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Understanding Phimosis: Causes, Treatments, and Alternatives to Circumcision


Male circumcision is a topic that often does not receive the attention it deserves, leading to a lack of information about conditions related to the foreskin. Among these conditions, phimosis is a common yet often misunderstood issue. This blog aims to shed light on phimosis, its causes, available treatments, and alternatives to the traditional solution of circumcision.

What is Phimosis in Adults and Men?

Phimosis refers to a condition where the foreskin is too tight to be pulled back, making it difficult or impossible to expose the tip of the penis. While some cases may resolve naturally as children grow, others can lead to complications when left untreated. Let’s delve into this condition’s details and explore its contributing factors.

Causes of Phimosis

  1. Skin Conditions: Skin disorders like Balanitis xerotica obliterans (BXO), Lichen planus, or Eczema can result in scarring that leads to phimosis.
  2. Infections: Studies show that circumcised men have a lower risk of sexually transmitted infections such as syphilis, chancroid, and genital herpes (HSV-2).
  3. Scarring: Severe scarring, often caused by BXO, can tighten the foreskin.
  4. Potential Cancer: Uncircumcised men have an increased risk of penile cancer. Phimosis, especially chronic, is linked to a higher incidence of penile cancer.

Differentiating Between Types of Phimosis in Children and Adults

It’s essential to distinguish between physiological phimosis (natural tight foreskin) and pathological phimosis (diseased or scarred foreskin). Treatment options vary depending on the type and severity of phimosis.

Nonsurgical Treatment Options

For mild cases, nonsurgical treatments may be effective:

  1. Steroid Cream/Ointment: Applying these can help reduce inflammation and loosen the foreskin.
  2. Stretching Exercises: Gentle stretching exercises can gradually increase the flexibility of the foreskin.
  3. Anti-Fungal or Antibiotics: These can be used to address infections contributing to phimosis.

However, it’s crucial to note that scarred foreskin in children and adults might not respond well to stretching and could lead to further complications.

Surgical Treatments for Tight Foreskin

When nonsurgical methods fall short, surgical interventions are considered:

  • Frenuloplasty: A procedure to release the frenulum, allowing the foreskin to detach from the head of the penis.
  • Preputioplasty: This procedure involves an incision to expand the foreskin’s diameter, facilitating retraction.
  • Partial Circumcision: Removing part of the foreskin, leaving some coverage over the glans.
  • Full Circumcision: The complete removal of the foreskin, often considered for severe cases like BXO phimosis or penile cancer.

Considering Alternatives to Circumcision

If full circumcision isn’t preferred, alternatives include various treatments and procedures. These can be discussed with specialists or urologists based on individual preferences and needs.


Phimosis in men and children is a condition that requires attention and proper treatment. Whether it’s physiological or pathological, understanding the causes and available treatments is essential for maintaining penile health. While surgical options like circumcision exist, nonsurgical methods and alternative treatments offer viable choices. If you or someone you know is experiencing phimosis, consulting with a top London Urologist will provide insights into the best course of action for the best sexual health.

Please book at the London Circumcision Centre for further consultation and circumcision.

Adult Circumcision, London UK

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