Phimosis and Circumcision
What is Phimosis?
Phimosis is tight foreskin leading to the inability to pull the foreskin over the glans penis. It can present during childhood or adulthood.
What are the side effects or consequences of phimosis if untreated?
Untreated phimosis can lead to:
- Accumulation of secretions leading to recurrent infections of foreskin (balanoposthitis /balanitis/ posthitis)
- Recurrent urinary tract infections
- Retention of urine in extreme cases due to complete blockage of urinary meatus
- Difficulty in sexual intercourse
- Transfer of infections to partner/wife
Will phimosis go away in children?
Many children have physiological phimosis which usually gets resolved by 5-7 years of age without any intervention. If the physiological phimosis doesn’t interfere with urinary passage or doesn’t cause infections, then the child may be observed up to 5-7 years of age without circumcision surgery.
What is circumcision?
Circumcision is a very common surgical procedure carried out to remove the prepuce (tip of penile skin). Circumcision is done for phimosis (any religion) and for religious purpose (Muslims, Jews).
Is circumcision a daycare procedure?
Yes, circumcision is a daycare procedure. Usually, it takes around 15-45 minutes depending on the seriousness of the phimosis and the method used to do the circumcision.
What are the various methods of circumcision?
There are broadly three types of circumcision:
- conventional circumcision
- stapler circumcision
- laser circumcision
Conventional circumcision is a traditional way of doing the circumcision where the right foreskin is cut using a surgical knife (scalpel) and sutures (stitches) are put for approximation of cut edges. The stitches need not be removed as these are absorbable stitches. It is the safest and is the treatment of choice in complicated phimosis (associated with pus).
Laser is used instead of surgical knife in Laser circumcision which has no additional benefit in any factor.
Stapler circumcision is done using specialized anastomat stapler device. The procedure is quick, less painful, causes less bleeding and cosmetically better. The staplers usually fall off on its own by 2 weeks. Stapler retention even at 2-3 weeks is a disadvantage which can be addressed by manually removing the residual staplers.
What are the precautions after circumcision surgery?
There is no need for bedrest after surgery. The person can resume most of his routine activities from the very next day after surgery. He can drive a car home the same day but may not be preferable to ride a bike the same day. It is advised to not have intercourse for the first 15 days after surgery.
Frequently Asked Questions
A foreskin that cannot be pulled back over the glans may indicate phimosis, but the need for treatment depends on symptoms and the individual's situation. Problems such as infections, difficulty with urination or sexual difficulties are reasons to seek professional assessment. Phimosis treatment should be decided after an appropriate examination.
Yes. The page explains that untreated phimosis can allow secretions to accumulate and contribute to recurrent infections such as balanitis, posthitis or balanoposthitis. Recurrent penile infections associated with a tight foreskin should be evaluated by a qualified urologist.
In severe cases, yes. The page notes that complete blockage of the urinary opening can result in urinary retention. Difficulty passing urine should not be ignored, particularly when it occurs together with a very tight foreskin. Phimosis and urinary problems require prompt medical evaluation when symptoms are significant.
No. The page explains that many children have physiological phimosis that naturally resolves by around 5–7 years of age. If it does not interfere with urination or cause infections, observation may be appropriate rather than immediate surgery. Childhood phimosis should therefore be assessed according to the child's symptoms and development.
Yes. The page states that phimosis can occur during both childhood and adulthood. A new or worsening inability to retract the foreskin in adulthood deserves evaluation to determine the underlying problem and appropriate treatment. Adult phimosis should not be self-treated without professional advice.
Yes. Difficulty with sexual intercourse is listed as one of the possible consequences of untreated phimosis. If tightness or discomfort is affecting sexual activity, an examination can help determine whether phimosis is contributing to the problem. Phimosis and sexual health can therefore be discussed confidentially with a urologist.
The page describes conventional, stapler and laser circumcision. It specifically states that conventional circumcision is considered the safest and treatment of choice for complicated phimosis associated with pus. The appropriate technique should ultimately be selected by the treating surgeon. Circumcision surgery can therefore vary according to the clinical situation.
Not according to the information on this page. It states that laser circumcision does not provide an additional benefit in any factor compared with the alternatives described. The choice of technique should therefore be based on the clinical situation rather than assuming that laser is automatically superior. Laser circumcision should be discussed with the surgeon before choosing a procedure.
The page states that bed rest is not required and that most routine activities can usually be resumed from the next day. It also advises avoiding intercourse for the first 15 days after surgery. Circumcision recovery can vary between individuals, so the surgeon's specific post-operative instructions should be followed.
The page lists transfer of infections to a partner or wife among the possible consequences of untreated phimosis. Recurrent infections and difficulty during intercourse can also affect sexual wellbeing. Phimosis and sexual health should therefore be discussed with a healthcare professional when these concerns are present.
