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Phimosis can be described as a narrowing of the opening of the penile foreskin (prepuce), restricting its free and easy retraction.

In infancy, the movement of the prepuce is naturally restricted due to adhesions on its under-surface. In most boys, these adhesions gradually separate spontaneously by the age of 2-3 years. Since this form of phimosis is very common in newborns, this phimosis is called physiological. It is self-limiting and rarely if at all causes any symptoms, and usually does not require any aggressive treatment.

Pathological phimosis, in contrast is due to the Fibrosis or thickening of the skin of the preputial opening which will not permit retraction of the prepuce over the glans and this requires surgical treatment. Till recently, the surgery performed for pathological phimosis (Circumcision) involved removal of most of the prepuce (foreskin) although the pathology is restricted only to its opening. Such a removal of the preputial skin leads to:

  1. A loss of its potential functions
  2. A conversion of the sensitive pink skin (mucosa) of the glans to a less sensitive and thicker brownish skin.
  3. Possible damage to the highly sensitive Pacinian corpuscles situated in the glans due to the constant friction with underclothing. {Comparison: Barefooted people develop thick, insensitive skin on their soles due to constant friction.

In recent years, preputioplasty, which avoids most of the disadvantages of phimosis is rapidly gaining popularity as a therapeutic modality for phimosis. Preputioplasty (preputial reconstruction) is a surgical procedure which tackles only the narrowing of the opening and leaves the remaining prepuce intact.