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Phimosis has a range of treatment options, and choosing the best one depends on the patient’s age and symptoms. Congenital phimosis — or phimosis that is present from birth — is treated with gentle retraction maneuvers, steroid cream application, retraction using tools, and surgery. Adult phimosis, which affects older men, in many ways can be treated similarly to congenital phimosis. In adult patients, however, it is also important to address the reason the condition developed.
Many young uncircumcised male children have some degree of congenital phimosis. Most often this is natural, and will resolve as the child grows and develops. Pediatricians and pediatric urologists often distinguish between physiologic phimosis, which is normal, and pathologic phimosis, which is more severe and might require treatment.
Although no physiologic phimosis treatment is typically required, parents and caretakers of boys affected with this condition should follow some basic guidelines. They should gently retract the foreskin in order to clean the area daily. They should never forcefully retract the foreskin, because this can result in a dangerous condition called paraphimosis. In this state, the foreskin is trapped in the retracted position, and can cut off the blood flow to the end of the penis. People who have their foreskins stuck in retracted positions should visit a doctor immediately or go to the emergency room.
Treatment of pathologic phimosis usually starts with non-invasive techniques, but eventually could require surgery. The first step in phimosis treatment is to apply steroid creams. Using these medications for four to six weeks often resolves the phimosis. Another treatment option can involve using tools or balloons to loosen the foreskin. Over time, these manipulations can stretch the foreskin and resolve the phimosis.
If simple methods such as creams and retraction do not fix the pathologic phimosis, surgery is often an option for phimosis treatment. Circumcision is a procedure that removes the foreskin completely. Other surgical options involve making a slit either in the upper or lower surface of the foreskin. The slit increases the effective diameter of the foreskin, and allows the foreskin to freely move.
Another type of phimosis is adult phimosis, which is often seen as a result of infection, cancer, trauma, or the loss of skin elasticity with age. Men with this condition can have problems with urination and sexual function. Choosing the best phimosis treatment for these men depends on what caused the condition, but options can include surgery, retraction therapy, and cream application. In these patients, an important aspect of therapy is also addressing the underlying reason that the phimosis developed.
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