Phimosis is one of those subjects many men are uncomfortable talking about. However, for the men this condition affects, it’s a very real issue. Following is an overview of phimosis (aka “tight foreskin”) and the various treatment options.

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Phimosis is the condition that occurs when the foreskin cannot be retracted over the head of the penis.

Phimosis Overview

In its simplest terms, phimosis is the condition that occurs when the foreskin cannot be retracted over the head of the penis. According to WebMD, there are typically four possible causes behind phimosis:

1. The inability to retract the foreskin simply may be a condition that was present at birth.
2. The adhesion may be a result of an infection.
3. Scar tissue, due to an injury or chronic inflammation, may result in phimosis.
4. Balanitis (swelling of the head of the penis due to infection) may also prevent the foreskin from retracting.

It is completely normal for the foreskin to be adhered to the head of the penis, at birth. This membrane is called “synechia,” and is similar to the membrane that attaches your fingernails to your nail beds. However, by the age of 10, most boys are able to retract the foreskin over the head of their penis. 95 percent have retractable foreskin by the age of 17. However, for the 5% of uncircumcised men who suffer from phimosis, there are several treatment options.

Phimosis Treatment Options

There are three primary treatment options, for men suffering from phimosis. These include:

1. Manual stretching with or without prescription medication
2. Preputioplasty – surgical opening of the foreskin
3. Full circumcision

Manual Stretching for Phimosis

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Manual stretching is the least invasive phimosis treatment.

The least invasive method of phimosis treatment is manual stretching. This can be combined with an application of Betamethasone cream two to three times a day. Betamethasone alone will not treat phimosis, but it will speed up the effects of the manual stretching. According to WebMD, to manually stretch the foreskin:

• While in the bath or while using a lubricant, if there is enough of an opening to insert the tips of one finger on each hand, do so and very gently stretch the opening. Be sure to do this when your penis is completely flaccid.
• Hold the stretch for 30 to 60 seconds.
• Repeat for 10 to 20 reps, twice a day.
• If your opening is not that large yet, gently pinch your foreskin between your thumb and index fingers of both hands, at the opening, and stretch it from the outside of the skin.
• Continue this process until the foreskin can be retracted over the glans of the penis.
• This process may take a few months.

Preputioplasty or Surgically Widening the Opening for Phimosis

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Preputioplasty involves one or more vertical slits to release the stenosis, and then stitching laterally, to widen the opening of the foreskin

Preputioplasty uses a slit in the foreskin to surgically widen the opening, to allow the head of the penis to emerge. This procedure preserves the foreskin and is less traumatic than circumcision. One or more short incisions are made vertically to widen the stenosis, the restrictive ring of the foreskin, and the re-sewn laterally.

Circumcision for Phimosis

Circumcision is the most invasive treatment of phimosis. With a circumcision, the foreskin is completely removed. Although approximately half of all American male babies are circumcised, in other parts of the world, the practice is much more uncommon.