Phimosis is a benign condition characterized by the inability of foreskin (prepuce) to retract behind the glans (head) of the penis. It is congenital in almost all the baby boys and resolves on its own as they transit into childhood. Adult phimosis is a true pathologic condition and may be caused either due to poor hygiene or because of an underlying medical condition (e.g., diabetes mellitus).
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The pathological phimosis is usually asymptomatic and responsive to conservative medical treatment. But in cases where the medical treatment fails to cure the phimosis, surgical intervention is done usually by the traditional form of Circumcision.
Causes of Phimosis:
- Balanitis or the infection of the foreskin
- Balanoposthitis (infection of glans and foreskin)
- BXO, a genital form of lichen sclerosus et atrophicus
- Poor hygiene
Symptoms of Phimosis
- Ballooning of the foreskin during voiding
- Skin irritation
- Pain and discomfort during sexual activity
- Occasionally enuresis or urinary retention
Circumcision and adult circumcision
Circumcision is one of the earliest elective operations which has been performed for various religious reasons, social reasons, or both. When circumcision is performed for phimosis, 25%-46% of removed foreskins are histologically normal.
Common indications for circumcision
- Para phimosis
- Recurrent balanitis or balanoposthitis
- Social or religious reasons
- Bowen disease
Contraindications for circumcision
Circumcision is generally not performed in premature born children or those with blood dyscrasias. It should also not be performed in children with congenital penile anomalies such as the following:
- Penile webbing
- Buried penis