Phimosis: Difference between revisions
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[[File:Phimosis.jpg|thumb|An erect penis with a case of phimosis]] | [[File:Phimosis.jpg|thumb|An erect penis with a case of phimosis]] | ||
'''Phimosis''' (''fɪˈmoʊsɨs'' or ''faɪˈmoʊsɨs'', from the Greek ''phimos'' (φῑμός "muzzle"), in adults is a natural variant of the [[penis]] in which the [[foreskin]] cannot be fully retracted over the [[glans penis]] to uncover and expose the [[glans penis]] that occurs in | '''Phimosis''' (''fɪˈmoʊsɨs'' or ''faɪˈmoʊsɨs'', from the Greek ''phimos'' (φῑμός "muzzle"), in adults is a natural variant of the [[penis]] in which the [[foreskin]] cannot be fully retracted over the [[glans penis]] to uncover and expose the [[glans penis]] that occurs in up to ten percent of [[foreskinned]] adult males.<ref>{{REFweb | ||
|url=https://www.phimosis.care/ | |||
|title=phimosis.care | |||
|last=Anonymous | |||
|publisher=Thames Metal Designs | |||
|date=2024 | |||
|accessdate=2026-04-25 | |||
}}</ref> A medical dictionary defines phimosis as "Tightness of the foreskin (prepuce) of such degree as to prevent retraction. This may be congenital or the result of inflammation. Severe phimosis that interferes with urination is an indication for circumcision. From the Greek <i>phmoun</i>, to gag or muzzle."<ref>{REFweb | |||
|url=https://medical-dictionary.thefreedictionary.com/phimosis | |url=https://medical-dictionary.thefreedictionary.com/phimosis | ||
|title=Phimosis | |title=Phimosis | ||
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Phimosis is classed as [[physiological phimosis]] or [[pathological phimosis]]. The physiological phimosis condition in adults is a natural variant, not a disease, so it does not threaten health. Men may elect to treat it or not treat it. Some men live their entire lives with a non-retractile foreskin. [[Sex with phimosis| They are able to have sexual intercourse and father children]]. | Phimosis is classed as [[physiological phimosis]] or [[pathological phimosis]]. The physiological phimosis condition in adults is a natural variant, not a disease, so it does not threaten health. Men may elect to treat it or not treat it. Some men live their entire lives with a non-retractile foreskin. [[Sex with phimosis| They are able to have sexual intercourse and father children]]. | ||
[[Adult circumcision]] is an <i>elective</i> surgical [[amputation]]. One choses to be [[circumcised]] and must first grant [[informed consent]]. When a man states, "<b>I had to have a circumcision</b>," it is usually a lie. | |||
==Positive aspects of phimosis== | ==Positive aspects of phimosis== | ||
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* <b>Alternative Intimacy Experiences:</b> Individuals with phimosis sometimes develop unique approaches to intimacy that focus on broader sensual experiences rather than conventional techniques. | * <b>Alternative Intimacy Experiences:</b> Individuals with phimosis sometimes develop unique approaches to intimacy that focus on broader sensual experiences rather than conventional techniques. | ||
Some men state that they prefer non-retractable foreskin over retractable foreskin. | |||
==Physiologic phimosis== | ==Physiologic phimosis== | ||
[[Michel Beaugé| Beaugé]] (1997) states that adult phimosis persists when the individual uses unusual methods of [[masturbation]] that fail to stretch the narrow foreskin of [[Foreskin#Foreskin_in_infancy_and_childhood| childhood]].<ref name="beauge1997">{{REFjournal | [[Michel Beaugé| Beaugé]] (1997) states that adult phimosis persists when the individual uses unusual methods of [[masturbation]] that fail to stretch the narrow foreskin of [[Foreskin#Foreskin_in_infancy_and_childhood| childhood]].<ref name="beauge1997">{{REFjournal | ||
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From a medical standpoint, an otherwise symptom-free [[phimosis]], even after dissolution of preputial adhesions, does not require any treatment before the child enters [[puberty]]. The widespread notion that full retractability has to be achieved by a certain age, derives from obsolete assumptions and studies which only covered children's development until they entered school, but not beyond that point. | From a medical standpoint, an otherwise symptom-free [[phimosis]], even after dissolution of preputial adhesions, does not require any treatment before the child enters [[puberty]]. The widespread notion that full retractability has to be achieved by a certain age, derives from obsolete assumptions and studies which only covered children's development until they entered school, but not beyond that point. | ||
Even though the data from [[Jakob Øster]]'s studies have been known for more than half a century,<ref name="Øster1968">{{OesterJ 1968}}</ref> some check lists for school doctors‘ examinations still erroneously refer to [[physiological phimosis]] as an abnormality. | Even though the data from [[Jakob Øster]]'s studies have been known for more than half a century,<ref name="Øster1968">{{OesterJ 1968}}</ref> some check lists for school doctors‘ examinations still erroneously refer to normal, healthy [[physiological phimosis]] as an abnormality. | ||
In most cases, only watchful waiting is necessary, not surgery or other treatment. Parental reassurance is the only treatment required.<ref name="shahid2012" /> | In most cases, only watchful waiting is necessary, not surgery or other treatment. Parental reassurance is the only treatment required.<ref name="shahid2012" /> | ||
