Phimosis
Phimosis is defined as the inability to fully retract the foreskin and expose the glans. This common condition can be congenital (primary, without signs of scarring) or acquired (secondary and pathological); the latter is a consequence of local inflammation (recurrent balanitis or balanoposthitis) or infections due to poor hygiene. Some diseases like diabetes mellitus and lichen sclerosus (LS) can also cause phimosis. It is more common in children during the first decade of life, with a second peak of incidence occurring after the sixth decade of life
The treatment of phimosis varies depending on the patient’s age and the severity of the condition. It should be adapted to the clinical and individual situation, considering the presence of local infections, cultural and religious aspects. Conservative treatment is an option for both congenital and acquired phimosis, especially in the early stages.
Circumcision remains the standard of care. Circumcision is considered a simple surgical procedure; however, an overall complication risk of 3.8% has been reported. Additionally, if left untreated, phimosis is strongly associated with invasive penile cancer due to chronic infections.
In an effort to maintain effectiveness and reduce the risk of complications, other more conservative surgical techniques (dorsal incision, partial circumcision, preputioplasty) have been described, as well as the use of various in situ devices that crush the foreskin and simultaneously create hemostasis.
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