Skip to main content

Phimosis

  • Chapter
  • First Online:
Normal and Abnormal Prepuce

Abstract

Confusion in the precise definition and classification of phimosis results in either over or under estimation of the true incidence of this common condition, most of the practitioners ignoring the fact that normal prepuce is passing through a different stages of maturity from infancy to adulthood, and had a variable ranges of preputial hiatus configuration, with a different degrees of the potential balanopreputial space separation. At the meantime, many researchers are not aware about the difference between phimosis and preputial synechiae, describing the normal neonatal synechiae as a physiological phimosis with a resultant misleading in the incidence rates of both conditions, which translated into unnecessary circumcisions in many young boys. The simple fact that the foreskin non retractability should not be a synonymous with phimosis, phimosis is a pathological condition, characterized by hardening, scaring and stenosis of the tip of the foreskin, banning exposure of the glans penis, it could be a congenital anomaly or an acquired pathology; which is commonly inflammatory in nature.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hodges FM. The history of phimosis from antiquity to the present. In: Oenniston GC, Hodges FM, Milos MF, editors. Male and female circumcision: medical, legal and ethical considerations in pediatric practice. New York: Kluwer Academic/Plenum Publishers; 1999.

    Google Scholar 

  2. Hsu CC. The development of the prepuce. Taiwan Yi Xue Hui Za Zhi. 1983;82:314–20.

    CAS  PubMed  Google Scholar 

  3. Williams N, Chell J, Kapila L. Why are children referred for circumcision? BMJ. 1993;306:28.

    Article  CAS  Google Scholar 

  4. Celsus AC. De Medicina 7.25.2. In: Spencer WG, editor and translator. Cambridge: Harvard University Press; 1938. vol. 3. p. 422.

    Google Scholar 

  5. Dionis P. Cows d’operationsde Chirurgie. Bruxelles: Les Freres t’serstevens; 1708. p. 177.

    Google Scholar 

  6. Hunter J. A treatise on the venereal disease. First American ed. Philadelphia: J Webster; 1818. p. 205–8.

    Google Scholar 

  7. Rickwood AMK, Hemalatha V, Batcup G, Spitz L. Phimosis in boys. Br J Urol. 1980;52:147–50.

    Article  CAS  Google Scholar 

  8. Oenniston GC, Hodges FM, Milos MF, editors. Male and female circumcision: medical, legal and ethical considerations in pediatric practice. New York: Kluwer Academic/Plenum Publishers. p. 37–62. https://doi.org/10.1007/978-0-585-39937-9_5. ISBN 978-0-306-46131-6.

  9. Hajinasrollah M, Mohitmafi S, Asadian A. Two case reports of unusual phimosis in rhesus monkeys (Macaca Mulatta). J Med Primatol. 2018;48:58. https://doi.org/10.1111/jmp.12367.

    Article  PubMed  Google Scholar 

  10. Papazoglou LG, Kazakos GM. Surgical conditions of the canine penis and prepuce. Compend Contin Educ Pract Vet. 2002;24(3):204–18.

    Google Scholar 

  11. Gairdner D. The fate of the foreskin, a study of circumcision. Br Med J. 1949;2(4642):1433–7, illust.

    Article  CAS  Google Scholar 

  12. Oster J. Further fate of the foreskin. Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child. 1968;43(228):200–3.

    Article  CAS  Google Scholar 

  13. Imamura E. Phimosis of infants and young children in Japan. Acta Paediatr Jpn. 1997;39:403–5.

    Article  CAS  Google Scholar 

  14. Hsieh TF, Chang CH, Chang SS. Foreskin development before adolescence in 2149 schoolboys. Int J Urol. 2006;13:968–70.

    Article  Google Scholar 

  15. Favorito LA, Balassiano CM, Rosado JP, Cardoso LEM, Costa WS, Sampaio FJB. Structural analysis of the phimotic prepuce in patients with failed topical treatment compared with untreated phimosis. Int Braz J Urol. 2012;38(6):802–8.

    Article  Google Scholar 

  16. Spilsbury K, Semmens JB, Wisniewski ZS, Holman CD. Circumcision for phimosis and other medical indications in Western Australian boys. Med J Aust. 2003;178(4):155–8.

    Article  Google Scholar 

  17. Celis S, Reed F, Murphy F, Adams S, Gillick J, Abdelhafeez AH, Lopez PJ. Balanitis xerotica obliterans in children and adolescents: a literature review and clinical series. J Pediatr Urol. 2014;10(1):34–9.

    Article  Google Scholar 

  18. Kumar P, Deb M, Das K. Preputial adhesions – a misunderstood entity. Indian J Pediatr. 2009;76:829–32.

    Article  Google Scholar 

  19. Reddy CRRM, Devendranath V, Pratap S. Carcinoma of penis - role of phimosis. Urology. 1984;24(1):85–8. https://doi.org/10.1016/0090-4295(84)90398-4.

    Article  CAS  PubMed  Google Scholar 

  20. Johal N, Cuckow P. Phimosis and buried penis. In: Puri P, Höllwarth M, editors. Pediatric surgery, Springer surgery atlas series. Berlin: Springer; 2019.

