Penis has a shaft and a thickened terminal part called glans penis. All males are born with skin covering both the shaft and glans penis. Normally the skin covering the glans (foreskin) is mobile and in older children, adults can be retracted to expose the glans penis. Inability to retract the foreskin to expose the glans is called Phimosis.

Sweat glands are present in skin and they tend produce secretions and also seminal discharge tends to get accumulated under the surface of the prepucitial skin in active sexual life. This accumulation leads to infections and bans form between the skin and glans causing both of them to stick together.

CLINICAL FEATURES

Phimosis as such is not painful except when the degree of Phimosis is severe making the urinary orifice almost invisible. Complications due to Phimosis are extremely painful.

Paraphimosis - During sexual activity the phimotic skin suddenly slips back over the glans but is unable to come back to it’s natural position. This produces swelling due to fluid accumulation and appears like a big balloon.

Balanitis and Balanoposthitis – Infection in the skin and beneath the skin leads to pain, cracking and ulcers in the skin foul smell. Burning pain while passing urine.

Urinary problems – More the degree of Phimosis smaller the urinary orifice and consequently greater the difficulty in passing urine. In severe cases there may total obstruction to pass urine.

Stone formation will occur in neglected especially old people.

Painful sexual activity – due to ulcers in the skin and painful ejaculation. Degree of erection also decreases due to pain and inability of the penis to enlarge.

Cancer of the penis – in badly neglected cases

Treatment

Young children under the age of 7 years have some degree of Phimosis and its significance is assessed only on clinical examination. In severe cases there is ballooning of the skin during voiding and painful micturition. Most of these children can be managed by stretching the penile prepucitial skin during bathing. Your pediatrician / surgeon is best contacted for further advise.

Older children and adults have pain and difficulty to pass urine and if confirmed will require Circumcision. Circumcision is cutting of the foreskin and exposing the glans penis.

Muslims follow ritual circumcision. Circumcision done under the age of one year is known to give protection against development of cancer of the penis. Circumcision done later in life will not provide the same protection.