Phimosis / Circumcision

Phimosis is a very troublesome situation, with potential dangers of inflammation for the development of malignant lesions in glans and dangerous surgical problems such as paraffinosis. The treatment of fusion is only surgically performed by excision of the narrowed foreskin.

What is the normal extra skin (foreskin)?

The skin at the top of the penis is naturally folded on its own as a sleeve and detaches from the head of the penis by revealing it. This extra skin is called foreskin. Newborn babies under the surface of this extra skin cover the head of the penis. Because of this in the 95% of newborn babies, the extra skin can not be pulled back, referred to as "normal phlegm" or "non-expandable skin". During development in the first childhood and about the age of five years in 50% of cases the foreskin can be pulled back and the glans are revealed. In adults, extra skin is best to cover only half or 3 / 4 of the penis head for aesthetic, practical and hygienic purposes.

Is it normal to have non-expandable extra skin?

By the age of five, there is variety in the proportion to which the additional skin is attached to the penis. Sometimes there may be accumulation of a white outflow called "sebum" giving the appearance of "white pearls" under the skin. Sometimes this extra skin inflates when urinating, but there is no other problem. It is entirely within the normal range and does not need to be anxious.

Is there a normal non-transient foreskin?

If parents resort to the practice of balancing exercises, they should be particularly careful so as not to cause bleeding and trauma, which can aggravate the problem of fusion. Violent effort should be avoided because it will cause pain and the possibility of developing an acute surgical problem of paraffinization that needs immediate medical attention.

When is silencing a real problem?

In a boy with phimosis, surgery is required if the following problems occur:

  • scarring the skin to the tip
  • continuous infections
  • and only a few drops of urine when the urine passes the distortion that exists (swelling and inability to return back the extra skin again).
  • when functional sexual problems occur

What do we mean by circumcision?

It is one of the oldest interventions known to mankind. Basically it involves removing extra skin from the tip of the penis. There are many reasons for someone to do this.

As a cure: in real silencing.

As a preventative step: in children with concomitant urological infections (this removal reduces the risk of penis cancer and sexually transmitted diseases).

For reasons of religion: to Muslims and Jews.

For social reasons: to look like dad or brother.

For routine reasons: in some countries, this removal takes place as a routine form.

As an improvement in sexual function.

Are there other alternatives to removing extra skin?

In the surgery, which is called prepucioplasty plastic, the narrow ring is intersected from one side to the other and stitches longitudinally. This strengthens the skin without removing the extra skin. For this procedure to be successful, boys should self-call after surgery for two to three months.


Non-folding foreskin may be part of the normal growth process in boys under four years of age. Removal is indicated in cases of recurrent infections, or if there is scarring. It is a safe procedure, which can be done without staying in the clinic. For a good aesthetic result and minimal complications, it should be done by a well-qualified plastic or surgeon urologist.

For more information, please contact us for an appointment with plastic surgeon Dr. Andrea Ioannidis.

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