Dr. Amrish Vaidya
Phimosis

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What is phimosis?

Phimosis implies that it is difficult to retract the foreskin of the penis fully, and freely, to expose the glans. Phimosis is normal in newborns, and can take some years to resolve. While this happens, a secretion from the lining of the glans called smegma, which is a white pasty substance, may accumulate between the skin and the glans. Parents often believe this to be pus, denoting an infection. Infact, this is part of the normal process.

This kind of phimosis  is generally not significant, and does not need treatment.

 
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When is phimosis significant?

Phimosis is significant when it persists beyond the age of 6-7 years. Also, when changes have taken place in the foreskin, which causes a loss of skin elasticity, so that this skin is unlikely to open up.

When there are repeated episodes of urinary infection, or when  paraphimosis develops, then also phimosis may need treatment. Paraphimosis is a condition when the foreskin, which has been retracted back to expose the glans, cannot be restored to its original position. It cannot be manipulated over the ridge that separates the glans from the shaft. The glans may swell up after a while. It’s best to have the child seen by a doctor as soon as possible.

 
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How is phimosis treated?

When the skin maintains its elasticity, gentle manipulation, and application of mild steroid creams may resolve phimosis.

More severe situations may have to have surgery. This could be a preputioplasty, where the skin is retained, but its opening enlarged, or, alternatively, a circumcision, where the skin is removed to permanently expose the glans.

True Phimosis has an inelastic ring at the preputial opening
Very often, beads of smegma (whitish, pasty material) accumulate under the adherent foreskin. These may be normal
True Phimosis has an inelastic ring at the preputial opening
Very often, beads of smegma (whitish, pasty material) accumulate under the adherent foreskin. These may be normal
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