Phimosis

Phimosis is a condition where the foreskin of the penis (prepuce) cannot be fully retracted freely up to the coronal sulcus exposing the entire glans penis. At birth all male neonates will have foreskin fully covering the glans and because of adhesions it may not be possible to retract. This can persist up to 4 years and during this period slowly the foreskin will start retracting towards full extent. However, 1% of all males will continue to have non retractile prepuce and many of them will go for complications because of phimosis. The opening in the prepuce may be so small that the foreskin will balloon with urine before urine starts to dribble out. This can easily lead to such complications like urinary tract infection, balanitis and balanoposthitis. At times a partial phimosis which can retract to some extent can become a tight band resulting in swelling of the prepuce and the glans - a condition called Paraphimosis.



In the sixties and early seventies in many western countries, all male children were routinely circumcised. The reason given was that circumcised males are protected from future carcinoma of penis. On this basis, millions of circumcisions were done in the neonatal period. But this view has been questioned by many and routine circumcision as a prophylaxis against carcinoma penis is not recommended. Occasionally diabetic patients may develop induration and thickening of the prepuce leading to phimosis.