Phimosis FAQs

A tight foreskin can be extremely painful but it can be treated - often without surgery.

Phimosis

What is it?

An unusually tight foreskin that cannot be drawn back from the head of the penis.

What are the main symptoms?
  • You cannot retract the foreskin to expose the head of your penis.
  • The foreskin is too tight.
  • Severe phimosis can make erections painful. 
What's the risk?

Only uncircumcised men are affected. Some have phimosis from childhood but it can develop later in life.

The foreskin is stuck to the glans in small children but should begin to separate at around three years of age. As the child gets older the foreskin normally retracts to expose the glans but often the foreskin, although partially retractable, will remain attached to the glans until after puberty

If you cannot fully retract your foreskin you won't be able to wash it properly. This may lead to a build-up of smegma, which can become infected.

What causes it?
How can I prevent it?

The traditional view is that there's not a lot you can do. In fact, there is. Check out our Circumcision FAQs

Should I see a doctor?

Yes you should, as trying to force the foreskin back will only cause painful cracks on the inside of the foreskin; these will scar as they heal and make the condition worse. The doctor will carry out a physical examination. 

What are the main treatments?

Try the other options first but you may need to be circumcised. This involves an operation to separate the foreskin from the glans. The foreskin is then cut away and the incision stitched up.

If the cause is balanitis xerotica obliterans you may first be prescribed steroid creams. This can relieve the condition but circumcision may still be required later. 

How can I help myself?

As we said, the traditional view is that there's not a lot you can do. In fact, there is.

What's the outlook after circumcision?

At the very least, the glans will feel sensitive after circumcision as it is not used to being exposed. Wearing loose boxer shorts and using a condom during sex for the first month or two after the operation (even if you have a regular partner) should reduce any irritation.

Paraphimosis

What is it?

A painful condition in which the foreskin can't be pulled back over the head of the penis.

What are the main symptoms?
  • The retracted foreskin becomes stuck behind the head of the penis (glans) and cannot be pulled forward again, leaving the glans exposed.
  • The penis becomes swollen and painful. 
What's the risk?

You are at risk if you are uncircumcised or have not been properly or completely circumcised. 

What causes it?

Paraphimosis is caused by inflammation and narrowing of the foreskin. This may be the result of infection, poor personal hygiene, or damage to the penis, causing swelling. 

How can I prevent it?

It's not always possible to prevent it, but keeping your penis clean and treating any infections quickly will definitely help. Also, make sure you roll your foreskin back after sex. 

Should I see a doctor?

Yes. If you can't move the foreskin gently back into position, or if the problem starts to occur regularly, you should get medical advice. If the foreskin remains retracted for too long it can become extremely painful and may even cause permanent damage.

What are the main treatments?

A doctor can manually retract the foreskin under local or general anaesthesia. You may also be shown how to gradually retract the foreskin after a bath, using petroleum jelly (Vaseline) or some other form of lubrication. But if the problem persists, circumcision may be necessary. 

How can I help myself?

Keep your penis clean.

What's the outlook?

The probable outcome is excellent if the condition is diagnosed and treated rapidly. But if it is not treated promptly, the penis may — in very rare cases — be permanently damaged or become gangrenous.

Who else can help?

If circumcision is suggested it is not something to be entered into lightly. You might like to check out the following website:

15 Square (the trading name of NORM UK) - they offer help with tight foreskin (phimosis) and unwanted circumcision, information, education and advice

 

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Last published 07/04/14
Date of last review 07/04/14
Date of next review 07/04/17

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