreskin. 

Phimosis in older children and adults can vary in severity, with some men able to retract their foreskin partially ("relative phimosis"), and some completely unable to retract their foreskin even in the flaccid state ("full phimosis").

Side Effects

The side effects of Phimosis can include a higher likelihood of infection, build-up of smegma (the white substance under the foreskin), ballooning of the foreskin during urination, pain during sex and loss of sensation during sex.

A more serious condition, called paraphimosis occurs when a tight foreskin is pulled back over the head of the penis and remains there, constricting the blood flow. This can rapidly lead to permanent damage and/or loss of the penis. This is a very serious issue, and one that warrants immediate medical attention from your doctor. Don’t hesitate one minute if you think you have this. To help avoid this complication it is important that you don’t try to “force” the foreskin to retract over the head of your penis before it is ready. In other words, be patient with stretching the foreskin, it does take time. And don’t pull it back before it is ready and easy. 

Incidence

The incidence of phimosis varies, but it is thought to be around 5% of the non-circumcised male population. The absolute incidence is much higher in Japan, which has never had a cultural practice of circumcision.     

Relieve a tight foreskin with gentle foreskin stretching.

For men who have Phimosis, they have historically faced the option of leaving the foreskin alone, or going through the process of an adult circumcision, which can be quite painful. Either pathway is still regarded as valid by the medical community. With regular washing and proper hygiene control, men with Phimosis can cope for years in this way. However, they are unable to fully benefit from the pleasures of sexual intercourse in the same way as men who are able to retract their foreskin normally. Furthermore, circumcision is not for everyone. Amazingly there is even an industry now built up around foreskin restoration for men who feel the need to reverse their circumcision. It is evident that foreskin restoration is only partially successful.

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