Phimosis: where to go in London, when and why

At Diga33, our consultants often get calls from patients about how to treat phimosis. Given the very common nature of the problem, we decided to write a post on the subject. Here there is everything you should know on this topic and, above all, how to cure it naturally and to prevent it. Let’s start with defining this disorder: the phimosis is the narrowing of the foreskin, which is the skin that covers the end of the penis. Phimosis leads to the inability to uncover the glans (the tip of the penis), lowering the skin. Phimosis may be evident when the penis is erect (erect phimosis) or, in severe cases, when the penis is flaccid.

What are the causes of phimosis?

The phimosis is the situation that occurs when the foreskin becomes too tight around the glans. The foreskin is often so tight that it cannot be pulled back. In adults, this disorder occurs because of the following causes:

  • Urinating in the wrong way (not by retracting the foreskin)
  • Bad intimate hygiene
  • Lichen sclerosus
  • Diabetes
  • Balanitis (inflammation of the foreskin)
  • Balanoposthitis (inflammation of the glans, penis and foreskin)
  • Genital bacterial infections

Phimosis can generally occur in childhood and this is quite worrying for parents. But this kind of phimosis is normal. You are a parent of a boy, don’t be scared, in most cases, the phimosis disappears naturally after 3 years.

physiological phimosis is quite normal up to 3 years. Only after 3 years, if the child continues to have the foreskin closed, it is good to have it assessed by an Andrologist in London.

For babies, from the first year onward, it is recommended to gently lower the foreskin, of course without forcing it or causing any harm to the little one. 

The pathologic phimosis is easier to identify. It presents a whitish, fibrous ring / scar, which makes it difficult or even impossible to lower the foreskin. Pathological phimosis can be congenital or acquired. If congenital, a parent may notice the problem in babies after the age of 3 when it should disappear. Acquired phimosis, on the other hand, can also occur in children who initially had a foreskin that opened up correctly. This condition arises as a result of trauma or because of an inflammatory disease called lichen sclerosus (BXO), which causes the foreskin to shrink. 

The majority of traumas are caused by incorrect manoeuvres of retraction of the foreskin!

How do I know if I have phimosis?

In adults,themain symptom of phimosis is characterized by the inability to retract the foreskin to reveal the glans. As you may imagine, phimosis can make sexual intercourse, or even having a simple erection, a painful exercise. In some more severe cases, the person affected may experience discomfort or pain even when urinating. This is because the foreskin cannot be pulled back while urinating, causing urine to come into contact with the glans and foreskin. In turn, this will cause inflammation and promote infection.

How do I know if my child has phimosis?

In children, the signs of phimosis can be found in the glans: it can be red, swollen or painful. The child may have difficulties urinating or have blood in the urine. Unfortunately, phimosis can be completely asymptomatic and therefore it may take some time to notice it. In some cases, the phimosis would only allow for a partial lowering of the foreskin. In other cases (called Balanoposthitis), the skin does not retract due to the stagnation of pee and can become inflamed and cause pain. Paraphimosis may occur when the foreskin gets stuck under the glans and can no longer pulled back. If this happens, do not hesitate and call the hospital: a doctor will perform a recovery manoeuvre. If there is to much delay, a circumcision may be needed.    

For parents: when should you seek immediate care for your child who has phimosis?

For parents: when should you contact an Urologist in London for my child who has phimosis?

How is phimosis treated in adults and children?

As already mentioned, in children phimosis can improve without any treatment. However, it is key to never pull the foreskin back forcefully. Beyond causing more pain, this makes the situation worse and can cause paraphimosis.

In the presence of a phimosis or a suspicion of it, a urological examination with your urologist in London is always recommended. Following the consultation, you can get a diagnosis and think about the type of treatment to apply. The treatments are of two types, conservative and surgical.

Conservative and natural treatments of phimosis

If this is an option, conservative treatments are always preferred to surgical ones. They entail the application of cortisone creams. 

In 90% of children, the use of these creams, combined with constant preputial “retraction” exercises during the moment of intimate hygiene, delicately solve this problem.

Surgical treatment of phimosis

Circumcision is an outpatient surgery that involves the removal of the foreskin. The result is that the glans remains exposed, and therefore not covered by the skin, even when the penis is at rest. Circumcision is performed using a local anaesthetic (lidocaine), applied by an injection with a small needle at the base of the penis. The surgeon then proceeds by cutting the part of the foreskin which is narrowed and then stitching it up using absorbable sutures. However, circumcision is generally an option in the case of an acquired phimosis and in the presence of discomfort during sexual intercourse.

To sum up

We started this post with a simple question: “Phimosis, where to go?”. As discussed, this question has many answers. Nevertheless, the best choice is to call your Urologist Andrologist in London. Diga33 is here for you. We are waiting for your call!

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