Phimosis surgery
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Steven C. Campbell, M.D., Ph.D.
Surgery
Phimosis in infancy is nearly always physiological, and needs to be treated only if it is causing obvious problems such as urinary discomfort or obstruction. In older children and adults phimosis should be distinguished from frenulum breve, which more often requires surgery, though the two conditions can occur together.
If phimosis in older children or adults is not causing acute and severe problems, nonsurgical measures may be effective. Choice of treatment is often determined by whether the patient (or doctor) views circumcision as an option of last resort to be avoided or as the preferred course. Some adults with nonretractile foreskins have no difficulties and see no need for correction.
- Circumcision is the traditional surgical solution for pathological phimosis, and is effective. Serious complications from circumcision are very rare, but minor complication rates (e.g., having to perform a second procedure or meatotomy to revise the first or to re-open the urethra) have been reported in about 0.2-0.6% in most reported series, though others quote higher rates.
- Preputioplasty, in which a limited dorsal slit with transverse closure is made along the constricting band of skin[1][2]can be an effective alternative to full circumcision. It has the advantage of only extremely limited pain and a very short time of healing relative to the rather more traumatic circumcision, together with no cosmetic effects.
References
- ↑ Cuckow, PR, Rix, G, Mouriquand, PDE. Preputial Plasty: A Good Alternative to Circumcision J Pediatr Surg 29(4):561-3, 1994
- ↑ Saxena AK, Schaarschmidt K, Reich A, Willital GH.Non-retractile foreskin: a single center 13-year experience Int Surg 85(2):180-3, 2000