Treatment

The treatment of phimosis is circumcision. This procedure involves circumferential excision of the foreskin securing of bleeding points and approximation of the skin to the mucosa left behind for a-bout 3-4 mm around the glans penis
at the coronal sulcus. Care has to be excised in repairing the frenum in terms of hemostasis, cosmesis and also to avoid any injury to the urethra. Phimosis in persons who have other penile conditions like hypospadiasis, chordee, Peyronie's disorders etc., should be handled by specialists trained in that area. Children below 4 years; unless complicated by UTI etc, no immediate circumcision is necessary for phimosis as the situation can improve. For older children and adults; it is better to perform circumcision to improve the hygiene as well as to prevent complications. Phimosis in patients with diabetes are better handled by circumcision and follow up management.

• In many patients, circumcision may be the first operation that he may be undergoing and it is better to make sure that he does not have any bleeding diathesis.
• Redundant foreskin which is freely retractile does not require routine circumcision, unless the patients specifically request for the same.
• Circumcision although a small procedure is not entirely free of post operative complications.
• 0.2 to 3% of circumcisions can develop minor post operative complications and at times re-exploration for bleeding.