Phimosis Treatment In Singapore

Phimosis refers to the condition where the foreskin of the penis cannot be fully retracted over the glans (head) of the penis. This condition can be present from birth or develop later in life, and while it’s common in infants and young children, it can also affect adults.

image image

Causes of Phimosis

Phimosis can be categorised into two main types based on its origin: physiological and pathological.

Physiological Phimosis

In infants, the foreskin is typically fused with the glans of the penis. As the child grows, the foreskin starts to separate naturally, allowing for increased retraction. By the age of three, most boys can retract their foreskin partially, and by the age of seven, most can retract it fully. However, in some cases, full retraction may not be possible until adolescence.

Considerations: Physiological phimosis is not a cause for concern unless it persists beyond adolescence or is accompanied by other symptoms like pain or difficulty in urination. It’s essential to differentiate physiological phimosis from pathological phimosis to ensure appropriate care.

Pathological Phimosis

This form of phimosis arises due to specific causes other than natural development. It can occur at any age and is not the normal state of the foreskin. Several factors can lead to pathological phimosis:

  • Infections: Conditions like balanitis (inflammation of the glans) or posthitis (inflammation of the foreskin) can lead to scarring, making retraction difficult. These infections can be caused by bacteria, fungi, or other pathogens.
  • Inflammatory Skin Conditions: Diseases like lichen sclerosus or eczema can affect the penis, leading to changes in the foreskin’s elasticity and texture.
  • Trauma: Physical injury to the foreskin, whether accidental or due to forceful retraction, can cause scarring and subsequent phimosis.
  • Poor Hygiene: Lack of regular cleaning can lead to the accumulation of smegma (a white, cheesy substance) under the foreskin, increasing the risk of infections and subsequent scarring.

Considerations: Pathological phimosis requires medical attention, especially if it results in symptoms like pain, swelling, or difficulty urinating. Treatment options vary based on the cause and severity of the condition.

Symptoms and Diagnosis of Phimosis


Difficulty in Retraction: The most evident symptom of phimosis is the inability to retract the foreskin fully over the glans of the penis. This difficulty can range from slight resistance to complete inability.

Pain or Discomfort: Individuals with phimosis may experience pain or discomfort, especially during erections or sexual activity.

Swelling and Redness: The tip of the penis, especially the foreskin, may appear swollen or red, indicating inflammation.

Ballooning of the Foreskin: During urination, the foreskin may balloon out due to the trapped urine, especially in cases where the opening is particularly narrow.

Discharge: There might be a white, cheesy substance known as smegma accumulating under the foreskin. In cases of infection, there might also be a foul-smelling discharge.

Urinary Symptoms: Some individuals may experience a weak urine stream, dribbling, or difficulty starting urination. In severe cases, urinary retention (inability to urinate) can occur, which is a medical emergency.

Visible Scarring: In cases of pathological phimosis due to trauma or chronic inflammation, visible scarring or white patches might be present on the foreskin.


Physical Examination: The primary method of diagnosing phimosis is through a physical examination by a urologist. The doctor will assess the foreskin’s ability to retract and check for signs of inflammation, scarring, or other abnormalities.

Medical History: A detailed medical history can help determine if the phimosis is physiological (natural) or pathological (due to an underlying cause). The doctor may ask about the onset of symptoms, any previous episodes, history of infections, or trauma to the area.

Swab Test: If an infection is suspected, especially in cases with discharge or significant redness, a swab may be taken from the foreskin area. This swab is then tested in a laboratory to identify the causative organism, be it bacterial, fungal, or another pathogen.

Urine Test: In cases where urinary symptoms are present, a urine test might be conducted to rule out urinary tract infections or other related conditions.

Treatment Options for Phimosis

Non-surgical Treatments

  • Steroid Creams
    Topical steroid creams are often the first line of treatment for phimosis. They are applied directly to the foreskin.
    Mechanism: These creams help reduce inflammation and can increase the elasticity of the skin, making it easier to retract.
    Duration: Typically, the treatment lasts for a few weeks, and patients are also advised to gently stretch the foreskin regularly.
    Effectiveness: Many individuals find relief with this treatment, especially if the phimosis is not due to scarring.
  • Gentle Stretching
    Technique: Along with or without the use of steroid creams, gentle manual stretching exercises can be beneficial. It involves carefully and gently pulling back the foreskin to increase its elasticity over time.
    Precautions: Be gentle to avoid causing tears or injury. Forceful retraction can lead to pain and potential complications.
    Guidance: It’s advisable to perform these exercises under the guidance of a urologist to ensure they are done correctly and safely.

