Phimosis is a condition that keeps the foreskin from retracting away from the head of an uncircumcised penis due the tightness of the skin. At birth, most boys do not have a retractable foreskin, but they frequently outgrow phimosis without treatment between the ages of 5 and 18.
Physicians distinguish between two types of phimosis:
- Physiologic phimosis is a non-retractable foreskin, but causes no pain during urination or complications from urinary infections.
- Pathologic phimosis is a non-retractable foreskin that causes symptoms such as:
- Chronic irritation
- Bleeding
- Difficulty with urination
- Ballooning of the foreskin during urination
- Recurrent infections of the foreskin
- Urinary tract infections
- Painful erections
Paraphimosis is a related condition, which occurs when tight foreskin stays retracted behind the head of the penis, causing constriction, pain and swelling. Paraphimosis is a medical emergency because it decreases blood flow to the penis.
Diagnosis of Phimosis
Our pediatric urologists and pediatricians can determine whether your child has phimosis through a physical examination and a review of his health history. Testing is not usually necessary, and treatment can come before, after or without circumcision, although treatment is not always necessary.
Treatments
Treatments
In most cases, simple hygiene (never voiding through a closed foreskin and regular bathing) and a corticosteroid cream or ointment will treat phimosis. Sometimes phimosis must be treated with surgery, which usually means circumcision.
About Circumcision
Families consult urologists at Riley at IU Health to arrange circumcision or seek care for an abnormal circumcision, diagnosed by a pediatrician.
We follow guidelines set by the American Academy of Pediatrics (AAP), which state that the benefits of circumcision outweigh the risks and encourage parents to decide whether their child should be circumcised. Occasionally, we recommend circumcision when it reduces your child’s risk of urinary tract infection or corrects persistent problems (infection or pain) with the foreskin or penile anomalies.
Care of an Uncircumcised Penis
If you decide not to circumcise your child, no special care is needed for foreskin during infancy. The foreskin can be gently retracted and cleaned at bath times. As little boys mature, they learn to retract, clean and dry the foreskin as part of daily hygiene. Afterwards, it should be placed back over the head of the penis. Boys should avoid urinating through a closed foreskin.
Key Points To Remember
Key Points To Remember
- Your child may outgrow phimosis without treatment.
- Phimosis treatments, if needed, have good outcomes, especially when treated early in life.
- Treatment for paraphimosis is urgent because it restricts blood flow to the penis.
- Circumcision can sometimes help boys who have chronic problems with the foreskin, such as phimosis, recurrent penile infections or high risk for urinary tract infections.
- If your child needs circumcision to treat phimosis, his recovery should be very quick.
- Infants usually have quicker recoveries from circumcision than older children
Support Services & Resources
Support Services & Resources
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This website is supported through the American Academy of Family Physicians and has information about conditions such as phimosis and paraphimosis.
This online resource is part of the U.S. National Library of Medicine and publishes scholarly articles for medical professionals about health conditions such as phimosis.
This website is supported by the American Academy of Pediatrics and provides health information about conditions and procedures, including phimosis, paraphimosis and circumcision.