On occasion there are men who are not circumcised and unable to retract their foreskins. This condition is referred to as phimosis. The condition usually results when the man fails to retract his foreskin and a few drops of urine collects under the foreskin and sets ups an infection resulting in scarring and tightening of the foreskin making retraction difficult and sometimes impossible.
Phimosis may be detected in males who report painful erections, blood in the urine, recurrent urinary tract infections, or a weakened urinary stream.
Patients with phimosis may require an emergency intervention and should be referred to a urologist prior to development of irreversible penile damage.
If the foreskin cannot be retracted and hygiene will be a continued problem., then a surgical procedure needs to be performed. This is a last resort, to be performed by a urologist, to achieve the necessary reduction in infections and allow the man to have optimal penile hygiene.
Surgical methods range from the complete removal of the foreskin to more minor operations to relieve foreskin tightness:
• Circumcision is sometimes performed for pathological phimosis, and is effective.
• Dorsal slit is a single incision along the upper length of the foreskin without removing any tissue.
• Preputioplasty, is a limited dorsal slit with a relaxing incision is made on the constricting scar tissue of the foreskin can be an effective alternative to circumcision. It has the advantage of only limited pain and a short time of healing relative to circumcision, and avoids cosmetic effects.
Bottom Line: A tight foreskin is a condition that requires medical attention and the man should be referred to a urologist for further treatment.