Circumcision Not Recommended

Pathological phimosis—more accurately called preputial stenosis and sometimes described as acquired phimosis1—occurs in less than 1% of males,2 and is often misdiagnosed and has many causes. Lichen sclerosus et atrophicus (LSA), thought to be the same condition as balanitis xerotica obliterans (BXO), is regarded as a common cause of pathological phimosis. Other causes include: scarring caused by forcible retraction of the foreskin, and balanitis.

Males with phimosis have masturbation practices that differ from the usual gliding the foreskin back-and-forth that mimics sexual intercourse. Some studies found phimosis to be a risk factor for urinary retention and cancer of the penis. Common treatments include steroid creams, preputioplasty, manual stretching, and circumcision.

Using circumcision to avoid phimosis is not advised. Less than one-tenth of one percent of intact adolescent boys per year will develop pathological phimosis, while the risk of post-circumcision phimosis due to adhesions is twenty-five times higher.

This information has been reviewed by our panel of experts and other trusted advisors, however, it is not a substitute for professional medical, legal, or spiritual advice.

  1. Van Howe R. Cost-effective treatment of phimosis. Pediatrics. 1998;102:e43.
  2. Øster J. Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child. 1968;43:200-3.
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