Patologisk eller fysiologisk fimose? [Phimosis: Pathological or Physiological?]

Abstract

Background: Studies from England indicate that only a minor part of boys referred for phimosis had a real pathological stricture of the foreskin. Most of them probably had a physiological narrowing of the prepuce. The purpose of this study was to evaluate the normal physiological condition regarding retraction of the prepuce in childhood.

Materials and methods: Based on a questionnaire study of 4,000 young men in Frederiksborg County, Denmark, we evaluated the normal physiology of the prepuce in childhood.

Results: Only 38% of those contacted responded to the questionnaire. In newborns and in boys seven years old, the prepuce could not be retracted in 22% and 21%, respectively, compared to 7% at puberty. The boys themselves retracted the foreskin for the first time at a mean age of 10.4 years. Problems with the prepuce were reported by 23% but disappeared spontaneously at a mean age of 13.3 years. Overall, 8% were operated on on the foreskin at a mean age of 11.6 years, but 20% were not satisfied with the results. Furthermore, significantly more young men who had their foreskin operated on had problems reaching ejaculation and orgasm (p < 0005).

Discussion: Our results indicate physiological phimosis to be a frequent condition that often disappears by itself at puberty. Knowledge of normal physiology of the foreskin is important, and treatment or operation should probably await puberty.