Phimosis treatment includes both conservative management with steroid ointments and surgical options such as foreskin plasty, frenuloplasty, or circumcision. The choice of method depends on the patient’s age, the degree of narrowing, and the presence of complications.
Early intervention helps prevent inflammation, improves hygienic comfort, and eliminates pain during sexual activity.
Phimosis is a narrowing of the foreskin ring that prevents full retraction of the glans. It may be congenital (physiological in boys under the age of 3) or acquired as a result of scarring after inflammation or micro-injuries. In adults, the condition persists in approximately 2–3% of the population and often requires surgical treatment.
A narrowed foreskin makes urination and intimate hygiene difficult; the accumulation of smegma, urine, and bacteria promotes inflammation of the glans and foreskin. Some patients experience painful erections, which negatively affects sexual function. Chronic inflammation increases the risk of scarring and the development of secondary cicatricial phimosis.
The doctor assesses the possibility of foreskin retraction, the degree of narrowing, and the condition of the skin. A physical examination is the standard diagnostic method. Scrotal or urethral ultrasound may be performed if there is suspicion of external meatal stenosis or cicatricial changes in the urethral shaft. Before surgery, if necessary, local infections are treated with antiseptics and topical antibiotics to ensure patient safety and optimal healing.
Foreskin plasty (widening of the opening) – The surgeon makes longitudinal incisions in the narrowed ring and sutures them transversely. This procedure preserves the foreskin, lasts about 30–40 minutes, and is performed under local anesthesia.
Frenuloplasty – The short frenulum is lengthened either by a transverse incision closed longitudinally or by wedge excision. The procedure improves foreskin retraction and reduces pain during erection.
Circumcision – Complete removal of the foreskin is indicated in cases of cicatricial phimosis, recurrent inflammation, or recurrent fungal infections. The operation takes 20–40 minutes and involves absorbable sutures and a compression dressing. In adults, it is performed on an outpatient basis under local penile block or regional anesthesia.
The dressing should be changed after 24 hours, and the penis should be kept elevated using supportive elastic underwear. Swelling and minor bleeding may persist for up to 5 days. The stitches dissolve within 3–4 weeks, and sexual abstinence is recommended for 4–6 weeks.
At our urology clinic, we provide comprehensive diagnostics, qualification for conservative treatment, and perform procedures such as foreskin plasty, frenuloplasty, as well as partial and complete circumcision. All procedures are carried out by a specialist urologist under local anesthesia, using absorbable sutures.
Postoperative follow-up visits are recommended.