Phimosis is a condition of the penis that is characterized by the inability of the foreskin (a retractable fold of skin that covers the head of the penis) to be pulled back or retracted over the penis glans.
Phimosis itself is not necessarily a problem, and as long as it doesn’t exhibit any symptoms such as pain and discomfort, it does not require any surgical intervention.
Severe cases of phimosis, however, usually require surgical procedures such as circumcision for treatment.Â
Virtually all newborns and young boys have a tight foreskin, similar to phimosis. As a person continues to age, however, the foreskin slowly begins to loosen up on its own, and, by adolescence, most people can retract the foreskin as required.
In some cases, though, the foreskin may not retract and cause symptoms such as pain while urinating, swelling and tenderness around the foreskin, weak flow of urine, frequent Urinary Tract Infection (UTI), and recurrent infections such as balanitis.Â
How Is Phimosis Surgery Performed?
Diagnosis
Tests and diagnostics: Prior to phimosis surgery, your healthcare provider will likely perform a series of simple tests and diagnostics to assess and evaluate your overall health.
These tests will also help your urologist uncover any underlying conditions you may have that could pose a significant threat of complications either during or after surgery.
Diagnosis for phimosis generally begins with a simple, routine physical examination.
In this, the urologist will try to retract the foreskin over the penile glans gently. If the foreskin is unable to be retracted over the penile glans either completely or causes pain while doing so, it is an indication of phimosis.Â
Alongside, your urologist may also perform some additional tests to determine the severity of your condition and make sure there is no infection on the penis either. Some tests that your urologist may perform before phimosis surgery include:Â
- Urinalysis: A urinalysis is performed to check for urinary tract infection, diabetes, or kidney problems you may have.Â
- Swab test: A swab test is commonly performed to check for the presence of any bacteria or excess microbes under the foreskin. In a swab test, your urologist will simply take a small sample of any discharge from the penile glans and analyze it under a microscope.
- Routine blood test: Prior to phimosis surgery, your urologist may perform a routine blood test to measure the blood sugar levels in the body.Â
Food and medications: Your urologist may instruct you not to eat or drink anything for the last 12 hours before your phimosis surgery. It is also advisable to inform your doctor about any medications you may take as well.
If you take any blood thinning medications, your doctor may also advise you to temporarily stop taking them to reduce the chances of excessive bleeding during surgery as much as possible.Â
Circumcision Procedure
Circumcision is generally considered to be a safe and effective method of treatment for phimosis in adults. Circumcision is a surgical procedure that involves the removal of the foreskin.
There are primarily three techniques for performing circumcision surgery:Â
- Laser circumcision: Laser circumcision is an advanced and minimally invasive surgical procedure that is performed as an effective treatment for phimosis in adults.
As the name suggests, a laser circumcision is performed using a highly focused beam of laser to make precise incisions around a predetermined incision line. Due to its advanced and minimally invasive nature, laser circumcision does not carry any chance of excessive bleeding or deep cuts. Laser circumcision is generally performed on an outpatient basis, and recovery can take anywhere from 7-10 days at most. - Stapler circumcision: Compared to laser circumcision, stapler circumcision is a slightly more invasive procedure but with equivalent quality of results.
A stapler circumcision is performed using a stapler device, an advanced and disposable surgical tool that is specially designed to remove the foreskin. This stapler device fits snugly over the head of the penis and, once fired, cuts and removes the foreskin in a quick motion.Once the foreskin is removed, the stapler device also leaves behind a silicone ring around the incision wound to close it off and minimize bleeding. The silicone ring will fall off on its own once the incision wound has healed completely. Similar to laser circumcision, stapler circumcision is also performed on an outpatient basis, and recovery can take anywhere from 7-14 days. - Open circumcision: Open circumcision, often referred to as the dorsal slit technique, is a conventional method of treatment for phimosis in adults. In an open circumcision, the surgeon makes an incision along the length of the foreskin just below the penile glans.
Once the incision is made, the surgeon carefully removes the foreskin from the penis by gently separating the foreskin from the glans. Compared to advanced procedures such as laser or stapler circumcision, open circumcision is a more invasive method of performing circumcision and requires longer to heal. In most cases, recovery after a circumcision surgery can take anywhere from 5-6 weeks.
Recovery After Phimosis Surgery
The healing capacity of every person is different, and as a result, the exact time it would take you to recover after phimosis treatment is likely to vary as well.
On average, recovery after phimosis treatment can take anywhere from 7-10 days. Most people can return to work in just 2-3 days after surgery.Â
In this time period, it is important to strictly follow any guidelines or precautions set by your urologist to not only minimize the chances of any postoperative complications but also boost your healing abilities.
Some guidelines or precautions that your urologist may suggest to you after your phimosis treatment include:
- Keep the surgical site clean and dry.
- Avoid any swimming pools or public bathrooms for at least 4 weeks after surgery. Doing so can significantly increase your chances of contracting an infection.
