A normal adult male can retract the foreskin of penis from penis head. This is normal and it does not cause any pain. This physiology of male sex organ provides a smooth and comfortable penis erection during intercourse. During sexual stimulus, penis shaft and head increase their length and weight and prepuce retract back and makes head visible.
But when a male is not able to do it, that condition is called phimosis. It happens because the opening of prepuce is small and it does not allow head of penis to pass through it. Thus foreskin of penis is unable to retract back over head.
Phimosis in child:
All male babies are born with it so this is normal. Foreskin of penis or prepuce has small opening and foreskin is attached to glans. Slight retraction of prepuce starts with the age of 4 to 7 years, but complete retraction of prepuce is only acquired after puberty in between the age of 13 to 16 years.
Phimosis in adults:
Only after the age 16, it is considered as Phimosis in adults. It has two types:
1. Congenital or physiological Phimosis- As mentioned above, in all males the complete retraction of prepuce is acquired in the age of 13 to 16 years, but some male do not acquire retraction of prepuce after that age. It is classified as congenital.
2. Pathological Phimosis- It is due to injury or infection.
Most of the time, it is not possible to differentiate between the two.
Symptoms of Phimosis:
- Unable of retraction of prepuce- The most common and important symptom.
- Ballooning of prepuce while urination– In complete Phimosis, prepuce opening swells and shows the appearance of the balloon while urination.
- Pain in urination
- Blood in urine
- Frequent urine infection and balanitis (infection of penis head or glans)
- Pain or inability of sex- This is because of forceful retraction of penis
- White ring- Opening of prepuce shows some white spot, these spots are fibrosis of the previous scar.
Reasons of Phimosis:
There are mainly three reasons which are as follows:
- Opening of prepuce is too small to slide back of penis head.
- Prepuce muscles are attached with head of penis.
- Frenulum is too short ( Frenulum is small elastic band type structure which connects prepuce and glans penis)
- Scar of prepuce– Forceful retraction of prepuce can cause minor injury, which gradually heals but leaves scar tissue. Scar tissues are hard and develop into phimosis.
- Injury or cut in prepuce– If any injury or cut happens in the prepuce then it causes phimosis.
- Infection of penis head (glans penis) – Chronic and recurrent infection of glans penis. Sclerosis disease of the penis is the main and most common cause of pathological Phimosis. Sclerous scar are non-elastic scar, which prevents retraction of foreskin.
- Diabetes- Diabetic person has the higher risk for phimosis. Increased amount of glucose in urine increases the chance of infection thus increases chance of it.
Severity of Phimosis:
There are 5 grade of it, which are as follows:
- Grade 1- Full retraction of prepuce, but tightly and with small discomfort.
- Grade 2- Half retraction. Only half of glans penis is visible after retraction.
- Grade 3– Little less than half retraction, only meatus can be seen.
- Grade 4- Very less open, minimal distance seen between glans and opening of prepuce.
- Grade 5- No retraction. Foreskin attached to glans.
In child less than 13 year does not need any treatment. After age of 13 years it is good to go for clinical checkup just to rule out any other complications. One should take effective treatment for it after the age of 16 only.
Relaxation massage or forceful retraction should not try as it may worsen the condition.
- Steroid cream for phimosis– Phimosis cream is the combinations of steroid. Application of steroid cream (such as betamethasone- dexamethasone etc) reduces inflammatory reaction and it also relaxes prepuce opening.
- Phimosis stretching- Gently stretching of the foreskin, after application of the cream, gradually relaxes muscle.
- Antibiotics- They treat infection of glans or UTI.
- Phimosis Surgery- Partial or complete circumcision is last and effective treatment for it.
Phimosis treatment in Ayurveda:
Ayurveda literature Sushurt Samhita, which is known as the most ancient book written on surgery, has defined phimosis as following:
“Injury due to unnatural sex or excessive sex or infection from pathogen causes adhesion in prepuce and penis head, which causes thin streaming of urine and not retraction of penis. This situation is phimosis.”
According to Ayurveda:
- Surgery is the last option.
- Application of chakra tail: Chakra tail is not easily available in market; it is extremely old Ayurveda medicine.
Home remedies and effective treatment:
- Massage with castor oil- Castor oil has property to relax muscle and reduce swelling and it is safe to use in genital area.
- Saindhavadi tailm– It is Ayurveda preparation for Phimosis.it is easily available in market.
- Coconut oil
Take any of the above-mentioned oil; apply at the tip of the penis and prepuce. If tip of penis is open then put few drops of oil in between prepuce and head. Then massage softly and slowly try to stretch foreskin backward. Always be cautious not to hurt or to use extra pressure. Do not retract skin in first chance. Be slow with this treatment.
Do above massage for 2-5 minutes for 2 months. This is a very effective treatment.
Above article is only for knowledge purpose. Please contact your healthcare provider before using any of above medicine or method. For any query or personal consultation according to your health condition Please Contact Us