Phimosis

Phimosis is a narrowing of the foreskin so that it cannot be retracted over the glans. During the first few years of life, a constriction and adhesion of the foreskin is still normal (physiological phimosis); it serves to cover and protect the glans and should never be retracted during infancy. As the child grows, the foreskin loosens and becomes wider, allowing it to be pulled back.

In most cases, phimosis does not cause any symptoms. Inflation of the foreskin (so-called ballooning) during urination is frequently observed. If symptoms do occur, they include repeated inflammation of the foreskin (balanitis), problems urinating (obstructive urination problems) and pain during erection.

Paraphimosis is an emergency. In this case, the retracted foreskin can no longer be brought forwards, which leads to circulatory problems and swelling of the glans.

Phimosis is diagnosed by means of a physical examination. The extent of the tightness and any adhesions are assessed. Occasionally, a short frenulum is also found on the underside of the glans.

Phimosis that does not cause any symptoms does not need to be treated until shortly before puberty. If therapy is required, the primary treatment is ointment treatment with a cream containing cortisone, which can be repeated several times. If this is unsuccessful, surgery can be performed. There are various surgical procedures. We adapt our recommendation to the clinical findings and the wishes of the parents and the child.

The operation takes place in an outpatient setting.

Conservative treatment for phimosis can have a success rate of 80% if used correctly. The operation is one of the most frequently performed operations at UKBB, with a complication rate of 2-3%.

PaediatricUrologyGuidelines 2022; European Association of Urology, C. Radmayr et al.