Phimosis and circumcision: what you need to know

The foreskin, the skin that covers the head of the penis (glans), raises many questions: about little boys whose foreskin "won't pull back", men who feel discomfort, or parents preparing for their son's circumcision.

Here is what you need to know about phimosis, its treatments, and circumcision carried out under proper medical conditions.

What is phimosis?

Phimosis is a ring that is too tight at the tip of the foreskin, preventing it from sliding back to uncover the glans. There are two very different situations.

When should you see a doctor about phimosis?

Medical advice is useful in case of:

• repeated infections of the glans and foreskin (balanitis): redness, swelling, discharge;
• difficulty urinating, a very thin stream, or a foreskin that balloons a lot when urinating;
• urinary infections in a boy;
• pain or tearing during erection or sex in adults;
• a white, stiff or cracked foreskin, which may suggest a skin condition (lichen sclerosus);
• phimosis that persists into adolescence.

How is phimosis treated?

Treatment depends on age, how bothersome it is and how the foreskin looks.

• A steroid cream, applied to the tight ring of the foreskin for a few weeks, softens the skin. It works in many cases, especially in children, and often avoids surgery.
• Preputioplasty widens the ring while keeping the foreskin.
• Circumcision removes the foreskin. It is the standard treatment for severe or recurrent scarred phimosis.

Circumcision: what does it involve?

Circumcision is the removal of the foreskin. It may be requested for medical reasons (phimosis, repeated infections) or for religious and cultural reasons, which are very common in Morocco. In every case, it is a surgical procedure that should be performed by a doctor.

It is done under anaesthesia suited to age: local anaesthesia in adults, often combined with light general anaesthesia in children. The procedure usually takes less than an hour, and patients go home the same day. Dissolvable stitches, which fall out on their own, close the wound.

What is recovery like after circumcision?

Does circumcision affect health or sex life?

Circumcision makes it easier to keep the glans clean and removes the risk of phimosis and paraphimosis. It also lowers the risk of some infections. Once healed, it usually has no effect on erections. Sensitivity of the glans may change slightly during the first weeks, then settles.

If you have pain during erection or sexual difficulties, read our article on erection problems. To learn which other signs should prompt a visit, read When should you see a urologist?

Phimosis consultation in Agadir

Dr. Abdellatif Mitach, urologist and andrologist, sees men and families at his practice on Avenue Hassan II in Agadir to examine phimosis and suggest the right treatment. See his areas of expertise or book an appointment online.

Sources

• French Association of Urology (AFU), patient information: urofrance.org
• European Association of Urology (EAU), Patient Information: patients.uroweb.org
• French National Authority for Health (HAS): has-sante.fr