Rigi10™ Malleable Penile Prosthesis
Also Known As
Tight foreskin, preputial stenosis, congenital phimosis, acquired phimosis.
Definition
Phimosis is a condition affecting uncircumcised males where the foreskin (prepuce) is too tight to be retracted (pulled back) from the head (glans) of the penis.¹ It can be physiological, commonly seen in infants and young children, which usually resolves spontaneously with age.² Pathological phimosis, on the other hand, can occur at any age and is often the result of scarring, infection, or inflammation, such as from conditions like balanitis xerotica obliterans (BXO), also known as lichen sclerosus.³⁻⁴ The primary purpose of a retractable foreskin is to allow for proper hygiene and comfortable sexual function. In phimosis, the inability to retract the foreskin can lead to difficulties with cleaning, painful erections, and an increased risk of infections.¹
Clinical Context
Phimosis is typically identified during routine physical examinations or when symptoms arise. In children, physiological phimosis is common and often requires no intervention beyond gentle hygiene, as the foreskin naturally becomes retractable over time.² Patient selection for treatment depends on the type and severity of phimosis and the presence of complications. Pathological phimosis, or physiological phimosis persisting into adolescence or adulthood causing symptoms, usually warrants treatment.¹ Symptoms that may necessitate intervention include pain, recurrent infections (balanitis or posthitis), difficulty urinating (such as ballooning of the foreskin during urination)⁵, or interference with sexual activity. Conservative treatment options, particularly for milder cases or in children, include the application of topical corticosteroid creams for 4-8 weeks, which can help soften the foreskin and improve retractability.⁶⁻⁷ Surgical procedures are considered if conservative measures fail or if phimosis is severe or caused by scarring (e.g., BXO).³ Surgical options include preputioplasty (a foreskin-preserving procedure that widens the preputial opening)⁸⁻⁹ or circumcision (complete removal of the foreskin).¹⁰ Expected outcomes after treatment are generally good, with resolution of symptoms and improved hygiene. Recovery from surgical procedures varies but typically involves a few weeks of healing.