By age 10.4 years, about 50 percent of [[intact]] boys have a retractable [[foreskin]].<ref name="Øster1968"/><ref name-"thorvaldsen2005">{{REFjournal | By age 10.4 years, about 50 percent of [[intact]] boys have a retractable [[foreskin]] and about 50 percent do not have a retractable foreskin.<ref name="Øster1968"/><ref name-"thorvaldsen2005">{{REFjournal | ||
|last=Thorvaldsen | |last=Thorvaldsen | ||
|init=MA | |init=MA | ||
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A [[Adolescent and adult circumcision| circumcision]] may be indicated in severe cases of pathological phimosis, where neither non-surgical methods with corticosteroid cream nor foreskin-preserving [[preputioplasty]] are promising (for example with chronic [[balanitis xerotica obliterans]]) or have failed in previous attempts. | A [[Adolescent and adult circumcision| circumcision]] may be indicated in severe cases of pathological phimosis, where neither non-surgical methods with corticosteroid cream nor foreskin-preserving [[preputioplasty]] are promising (for example with chronic [[balanitis xerotica obliterans]]) or have failed in previous attempts. | ||
==Pathological phimosis== | ==Pathological phimosis== | ||
Pathologic phimosis is phimosis caused by lichen sclerosis et atrophicrus (LSA), formerly known as [[balanitis xerotica obliterans]] (BXO), on the [[foreskin]].<ref name="rickwood1980">{{REFjournal | Pathologic phimosis is phimosis caused by lichen sclerosis et atrophicrus (LSA), formerly known as [[balanitis xerotica obliterans]] (BXO), on the [[foreskin]].<ref name="milos2022-09-19">{{REFweb | ||
|url=https://intactamerica.org/ask-marilyn-can-a-tight-foreskin-be-treated-without-circumcision/ | |||
|title=Ask Marilyn—Can a Tight Foreskin be Treated without Circumcision? | |||
|last=Milos | |||
|first= | |||
|init=MF | |||
|author-link=Marilyn Fayre Milos | |||
|publisher=Intact America | |||
|date=2022-09-19 | |||
|accessdate=2024-10-24 | |||
}}</ref> <ref name="rickwood1980">{{REFjournal | |||
|last=Rickwood | |last=Rickwood | ||
|first= | |first= | ||
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|doi= | |doi= | ||
|accessdate=2024-01-13 | |accessdate=2024-01-13 | ||
}}</ref> | }}</ref> | ||
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* Elongation of the frenulum with a [[skin]] graft. | * Elongation of the frenulum with a [[skin]] graft. | ||
Circumcision is not appropriate or necessary to treat [[frenulum breve]]. Patients must be careful when consulting a urologist, because urologists earn an attractive fee from performing | Circumcision is not appropriate or necessary to treat [[frenulum breve]]. Patients must be careful when consulting a urologist, because urologists earn an attractive fee from performing an [[adult circumcision]], so may be quick to recommend inappropriate and unnecessary injurious [[circumcision]] to an unwary patient. | ||
==Hygiene== | |||
The normal non-retractable [[foreskin]] may be easily flushed out with warm water and a [https://www.amazon.com/Syringe-Removing-Syringing-Medi-Grade/dp/B0842B1XMR?sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&psc=1 rubber-bulb type ear syringe]. Excessive washing and the use of soap should be avoided.<ref name="Birley1991">{{REFjournal | |||
|last=Birley | |||
|init=HDL | |||
|author-link= | |||
|last2=Wasker | |||
|init2=MM | |||
|last3=Luzzi | |||
|init3=GA | |||
|etal=yes | |||
|title=Clinical Features and management of recurrent balanitis; association with atopy and genital washing | |||
|journal=Genitourin Med | |||
|date=1993-10-01 | |||
|volume=69 | |||
|issue=5 | |||
|pages=400-3 | |||
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1195128/pdf/genitmed00029-0074.pdf | |||
|quote= | |||
|pubmedID=8244363 | |||
|pubmedCID=1195128 | |||
|DOI=10.1136/sti.69.5.400 | |||
|accessdate=2025-12-05 | |||
}}</ref> | |||
==Video== | ==Video== | ||
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* [[Frenulum breve]] | * [[Frenulum breve]] | ||
* [[Issues with American urologists and the practice of male circumcision]] | * [[Issues with American urologists and the practice of male circumcision]] | ||
* [[Jojoba]] | |||
* [[Longer foreskin is favored]] | * [[Longer foreskin is favored]] | ||
* [[Mitosis]] | * [[Mitosis]] | ||
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|date= | |date= | ||
|accessdate=2023-11-01 | |accessdate=2023-11-01 | ||
}} | |||
* {{REFweb | |||
|url=https://www.phimosis.care/ | |||
|title=phimosis.care | |||
|last=Anonymous | |||
|publisher=Thames Metal Designs | |||
|date=2024 | |||
|accessdate=2026-04-25 | |||
}} | }} | ||
* {{REFweb | * {{REFweb | ||
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|accessdate=2025-11-23 | |accessdate=2025-11-23 | ||
}} | }} | ||
* {{REFweb | |||
|url=https://www.reddit.com/r/Intactivists/comments/1nwbfkw/belgium_drops_coverage_for_circumcisions_for/ | |||
|title=Belgium drops coverage for circumcisions for phimosis | |||
|last=Anonymous | |||
|first= | |||
|init= | |||
|author-link= | |||
|publisher=REDDIT | |||
|date=2025-10 | |||
|accessdate=2026-01-07 | |||
}} | |||
The following link contains graphic images and is only for those who are 18 years of age and older. | |||
* {{NSFW}} {{REFweb | |||
|url=https://www.reddit.com/r/Phimosisappreciation/ | |||
|title=Phimosis appreciation | |||
|last=Anonymous | |||
|publisher=Reddit | |||
|accessdate=2026-03-11 | |||
}} | |||
{{REF}} | {{REF}} | ||