PHIMOSIS
phimos (Greek): a muzzle, or nose band of a bridle

THE CONDITIONS - A SUMMARY

INFANT PHIMOSIS
The pouting nozzle of an infant phimosis is easily recognisable. This is normal and natural, and even babies will play and pull the tube (the "dophin nose") forward. This is all common and normal in infants, and possibly also a healthy first natural step to releasing the epithelial adhesions.

Adults often retain a degree of this tube, when flaccid (non erect), and it is usually no problem. Occasionally, and only when in combination with other conditions, an infant phimosis remains unopened during erection and then it plays part of a more complex sexual problem.

INFANT ADHESIONS - (EPITHELIAL ADHESIONS)
Among infants the foreskin may stick entirely or partially to the glans. This adhesive layer is natural, normal and will generally release by the age of three, (4). Sometimes the adhesive layer does not release in childhood in which case it is almost always recognised at the beginning of puberty during erection when the foreskin is peeled (like elastoplast) off the glans, occasionally any movement of the foreskin is so intensely painful that it hinders further exploration and development.

Sometimes it does not release by itself a moment of pleasure and pain discovery is sometimes reported at the beginning of puberty,

They must be carefully released. Not only can this cause intense pain but the sticky skin surfaces can fuse together again causing skin bridges.

SKIN BRIDGES
If the infant epithelial adhesions are separated and the fresh sticky skin surfaces are allowed to rest in contact with each other again, they can fuse together causing small connecting strings or bands of skin tissue between the foreskin and the glans:

These unnatural secondary string like growths can occur singly, in groups or even as a sheet of skin. Skin bridges usually occur singly among uncircumcised boys, however they are particularly common among infants given full circumcisions with no post operative check-up, when they develop in groups between the circumcision scar and the glans.

Their effects are extremely varied depending on where they are. They are sometimes no problem, at other times very painful and/or even restrict the full erection.

FRENULUM BREVE
The frenulum is similar to the joining ridge under the tongue. A small sheet of skin underneath the glans joins the glans to the foreskin. On the erect penis, when the frenulum is too short, if one retracts the foreskin and then lets go, it slides or springs forward again. The condition is well described as a "tether" (80), (81).

This condition is one of potential antagonistic pulls: during erection the short frenulum tethers the foreskin forward, on the other hand intercourse, and masturbation exert forces which pull the foreskin backward.

The frenulum has various degrees of brevity and thickness and infinite variations in positioning, causing a variety of pleasure/pain sensations.

When masturbating the erection is manually controlled, so the foreskin can be kept in a forward position and painful movements can be avoided. Conscious problems start during intercourse.when the foreskin is involuntarily pulled backwards ... repeatedly (!)

The strain often causes pain, soreness, and bruising for some days afterwards, or the frenulum can rip. Ripping occurs typically during first love making often resulting in profuse bleeding. Subsequently the bleeding surfaces can congeal and the frenulum rejoins even shorter than previously, sometimes developing an ulcer like scar

THE PHIMOTIC RING
A thin tough contour of vulnerable skin tissue curves around the front of the inner foreskin, forming a noose around the glans.

A primary phimotic ring (from birth) will usually stretch; whereas when a secondary ring develops, it will tighten. LSA, diabetes, old age, and many other factors can be connected with the development of a secondary ring.

The anatomical and the sexual effects are varied and depend on the tightness of the ring. To start appreciating the phimotic ring, imagine a ring which is either too small to fit the finger, or if it does rub over the knuckle it hurts and gets sore often becoming inflamed, or it gets stuck. . A phimotic ring can make retraction of the foreskin over and behind the glans impossible, painful, or difficult, the foreskin may even get stuck behind the glans.

Common effects are (tight) urinary complications or infections, due to the closed warm moist environment;- (middle) penetration is difficult or impossible as the foreskin bags up, or the foreskin gets stuck behind the glans;- (loose) pain, soreness and infections as the ring rubs over glans.

Frenulo-phimotic combinations are common.

Sexual Effects
The specific sexual effects of each condition are extremely varied and depend on the positioning and/or the degree of elasticity involved.

Generally speaking whereas the phimotic ring is restrictive and inhibiting, frenulum breve is a frustrating condition.

Diagnosis
Only accurate diagnosis can ensure individual problem related treatment.

A doctor will usually only make a diagnosis in the flaccid state, this is often inadequate. The bridge, tether and noose conditions are by nature less elastic and expand relatively less than the rest of the foreskin. Therefore while they could be diagnosed in the flaccid state, the effects are far more remarkable and sometimes easier to diagnose during erection.

A diagnosis of phimosis or "tight" or "narrow foreskin" , will automatically lead to an insufficient understanding and inaccurate treatment.

If you are still unsure of which condition you have please go to Diagnosis

Treatment
Full circumcision is the treatment usually offered. However this is only very occasionally necessary, (in cases of gangrene, cancer etc.).

This site contains detailed information on the conditions, diagnosis and individual problem related treatment (often advising simple minimal specific surgery e.g. the time honoured operations of partial circumcision, dorsal slit and frenular incision, - with links where appropriate to anti-surgery and pro full-circumcision sources).

Chapter 1: The Conditions
links to all anatomical matters

Chapter 2 From Innocence to Ignorance
sexual-psychological effects