Phimosis is a medical condition characterized by tightness of the foreskin that prevents it from being retracted behind the glans penis.
Types of Phimosis
Non-surgical (physiological) phimosis: This is the most common type, occurring in about 60% of newborn males. The foreskin is tight due to immaturity.
Surgical (pathological) phimosis: This is caused by scarring or fibrosis of the foreskin, often as a result of injury, infection, or inflammation.
Phimosis with a hooded prepuce: This is a variation of non-surgical phimosis where the foreskin is tightly adherent to the glans penis, forming a hood-like structure.
Aetiology and pathophysiology of phimosis
Causes: Tightness of the foreskin due to immaturity, scarring, or fibrosis.
Pathophysiology: The foreskin fails to separate from the glans penis, leading to discomfort and difficulty during urination or ejaculation.
Clinical features of phimosis
Symptoms: Difficulty retracting the foreskin, pain during urination or ejaculation, and discomfort or pain during intercourse.
Physical examination: Tight foreskin, possibly with a hooded prepuce.
Complications of phimosis
Urinary tract infections: The tight foreskin can trap bacteria, leading to infections.
Circumcision: In severe cases, circumcision may be necessary to relieve symptoms.
Infertility: Phimosis can lead to difficulties with ejaculation, potentially affecting fertility.
Management of phimosis
Topical creams: Steroid creams can help soften the foreskin, making it easier to retract.
Manual stretching: Gradual manual stretching can help loosen the foreskin.
Circumcision: In severe cases, circumcision may be necessary to relieve symptoms.
Homoeopathic therapeutics for phimosis
Thuja occidentalis: For tightening of the foreskin and difficulty retracting.
Calendula officinalis: For inflammation and infection.
Sabal serrulata: For urinary tract infections and difficulties with urination.
Graphites: For phimosis with a hooded prepuce.
Cantharis: For burning sensations and pain during urination.
Apis mellifica: For inflammation and swelling.
Investigations
Clinical examination: The primary investigation is a thorough clinical examination to assess the tightness of the foreskin and any associated symptoms.