Phimosis Treatment Procedure,recovery time and Treatment Cost.
The condition where a man is not able to retract the foreskin on his penis is defined as phimosis. This condition is common in young children and young adolescents. Phimosis in adults may be caused by the ballooning of glands and/or due urinary tract infections.
It may be caused by repeated episodes of balanitis (inflammation of glans) or balanoposthitis. These infections are commonly due to poor penile hygiene. In some cases Phimosis may be a presenting a symptom of early diabetes mellitus.
Symptoms of phimosis
The main symptom of phimosis is when your foreskin is stuck in one place, either on the tip or behind the glans of the penis. Another common symptom of phimosis is the swelling of the foreskin while urinating.
Treatment for phimosis is not needed unless it causes symptoms like pain, soreness, swelling. Usually, these symptoms resolve themselves but if your phimosis interferes with a healthy erection or urination you must see an urologist or a sexologist near you immediately.
Recurrent infections of the glans or foreskin must also be evaluated. Signs of an infection can be:
- Changes in the colour of the glans or foreskin
- Presence of spots or rash
Treatment for phimosis
If your phimosis does not gradually improve and you have problems urinating or with an erection, please see a specialist. The doctor can check whether the phimosis is natural or acquired and whether pulling back can lead to paraphimosis.
The need for treatment will depend on the age of the patient and the extent of the problem and its cause. You should never try to force the foreskin back as it might be very painful and may lead to small injuries and scarring which can make it even harder to pull the foreskin back. This is known as pathological phimosis.
If the foreskin is too tight it might get stuck behind the head when it is pulled back resulting in the formation of a ring that restricts the blood supply to the glans. This may lead to a medical emergency called paraphimosis which must be treated by a doctor immediately.
If your phimosis does require a treatment, there are various treatment options available such as:
- Continue to wait
- Using a steroid cream
- Surgery to partially or completely remove the foreskin
Your doctors might suggest you waiting to see whether the problem might get better on its own, you can also start using a steroid cream to treat your phimosis.
When the foreskin becomes too tight or stuck to the head, this results in secondary phimosis which typically requires surgery.
Treatment with steroid cream
This non-surgical approach to treating phimosis involves the application of steroid cream to the tip of the foreskin twice a day over a period of four to eight weeks. The steroid cream makes it easier to stretch the skin. After two weeks, one can try to gradually stretch the foreskin once a day. It is important to stretch the skin gently so as not to damage the foreskin. The foreskin can be pulled back and the cream can be applied to the front part of the glans that is exposed and the foreskin must be retracted to its normal position.
An international research network found out that this treatment is often successful with a success rate of 87% with steroid cream treatment.
If phimosis still persists or pain or complications occur, surgery is considered to be a good idea.
Surgical treatment of phimosis
Surgical treatment of phimosis is usually a partial or a full circumcision. A full circumcision involves removing the entire foreskin whereas a partial circumcision is the removal of only the tight part of the foreskin or to keep the foreskin and simply widen it. Surgeons make lengthwise cuts into the foreskin in two or three places and then close the cuts by stitching across them.
In partial circumcisions or in surgical procedures that do not involve the removal of the foreskin, it may become tight or stuck to the head of the penis after some time. If the entire foreskin is removed, the head of the penis is no longer covered by foreskin and phimosis is no longer a problem.
This procedure is usually carried out under general anaesthesia in children and adults, it can also be carried out using a local anaesthetic to numb the area.
The recovery period usually takes at least 10 days for your penis to heal from a partial circumcision. You doctor will advise you on what to do and what not, you will probably be advised to take at least 1 week off from work to recover.
Side effects and Risk factors
The side effects of the surgery are uncommon. Only about 5% of men have side effects like bruising on the penis but it is not harmful and usually will fade away on its own. Only 2% of people who have the surgery will experience complications that need to be treated. Some of these complications may include bleeding, inflammation or curving of the penis or tightening of the urethra opening.
If only part of the foreskin is removed it may lead to the recurrence of phimosis and in such cases, a second operation is usually done to remove all of the foreskins.
Cost of phimosis surgery
Like any medical treatment, the cost of treatment or surgery varies with the clinic, doctor’s experience and the post operative care that will be needed. At our clinic, we try to keep the rates as affordable as possible relative to the care we give to our patients.