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'''Phimosis''' (''fɪˈmoʊsɨs'' or ''faɪˈmoʊsɨs'', from the Greek ''phimos'' (φῑμός "muzzle"), is a condition of the [[penis]] where the [[foreskin]] cannot be fully retracted over the [[glans penis]].<ref>{{URLwikipedia|Phimosis|Phimosis|2019-09-25}}</ref> Phimosis is a condition, not a disease. Phimosis may or may not require treatment. Some men live their entire lives with a non-retractile foreskin. They are able to have sexual intercourse and father children.
Beaugé (1997) states that adult phimosis is caused by unusual methods of [[masturbation]] that fail to stretch the narrow foreskin of [[https://en.intactiwiki.org/wiki/Foreskin#Foreskin_in_infancy_and_childhood| childhood]].<ref name="beauge1997">{{REFjournal
|last=Beaugé
|first=Michel
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 51 54 years,<ref name="Øster1968">{{OesterJ 1968}}</ref> some check lists for school doctors‘ examinations still erroneously refer to 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" />
By age 10.4 years, about 50 percent of [[intact ]] boys have a retractable foreskin.<ref name="Øster1968"/><ref name-"thorvaldsen2005">{{REFjournal
|last=Thorvaldsen
|init=MA
|DOI=
|accessdate=2019-11-01
}}</ref> Most of the rest develop a retractable foreskin in their teenage years.<ref name="Øster1968"/> About two percent of adult males live with a non-retractable [[foreskin]].<ref name="shahid2012" />
If treatment is deemed necessary, the application of topical steroid ointment to assist manual stretching is the most cost-effective treatment.<ref name="vanhowe1998">{{REFjournal
}}</ref>
This option preserves the [[foreskin]], its appearance, and most of the protective, immunological, sensory, and sexual [[https://en.intactiwiki.org/wiki/Foreskin#Physiological_functions physiological functions]], but does not make the foreskin retractable.
==== Manual stretching ====
|DOI=10.1016/j.surge.2019.08.004
|accessdate=2021-06-26
}}</ref> A good cosmetic result and total preservation of the [[foreskin ]] are achieved. The basic principle of most of those methods consists of making one or more small longitudinal incisions, and then suturing the wound or wounds transversely.
There are several different methods:
Phimosis or tight foreskin may be caused by a yeast infection. The proper treatment is to use an anti-fungal drug such as, for examle, a cream that contains Clotrimazole.
Lichen Sclerosis, formerly called [[balanitis xerotica obliterans]] when it occurs in males, hardens the [[foreskin ]] and makes it non-retractable.
In pathological phimosis, the foreskin cannot be retracted over the glans without injury, due to a lack of elasticity caused by scarring or hardening.
If the [[frenulum]] is too short, it can hinder or even prohibit retraction of the foreskin. If the mechanical strain is too great, the frenulum can tear or rip apart. If the frenular artery, which runs within, is damaged in the process, it can lead to considerable and prolonged [[bleeding]]. When only small tears appear, it may heal spontaneously.
[[Frenulum breve]] is frequently confused with phimosis. To make a differential diagnosis, one may attempt to retract the foreskin when the penis is erect. Since the underside of the glans is attached to the inner foreskin by the [[frenulum]], if frenulum breve is present, the head of the penis will bend downwards due to the resulting tension when the foreskin is retracted.
To help the healing, lukewarm camomile baths or cremes containing panthenol can be applied. With a very short frenulum and previous large tears, surgical treatment is advised.
* 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 a nice an attractive fee from performing a circumcision, so may be quick to recommend inappropriate and unnecessary injurious [[circumcision]] to an unwary patient.
{{SEEALSO}}