Chapter 1: THE CONDITIONS   The Various Forms of Phimosis Phimosis is such a generalised term - it obscures an accurate diagnosis, as successfully as the foreskin obscures its specific conditions. Phimosis or the inability to freely retract the foreskin, occurs with infant phimosis, epithelial adhesions, skin bridges, frenulum breve, or phimotic ring. These conditions occur singly and in many common combinations. Infant Phimosis: The pouting nozzle of an infant phimosis is easily recognisable. This is normal and natural. Adults often retain a degree of this elongated foreskin, but unless in combination with other conditions this is no cause for worry. Apart from the infant phimosis, all conditions, thus all the problem conditions, lie on the inner foreskin. Epithelial Adhesions: Among infants the foreskin normally sticks to the glans. This epithelium or adhesive layer usually degenerates releasing the foreskin in early infancy. Sometimes boys release it themselves or a doctors does this, often a painful experience. Occasionally the epithelium makes any movement of foreskin intensely painful or impossible. Skin Bridges: If the epithelial adhesions are forced apart, the sticky skin surfaces can fuse together again, causing skin bridges between the foreskin and glans. Frenulum Breve: A small sheet of skin underneath the glans joins the glans to the foreskin, if this is too short it holds the foreskin forward. Phimotic ring: A thin tight contour of vulnerable skin tissue loops over the front of the inner foreskin and joins underneath into the frenulum, forming a noose around the glans. A primary phimotic ring (from birth) will stretch; whereas when a secondary ring develops (e.g. in old age), it will tighten. Each condition has specific anatomical and sexual effects which vary depending on degree, exact position and the elasticity involved. Some conditions are merely irritating others are painful, some typically result in inflammations and disease, some cause problems by urination, others during masturbation; some cause problems previous to intercourse, others during it, and still others for several days after intercourse. To offer a very generalised understanding whereas phimotic ring is often merely restrictive, frenulum breve is usually a frustrating condition. Accurate diagnosis is essential for optimal individual treatment. Please see the Phimosis in detail (1,000 words) for further general explanations. 1 of 4