Surgical Treatments

  • Circumcision
    Procedure: This is the most common surgical treatment for phimosis. It involves the complete removal of the foreskin.
    Recovery: Post-operative care includes keeping the area clean and avoiding activities that might cause irritation or injury to the surgical site. Full recovery typically takes a few weeks.
    Considerations: Circumcision is a permanent solution and is often recommended in recurrent or severe cases of phimosis or when non-surgical treatments have failed.
  • Preputioplasty
    Procedure: Unlike circumcision, preputioplasty preserves the foreskin. It involves making one or more incisions in the foreskin to relieve the tightness and then stitching it in a way that widens the opening.
    Recovery: The recovery time is generally shorter than circumcision, and the foreskin’s function is preserved.
    Considerations: This procedure is less invasive than circumcision and is an option for those who wish to retain their foreskin.
  • Frenuloplasty
    Procedure: In some cases, the tightness is due to a short frenulum (the band of tissue connecting the foreskin to the underside of the penis). Frenuloplasty involves making an incision in the frenulum to lengthen it.
    Recovery: Similar to preputioplasty, recovery is relatively quick, and the procedure helps in retaining the foreskin’s function.
    Considerations: This procedure is specific to cases where the frenulum is the primary cause of the tightness.

Prevention and Care

Tips for maintaining penile health:
Regular cleaning of the penis, including under the foreskin, is important. Avoid using harsh soaps or chemicals that might cause irritation.

Importance of cleanliness and proper hygiene:
Maintaining proper hygiene reduces the risk of infections and complications. Teach young boys the importance of cleaning their genitals properly and to ensure they understand the need for gentle care.


Phimosis, while common in young children, requires attention and care when symptoms persist or arise in adulthood. Understanding the condition, its causes, and potential treatments ensures better penile health and reduces the risk of complications. Regular check-ups and consultations with urologists are important for timely diagnosis and treatment.

Get an Accurate Diagnosis & Proper Treatment
for Your Urological Conditions


Dr Lee Fang Jann image

Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders

He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).

  • Bachelor of Medicine and Bachelor of Surgery (Singapore)
  • Membership of The Royal College of Surgeons (Edin)
  • Master of Medicine (Surgery) (Singapore)
  • Fellowship of the Academy of Medicine (Urology)
  • Clinical fellowship at Oxford Transplant Centre in the UK

Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.

Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.

Our Clinic Locations

Farrer Park Medical Centre, #08-05
1 Farrer Park Station Rd, Singapore 217562

Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

3 Mount Elizabeth, #11-16 Medical Centre, Singapore 228510

Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

    Need Advice On Your Condition?

    Do you have an enquiry? Please fill out the form and we will be in touch with you shortly.

    Full Name*

    Email Address*

    Phone Number*


    Your Message*

    For Faster Response, Call us!

    +65 6993 3000

    Frequently Asked Questions

    At what age should I be concerned if my child's foreskin doesn't retract?

    While many children’s foreskins naturally retract by the age of five, it’s not uncommon for some to take longer, even up to adolescence. However, if there are other symptoms like pain, swelling, or difficulty urinating, consult a paediatrician or urologist.

    Can phimosis affect sexual function or pleasure?

    Phimosis can cause discomfort or pain during sexual activity, which might affect sexual function. However, once treated, most individuals can resume a normal and satisfying sexual life.

    How long does it take to recover from circumcision?

    Recovery time can vary, but most individuals heal within 4-6 weeks. Follow post-operative care instructions to ensure proper healing.

    Can phimosis recur after treatment?

    While non-surgical treatments like steroid creams and stretching can provide relief, there’s a possibility of recurrence. Surgical treatments like circumcision offer a permanent solution.

    Is there a link between phimosis and penile cancer?

    Chronic inflammation or infections associated with phimosis might increase the risk of penile cancer. However, penile cancer is rare, and not everyone with phimosis will develop it.

    Can I use over-the-counter steroid creams for phimosis?

    It’s not advisable to use over-the-counter steroid creams without a doctor’s recommendation. The wrong type or prolonged use can lead to skin thinning and other complications.