Medical Q&As

Phimosis - why does it happen?

I have mild phimosis, which I understand is a tightening of the foreskin. My doctor gave me some hydrocortisone ointment, which helps, but recently during intercourse small blood blisters formed on the glans and I once suffered a small tear in the frenulum. Why does phimosis occur and why has my glans become less strong against normal sexual wear and tear?

You are correct when you say that phimosis means a tightening of the foreskin. It also usually means that it is difficult to retract the foreskin over the glans or head of the penis. The term paraphimosis means that it is not possible to return the foreskin to its normal position having initially been retracted over the glans. Phimosis and paraphimosis can occur at any age; however, a higher incidence is seen in infancy and adolescence. With regard to the blistering you refer to this could be the result of the tight foreskin giving rise to oedema or swelling of the tissues in the glans when the penis is fully erect during intercourse. In that scenario the tight foreskin is acting almost like a tight ligature around the glans. If you have any difficulty returning the foreskin to its normal position after intercourse you could progress to develop paraphimosis, which might necessitate circumcision. Phimosis can be congenital or it may be acquired. In acquired phimosis there is often a history of recurrent episodes of balanitis, which means infection under the foreskin. Sometimes a minor degree of congenital phimosis can be made worse by forcefully retracting the foreskin during showering or bathing, which can cause micro abrasions under the foreskin, which in turn gives rise to further tightening of the foreskin.