Phimosis

(pronounced ‘Fi Moze Is” is a state in which the male foreskin is unable to retract properly from the head of the penis (or glans). This is 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. Also, over time it can also be exacerbated by tearing of the opening of the foreskin, which leaves little scars. This can leave a fairly right rim of scar tissue. Incidence of Phimosis varies, but it is thought to be as high as 1-5% of the male non-circumcised population. The absolute incidence is much higher in Japan, which has never had a cultural practice of circumcision.

The side effects of Phimosis

can include higher likelihood of infection, build-up of smeg (the white substance under the foreskin), ballooning of the foreskin during urination, pain during sex and loss of sensation during sex.

It is in fact the glans that gives men most of their sensation during sex. Un-circumcised men actually have a far more sensitive glans than circumcised men. Circumcised men build up a hard cornified layer of skin cells on their glans which means it is not nearly as sensitive as it was prior to circumcision. Conversely, with un-circumcised men, the glans is covered in a moist environment, which maintains the sensitivity of the penis.

Releive 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 the way men can that 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.

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.Below are some examples of different presentations of phimosis:

This individual did not manage his phimosis and is an example of a rare but preventable problem.Cleaning of the penis is rendered more difficult with Phimosis and there may be a tendency to avoid proper hygiene, including regular flushing and washing of the zone between the foreskin and the glans. Gentle Foreskin Stretching for Tight Foreskin may help.

Most doctors see this classic presentation of phimosis but it can be that your foreskin is tight but not so tight that retraction is impossible.

A real life example of the above schematic diagram, this shows the degree of constriction and narrow aperture that is present with phimosis.

See you doctor if your foreskin looks like this—urgently.