95% of male babies are born with physiological phimosis, a common condition that usually disappears around 3 or 4 years of age, as the skin adapts to the child’s growth. If this does not happen, the pediatrician will refer the patient to a pediatric surgeon for their respective evaluation, explains Dr. José Luis Apaza, pediatric surgeon at our clinic.

What is Phimosis?

The penis is made up of the body and the glans, which we commonly call the “head”. The skin that covers the glans is called the foreskin. When there is an inability to lower or retract the skin of the foreskin, preventing the glans from coming out, we speak of phimosis.

When is it necessary to treat phimosis?

Phimosis should be treated if there is discomfort when urinating, accumulation of smegma (dense, whitish discharge with a strong odor), or urinary or local infections.

Once phimosis has been diagnosed in a child, there are two ways to treat it:

• Medical treatment. It consists of making the narrow skin over the glans thinner and more elastic with the use of corticosteroids. In children with a phimotic ring (part of phimotic tissue with non-elastic cells that is created around the foreskin after an infection), the application of a corticosteroid cream for 1 or 2 months resolves the problem 75% of the time. This medicine is also beneficial if the patient has acute inflammation (balanitis).

• Surgical treatment. Indicated when there is no positive response to medical treatment and retraction of the foreskin over the glans has not been achieved, causing pain and recurrent infections. This procedure is called circumcision and consists of cutting and removing a part of the skin of the penis so that it ends where the glans begins and, thus, is exposed. The sutures are made with a thread that is reabsorbed between 3 and 4 weeks, approximately.

If a surgical intervention is required, at what age is it performed?

The age to perform a surgery will depend a lot on the symptoms that the minor presents. It is usually recommended from 4 or 5 years old, the age range in which the physiological phimosis should have been resolved.

Dr. José Luis Apaza
Pediatric surgeon at Clínica Ricardo Palma