What is phimosis?

Phimosis is when the foreskin is too tight, or the tip of the foreskin narrows and is unable to be pulled back to expose the head of the penis.

What causes it?

Phimosis is often seen in children or young adults (primary or congenital phimosis). The condition is at its highest incidence rate before puberty.

Phimosis can also happen because of injury or damage that causes the foreskin to tear (secondary or acquired phimosis). As the tear heals, scar tissue forms which reduces the elasticity of the foreskin. This scar tissue can then stop the foreskin from stretching open far enough to pull back. The scarring from BXO (balanitis xerotica obliterans) can also cause phimosis. Phimosis can often follow infection or inflammation such as balanitis. Adult men with phimosis should be checked for balanitis, diabetes and cancer.

What are other symptoms?

Severe phimosis can cause pain when urinating, urinary retention, urinary tract infections and the skin on the penis can become infected. In older men with severe phimosis, the foreskin can look swollen.

What are the treatment options?

Phimosis can be treated with steroid creams if it is mild but often circumcision is required.

What is Balanitis Xerotica Obliterans, BXO?

Balanitis Xerotica Obliterans (BXO) is not to be confused with balanitis (inflammation of the glans penis). BXO is a condition where scar tissue forms in the foreskin. A ring of white tissue develops at the tip of the foreskin, tightening the foreskin at the tip, and this may prevent the foreskin from retracting (phimosis). BXO may spread to the glans penis, but this is not common. It is important to speak to your doctor if you are concerned about white scarring of your foreskin, to distinguish BXO from early penis cancer. BXO is a progressive disease and it is usually treated by circumcision.