    Google Scholar 

  21. Bromage SJ, Crump A, Pearce I. Phimosis as a presenting feature of diabetes. BJU Int. 2008;101(3):338–40.

    Article  Google Scholar 

  22. Atilla MK, Dundaroz R, Odabas O, et al. A nonsurgical approach to the treatment of phimosis: local nonsteroidal anti-inflammatory ointment application. J Urol. 1997;158:196–7.

    Article  CAS  Google Scholar 

  23. Beaugé M. The causes of adolescent phimosis. Br J Sex Med. 1997;24:26.

    Google Scholar 

  24. Shahid SK. Phimosis in children (Review Article). ISRN Urol. 2012;2012:707329. https://doi.org/10.5402/2012/707329.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Santander CB, Campos E, Sánchez A, Marcos L, Díaz I. Púrpura de Schönlein-Henoch con afectación peniana. Caso clínico. Arch Argent Pediatr. 2016;114(4):e249–51.

    Google Scholar 

  26. Paulson DF. Genitourinary cancer, basic and clinical aspects. In: Cancer treatment research, vol. 6. 1st ed; 1982. p. 32. ISBN 90-247-2480-5.

    Google Scholar 

  27. Das S, Tunuguntla HS. Balanitis xerotica obliterans—a review. World J Urol. 2000;18(6):382–7.

    Article  CAS  Google Scholar 

  28. Yardley IE, Cosgrove C, Lambert AW. Paediatric preputial pathology: are we circumcising enough? Ann R Coll Surg Engl. 2007;89:62–5. https://doi.org/10.1308/003588407X160828.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. lalock HJ, Vemulakonda V, Ritchey ML, Ribbeck M. Outpatient management of phimosis following newborn circumcision. J Urol. 2003;169(6):2332–6.

    Article  Google Scholar 

  30. Turgut M, Yenilmez A, Can C, Bildirici K, Erkul A, Ozyurek Y. Fibroepithelial polyp of glans penis. Urology. 2005;65:593.

    Article  Google Scholar 

  31. Madsen BS, van den Brule AJC, Jensen HL, Wohlfahrt J, Frisch M. Risk factors for squamous cell carcinoma of the penis—population-based case-control study in Denmark. Cancer Epidemiol Biomark Prev. 2008;17(10):2683.

    Article  CAS  Google Scholar 

  32. Velazquez EF, Bock A, Soskin A, Codas R, Arbo M, Cubilla AL. Preputial variability and preferential association of long phimotic foreskins with penile cancer. Am J Surg Pathol. 2003;27(7):994–8.

    Article  Google Scholar 

  33. Douglawi A, Masterson TA. Updates on the epidemiology and risk factors for penile cancer. Transl Androl Urol. 2017;6:785–90.

    Article  Google Scholar 

  34. Ashfield JE, Nickel KR, Siemens DR, Mac Neily AE, Nickel JC. Treatment of phimosis with topical steroids in 194 children. J Urol. 2003;169:1106–8.

    Article  CAS  Google Scholar 

  35. Kolehmainen M, Taskinen S, Ossi L. Foreskin surgery. Duodecim. 2010;126:75–83.

    PubMed  Google Scholar 

  36. Christianakis E. Sutureless prepuceplasty with wound healing by second intention: an alternative surgical approach in children’s phimosis treatment. BMC Urol. 2008;8:6. https://doi.org/10.1186/1471-2490-8-6.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Yachia D. Text atlas of penile surgery. London: Informa Healthcare; 2007. ISBN 1-84184-517-5. p. 16.

    Book  Google Scholar 

  38. Goodwin WE. Uncircumcision: a technique for plastic reconstruction of a prepuce after circumcision. J Urol. 1990;144(5):1203–5. https://doi.org/10.1016/s0022-5347(17)39693-3.

    Article  CAS  PubMed  Google Scholar 

  39. Wåhlin N. “Triple incision plasty”. A convenient procedure for preputial relief. Scand J Urol Nephrol. 1992;26(2):107–10.

    Article  Google Scholar 

  40. Christianaki E. Sutureless prepuceplasty with wound healing by second intention: an alternative surgical approach in children’s phimosis treatment. BMC Urol. 2008;8:6. https://doi.org/10.1186/1471-2490-8-6.

    Article  Google Scholar 

  41. Kumar R, Pareek R. A holistic approach to phimosis in children. J Ayurveda Integr Med Sci. 2018;1:66–9. https://doi.org/10.21760/jaims.v3i01.11641.

    Article  Google Scholar 

  42. Ying H, Zhou X-H. Balloon dilation treatment of phimosis in boys. Chin Med J. 1991;104(6):491–3.

    Google Scholar 

  43. Cicia S, Florio G. Postectomy for phimosis: 5-year-experience. Chir Ital. 2000;52(6):733–6.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Fahmy, M.A.B. (2020). Phimosis. In: Normal and Abnormal Prepuce. Springer, Cham. https://doi.org/10.1007/978-3-030-37621-5_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-37621-5_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-37620-8

  • Online ISBN: 978-3-030-37621-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics