Phimosis and Pathological Phimosis: Symptoms, Causes and Treatment

Phimosis is when the foreskin can not be retracted (backward) due to a too-narrow opening.

However, it does not require treatment if there is no problem with urination, sexual intercourse, or infections.

What usually happens is that at birth, the foreskin and the glans (head of the penis) fuse but generally separate from each other during childhood (at the age of 3 years). Most cases of phimosis are mild, but a small percentage of children develop a severe form that manifests as a bulging foreskin during urination. The edge of the foreskin may have a pale appearance with scars that will be unable to fold when pulled.

Symptoms of phimosis include:

  • Pain when urinating.
  • Bleeding or irritation around the foreskin.
  • Urinary retention (inability to urinate).
  • This type of phimosis usually occurs in infants, but if it occurs in an adult man who was previously able to retract his foreskin, it is called acquired phimosis.

Causes of acquired phimosis

Most cases of phimosis occur at birth, but there is another type called acquired or “pathological” phimosis. This type of phimosis is caused by any number of factors that include:

  • Balanitis (Inflammation of the mucous membrane that lines the glans)
  • Back that pulls excessively on the foreskin.
  • Masturbation.
  • The frenulum is too short to restrict the foreskin (brief frenum).
  • Diabetes.
  • Frequent catheterization (insertion of a urinary catheter).
  • The lack of hygiene.
  • Infection.

Phimosis is often confused with the brief state of the frenulum, but the main difference is that the phimosis produces a band of scar tissue that forms in the foreskin, while the short frenulum means that it is too short. In both cases, this prevents you from pulling the foreskin backward.

The treatment of phimosis

Phimosis usually resolves in infants and young children by reaching their third year. The foreskin becomes loose, allowing it to be retracted, so no treatment is needed; however, if it causes problems with urination or results in an infection, then timely treatment is necessary, which is necessary to prevent it from becoming paraphimosis.

The treatment can be surgical or non-surgical. These include:


  • You are stretching the foreskin using a balloon and another device.
  • The creams with steroids.
  • The circumcision
  • The opinion remains divided about the effectiveness of circumcision in treating phimosis. Some argue that it is an effective means of treatment and prevention, but others claim that the results are inconclusive.
  • Complications of phimosis.
  • The pain and discomfort when urinating.
  • Pain and discomfort during sexual intercourse.
  • Paraphimosis (Strangulation of the glans).
  • A risk factor for penile cancer