Caution is advised when the foreskin is narrowed

Foreskin narrowing (phimosis)

Pediatricians warn: caution should be exercised if the foreskin is narrowed. Doctors warn against violent retraction of the foreskin in children and adults.

Foreskin narrowing (phimosis) is relatively widespread in boys. However, parents should not forcibly push back the foreskin during phimosis, as this can result in minor injuries that leave unpleasant scars, explained Hans-Jürgen Nentwich from the board of the professional association of pediatricians (BVKJ).

In newborn boys, the so-called "physiological phimosis" is a completely natural phenomenon due to development. To protect against harmful environmental influences, the foreskin is still glued to the glans at birth. According to experts, around 96 percent of newborn boys have this form of phimosis, which is also known as preputial bonding. Up to school age, the physiological phimosis declines in the course of the ripening processes in almost all those affected, so that the majority of the boys up to the age of 3 to 5 years lose their bond.

Consult a pediatrician if symptoms occur
If the adhesive does not go away on its own, this can lead to a narrowing of the foreskin, which hinders the flow of urine and causes the foreskin to inflate when urinating. According to the BVJK's advice, if symptoms are observed, parents should definitely see a pediatrician who can correct the foreskin narrowing with cortisone treatment or, in the worst case, with a relatively small surgical intervention. If the phimosis is not corrected, this can lead to considerable problems with the onset of puberty, since the narrowing of the foreskin can trigger blood congestion in the erect penis. However, the parents should not force the foreskin back in a phimosis, since small injuries and corresponding scarring are the result, warned BVKJ board member, Hans-Jürgen Nentwich.

Foreskin constriction is one of the most common causes of medical intervention Along with inguinal hernia and undescended testicles, foreskin narrowing is one of the most common causes of pediatric surgery. The corresponding operations usually take place between the ages of four and six. According to the BVKJ, however, medical intervention should be carried out at the latest until puberty, since serious complications may arise as sexual maturity begins. Phimosis can also occur later in life due to reduced elasticity of the skin or from scars from injuries or inflammation, although here too the risk should not be underestimated. Adults should also be warned against violent retraction of the foreskin. In this case, the foreskin can cut off the blood flow to the penis, which leads to a disruption of blood flow and painful swelling of the foreskin and glans. Without medical help, not only is there severe pain but also the loss of the glans.

Prefer conservative method in treatment first
The so-called conservative method or surgical interventions are available for the treatment of phimosis, although the experts believe that the conservative method is always preferable to an operation. With conservative treatment, attempts are made to solve the foreskin narrowing by light massages, stretching and careful, pain-free shifting of the foreskin while applying ointments containing cortisone. If carried out correctly over a longer period of time, this method can be used to treat phimosis relatively effectively and without side effects (50 to 70 percent treatment success according to the German Society of Urology). If the phimosis does not recede as part of the conservative treatment, the only thing left for the doctors is a surgical procedure to correct the foreskin narrowing. (fp)

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Photo credit: Sebastian Karkus /

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