- Refrain from sexual intercourse for at least 6 weeks after surgery or until your urologist thinks it’s safe to do so.
- Avoid performing any strenuous exercise that may exert excessive pressure or force on your incision wound.
- Refrain from smoking or drinking alcohol for at least 48 hours after surgery, as it may slow down your recovery.
- Stay hydrated. Drink 7-8 glasses of water every day.Â
- Do not miss any follow-up consultations. If you are experiencing any persistent side effects or odd signs after your surgery, it is advisable to let your doctor know about them as soon as possible.
Benefits of Phimosis Surgery
Alongside its capability to effectively treat phimosis in adults, circumcision surgery also has various additional benefits. Some of the most common benefits that are usually associated with phimosis treatment include:
- Better hygiene: With the removal of the foreskin, it becomes much easier to regularly clean and wash away any excess bacteria or smegma that may have accumulated under your foreskin over prolonged periods of time. This will also help you significantly reduce the chances of any future penile infection (such as balanitis) as well.
- Decreased risk of urinary tract infection: A Urinary Tract Infection or UTI is an infection that can occur in any part of the urinary system. Compared to circumcised men, uncircumcised adults are at an increased risk of contracting UTIs.Â
- Effective treatment of foreskin-related problems: A circumcision surgery is generally considered to be an effective treatment for various foreskin-related issues, including phimosis. Circumcision can also help you prevent paraphimosis, a condition that can occur due to phimosis.
- Reduced risk of penile cancer: There have been some studies that suggest a correlation between circumcision and reduced chances of developing penile cancer. While penile cancer itself is a very rare condition, it is even less common in circumcised men.Â
- Decreased risk of sexually transmitted infections: Compared to uncircumcised adults, circumcised men are found to be at a decreased risk of contracting Sexually Transmitted Infections or STDs. However, protection is considered to be minimal, and safe sexual practices remain essential.Â
Risks And Complications Associated with Phimosis Surgery
Complications of any kind after phimosis surgery are rare. But they can still happen and should not be taken lightly. Some of the most common complications that can occur after a phimosis surgery are given below:
- Excessive bleeding
- Excessive and persistent pain
- Infection
- Formation of scar tissue around the incision wound
- Meatitis (Inflammation in the opening of the penis)
- Insufficient or excessive removal of the foreskin
- Irritation on the penis glans
- Complications related to anesthesia
FAQs Related to Phimosis Treatment
Q. How long does phimosis surgery take?
Advanced circumcision procedures, such as laser circumcision, are generally performed on an outpatient basis and usually take anywhere from 10-15 minutes to complete. Depending on the method of your surgery, however, the exact duration of your phimosis surgery is likely to vary.Â
Q. Is circumcision a serious surgery?
Circumcision surgery is a relatively simple procedure and is generally not considered to be a serious or major procedure.Â
Q. What happens if phimosis is left untreated?
If left untreated, phimosis can lead to serious complications such as recurrent infections, gangrene, penile cancer, permanent damage to the penis, foreskin complications, or, in some severe cases, complete loss of the organ. If you are struggling with phimosis that is causing symptoms such as pain, ballooning, pain or discomfort during erection, or pain during urination, it is advised to contact your healthcare provider as soon as possible.Â
Q. What is the success rate of phimosis surgery?
The success rates of phimosis treatment through circumcision generally range from 92-95%. Circumcision is generally considered to be a safe and effective method for treating phimosis in adults.Â
Q. Is phimosis surgery painful?
Circumcision surgery is generally performed under local anesthesia meaning only a small area, in the case of the penis, will become temporarily numb. While you may feel slight discomfort during the procedure, there is no major pain involved. You can likely return home just a few hours after surgery.
Q. What is the cost of phimosis surgery in India?
The average cost of a circumcision surgery in India can range anywhere from Rs. 30,000 to Rs. 35,000. It is to be noted that the exact cost of surgery is likely to vary depending on various factors such as the city you undergo surgery, the hospital you choose, consultation fees, the cost of preoperative tests and diagnostics, and cost of any postoperative consultations or medications you may require.
Q. What are the side effects of circumcision surgery in adults?
Some side effects, such as mild swelling, minor bleeding, and discomfort, are to be expected and considered normal. Such side effects are mild and usually subside on their own in a few days without the need for any additional care or medications. However, if these side effects seem to persist or worsen over time, it is advisable to contact your healthcare provider as soon as possible.Â
Q. How long does it take to recover after a phimosis surgery?
On average, it can take anywhere from 7-10 days to recover completely after a phimosis surgery. However, depending on some factors, such as the method of surgery, your overall health, and the quality of your postoperative care, the exact time to recovery may vary.
Q. Can phimosis in adults be treated at home?
While some non-surgical options for phimosis treatment, such as phimosis treatment creams and phimosis rings, may help you relieve symptoms of mild phimosis, they may not be effective in treating it completely. Surgical intervention such as circumcision is generally considered to be a safe and effective treatment for phimosis.
