This type of phimosis can be present in childhood or noticed in adolescence.
Let’s start by saying that proper cleansing of the penis is important from the first years of life.
At birth, male babies mostly have an abundance of preputial skin that hides the glans. Over time, this skin adapts to the growth of the penis.
However, paediatricians recommend checking that there are no tenacious adhesions between the inner part of the foreskin and the glans, which prevent it from being uncovered.
But let’s get back to phimosis in children / teenagers.
In infants, from the first years of life, there is a tightening of the foreskin. This shrinkage is physiological and is normally overcome with growth.
In some cases, however, it may happen that the foreskin does not widen together with the penis. This happens to about 1% of the male population and, over the years, creates increasing difficulty in uncovering the glans.
This is known as congenital phimosis. If mild (not tight), it may only be noticed in adolescence, with the first spontaneous erections or during sexual activity. The tightening of the foreskin is so slight that it allows for normal cleansing of the penis, but, during the erection phase, it prevents the total uncovering of the glans.
If tight, on the other hand, adequate cleansing of the glans is also prevented and, on average, it is diagnosed before adolescence.
Some medical scientific authors state that the condition of phimosis in childhood is overdiagnosed because the doctor does not distinguish between the natural non-retractability of the developing foreskin and a genuine pathological situation. In this instance, before recommending an operation it would be advisable to wait to confirm the diagnosis, since, today, this condition can be resolved by adulthood without surgery.
Acquired Phimosis (adult phimosis)
Acquired phimosis, on the other hand, occurs in adulthood and is the disabling result of inflammation of the foreskin (balanoposthitis) caused by a microbial agent (bacteria and / or fungi). After solving the infectious problem through medical therapy, however, there often remains a tightening and scarring of the foreskin which is precisely called phimosis.
In even simpler terms, here’s what happens: you have inflammation of the penis; the inflammation is treated with appropriate medical therapy; the treatment takes effect but we witness the formation of a “noose”, a circle of harder skin around the foreskin. The “noose” that is formed is the phimotic ring, a set of epidermal cells which are now rigid. The scar resulting from the infection of the wounds on the foreskin creates this ring, which, over time, can stiffen more and more, making it almost impossible to uncover the glans.