Phimosis is not just a disease for children. It can appear in adulthood, especially in diabetic patients, where the skin of the foreskin suffers a loss of elasticity, with difficulty or impossibility of
retracting. Phimosis is the inability to retract the foreskin. It can appear from birth or in adulthood. The treatment is medical or surgical depending on the patient. In the case of surgery, it is an outpatient procedure performed under local anesthesia.
Phimosis is a narrowing of the skin that covers the glans of the penis. Most children are born with
phimosis. In addition, at the time of birth, the glans and foreskin are attached by a thin fibrous tissue, called Balanopreputial adhesions. Both conditions make it difficult for a newborn baby to retract the skin of the foreskin and expose the glans. This situation is absolutely normal.
Circumcision is a surgical procedure in which all or part of the skin of the foreskin is removed. During development, adhesions and phimosis gradually disappear spontaneously. The growth of the penis itself, spontaneous erections and a locally produced whitish secretion contribute to this, acting as a natural lubricant and helping to loosen the penis. This process can be variable from one child to another. In general terms, at the age of 4 years 80% of children can retract their foreskin without problems. Those who have not yet fully achieved this will do so in the following years, so that after 16 years there will be only 1% who will not be able to do so.
When faced with an absolutely natural process, the most sensible thing to do is to do nothing, just take care of the local hygiene with a gentle retraction of the foreskin, without forcing it. Traditionally, the traumatic retraction of the foreskin (the well-known stretch) has been recommended, which, in addition to being extremely painful, often contributes to generating scars that make the situation worse. This practice must now be definitively banished.
The need to operate on a child with phimosis, for health reasons, is reduced to isolated cases. It is contemplated in situations of very severe phimosis that do not resolve naturally, repeated local infections or malformations of the urinary system causing infections. For a few years now, an alternative treatment to surgery has been used and it is the use for a few weeks of a locally applied corticoid cream that has given good results.