Treatment of phimosis and paraphimosis: Will cream or other drugs, surgery help?

The treatment options for phimosis and paraphimosis depend on the cause, the severity of the condition and especially the age of the individual.

Phimosis

In the case of phimosis in young boys, it is essential that the foreskin is not forcefully pulled, otherwise it may become torn and scarred.

In the case of conservative treatment, pharmacotherapy and topical corticosteroid ointments are indicated to loosen the adherent and contracted layers of the foreskin. Topical antibiotics can be applied to treat infections.

This type of treatment is resorted to especially after the 2nd-3rd year of the boy's life if the foreskin does not spontaneously relax and retract.

At older ages, a surgical procedure is also performed to break the interlocking layers of the foreskin. In the case of phimosis in adult males, a surgical procedure called circumcision is performed.

During the procedure, the surgeon removes the narrowed part of the foreskin, partially exposing the glans penis. The procedure can be performed under local or general anaesthesia.

Paraphimosis

Treatment of a "stuck" foreskin under the glans penis can be conservative and surgical. The urologist will attempt to expertly pull the foreskin back over the glans to its original position. The doctor uses special anaesthetic (numbing) ointments and moisturising agents.

If displacement of the foreskin is not possible, a surgical procedure is necessary, in which part of the foreskin is cut. However, if the problem is that the foreskin is too narrow (phimosis), a conventional circumcision is usually performed.

Circumcision

Circumcision is a surgical procedure involving the removal of all or part of the foreskin. The procedure can be performed under general or local anaesthesia.

The operation is usually uncomplicated and without major post-operative complications. Patients take prophylactic oral and topical antibiotics after the procedure so that the new wound heals well without risk of infection.

The procedure can now be performed in both public and private medical facilities.

However, phimosis is not the only reason why circumcision is performed. Foreskin removal is also performed for religious beliefs or for sexual reasons (premature ejaculation and consequent reduction of penile irritation).

The health advantages and disadvantages of circumcision are still debated among doctors to this day. The reason is precisely the improved hygienic intimate habits of men after circumcision.