Phimosis in children

What is it?

It is the presence of a fibrous ring at the level of the foreskin, which makes it difficult or even impossible to retract the foreskin.

In the most severe forms, the foreskin is so thick that the external opening of the urethra is not visible: when the child urinates, the urine first collects under the foreskin, forming a kind of balloon, and then comes out.

In less severe forms, the foreskin may be pushed back, and the fibrous ring looks like a collar that squeezes the penis, giving it an hourglass appearance.

Causes and risk factors

By the age of 3, 10 out of 100 children have phimosis.

Phimosis may be present from birth or as a result of trauma after a sudden pulling away of the foreskin.

Which are the symptoms?

Phimosis may be asymptomatic. In other cases, it may cause the following problems

·         inflammation of the glans and foreskin (balanopostitis) with redness, swelling and burning of the glans and foreskin due to an accumulation of urine under the foreskin;

·         paraphimosis: the foreskin, once retracted to open the glans, can no longer be put back in place; the fibrous ring increasingly suffocates the penis, which becomes more and more swollen, making it even more difficult to lift the foreskin. The child experiences severe pain.

This is a serious complication and the child should be taken as soon as possible to the emergency room of the nearest hospital, where the foreskin will be manually returned to the correct position. If this fails, an emergency circumcision operation is performed. Therefore, if phimosis is suspected, it is advisable not to retract the foreskin until the doctor has determined the actual condition;

·         painful erections and difficulty with intercourse in adulthood.

How is it treated?

If phimosis is present, a circumcision operation is performed, which is the removal of the foreskin with an electric scalpel and the application of several stitches.

It is a common, uncomplicated operation that takes about 15 minutes. A few hours after surgery, the child is in good general condition and can be discharged.

The operation is definitive and solves the problem.

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