This site discusses phimosis in its specific forms of phimotic ring, frenulum breve, adhesions or skinbridges. During erection these conditions inhibit the relationship between foreskin and glans. This functionally restricts the erection, and thus has an effect on the sexuality. With our culture's attitudes on health care, it would be appropriate to monitor boys before puberty and encourage early prevention.

THE PHIMOTIC RING

Phimosis defined as an inability to freely retract the foreskin, is a very general term, involving specifically either the phimotic ring, frenulum breve, epithelial adhesions, skin bridges, infant phimosis, or indeed any combination of these. (see phimosis for summary)- On this page we will consider the phimotic ring.


A tightness at the end of the foreskin hinders retraction. There are two typical forms of this tightness, an infant phimosis and the phimotic ring. An infant phimosis has an easily recognisable tubular form, this is common and healthy in infants.

The phimotic ring is a thin contour of tough skin tissue which branches out from underneath the penis, and curves round over the front of the inner foreskin, like a noose.

Phimosis Research gives detailed information on the exact positioning of this phimotic ring. (To diagnose definately, underneath the foreskin is not so tight, you will notice that you even have a little flap which you can flip away).

The phimotic ring is by nature less elastic and expands relatively less than the rest of the foreskin, so any difficulty with retraction when flaccid is magnified when erect. The anatomical and sexual effects are varied and depend on the tightness and elasticity of the ring.

(Imagine a ring which is either too small to fit the finger, or if it does rub over the knuckle it hurts, or it gets stuck).

A primary phimotic ring (from birth) will stretch; whereas a secondary ring (developing later in life) will tighten. Phimosis Treatment gives details on the individual treatment of different types of ring.

Most infants have a ring and this usually stretches naturally during childhood. Sometimes the ring does not stretch, in addition it can reappear for a number of different reasons, at any time of life.

The development of a ring in mid-life is sometimes an indication for diabetes. In old age together with the general drying and tightening of the skin, fibrotic elements lead to a deterioration of the rings elasticity. The ring is also prone to rip and then as it joins, due to the scar it will become tighter.

The connection between the ring and LSA is particularly convoluted. Often the abrasive action of the ring during masturbation and the warm, damp, dark, enclosed area between the foreskin and glans can lead to LSA. On the other hand due to external influences (partner, soaps, side effects of other medicines,) LSA may occur and this leads to degeneration of the skin tissue when subsequently a ring will develop.

Phimosis Treatment gives details on the different histological types of ring.

THE DIFFERENT DEGREES of PHIMOTIC RING
and THEIR EFFECTS

The phimotic ring varies in tightness and it can have areas of different elasticity and tensile strength. It is by nature less elastic and expands relatively less than the rest of the foreskin, so any difficulty with retraction when flaccid is magnified when erect. The anatomical and sexual effects depend on the tightness of the ring.

Very extreme degrees (often called pinhole phimosis) cause urinary complications or infections in childhood, and therefore are often recognised and treated early.

A partial phimosis will reveal part of the glans but penetration will often cause frustration as the foreskin bags up in a barrier, sometime being forced painfully behind the glans causing paraphimosis.

A relative phimosis only becomes obvious during erection, and it usually starts being problematic at the beginning of puberty as it rubs over the glans during masturbation which hurts and causes soreness, often leading to infections.



FULL PHIMOSIS - (PINHOLE PHIMOSIS)
Extreme degrees often cause urinary complications in childhood, for example not being able to aim, spraying and ballooning, and lets face it, after urination, not being able to shake all the urine out, (and the consequent wet trousers). In addition, due to the hot damp environment between the foreskin and the glans, infections can easily develop.

Should a boy be unfortunate enough to arrive at puberty with a pinhole phimosis during erection the foreskin is held firmly in place over the glans, therefore masturbation causes no actual pain. It has been described as a straight jacket. Beauge describes in detail various methods of masturbation boys use without retraction.

Throughout adolescence as behavioural patterns develop, youths grow accustomed to their condition, either believing themselves to be normal, or if they do recognise their phimosed status some men obviously grow to prefer it. Intercourse is possible though this depends on the degree of lubrication and openness of the vagina and the brutality of penetration.

Reports suggest either little sexual activity or a one sided appetite. It is possible that at times late treatment would create greater disturbances than it would cure. Men who are aware of their condition often complain that the only problem they have is other people telling them they have a problem.

"Somehow I like the idea of the glans being hidden and stimulation being more of a challenge. ... the tightness of the skin is very exciting to me when it is played with or when I masturbate. ... It does have a smell most of the time, but it is a very nice male smell that hardly anyone has objected to." (see ARCforum1 letter no.37)

PARTIAL PHIMOSIS
With a partial phimosis when erect part of the glans is visible and some mobility is possible during masturbation.

Partial phimosis often first presents a problem by intercourse and (more than with pinhole phimosis), penetration requires lubrication, otherwise the foreskin ruffles up in a barrier (adding much frustration to the first sexual encounters). If the ring is a little looser or the vagina a little tighter, it may be forced behind the glans for the first time causing paraphimosis.

Paraphimosis is when the phimotic ring gets stuck behind the coronal ridge of the glans, this occurs typically during the first explorations at the beginning of puberty or on first love making and is considered a medical emergency.

RELATIVE PHIMOSIS
The condition which is loosely referred to as "tight foreskin", indicates a degree of this phimotic band which is hardly noticeable when flaccid. However when masturbating normally ("alternate back and forth movement" (Beauge) ) relative phimosis causes pain and difficulty.

As the foreskin is retracted the ring scrapes over the coronal ridge of the glans. As the ring repeatedly rubs against the glans, the soreness and abrasion often leads to inflammations and as the process continues these can easily cause infections, (LSA or balanitis). This development is frequently reported.

Ripping
When the phimotic ring is put under stress; (through stretching exercises or during masturbation when the ring passes repeatedly over the coronal ridge), it can easily rip. These rips appear to occur lengthwise between the ridges of the phimotic ring. As the rips heal, they leave scars which cause a tightening of the phimosis.

Washing
With all degrees because of the overall impression that the foreskin remains forward, there is a tendency for the adolescent to forget to wash the area. With a pinhole phimosis reports suggest washing is performed by flushing the area out and squeezing, and/or using a q-tip. or holding the foreskin closed when urinating, to "swill out all the smegma".

STATISTICS
Some medical studies misquote others and give statistics of 1%, there are other documents giving this figure which have no references Even if the statistics were only 1%, this would be too many to ignore.

There are no reliable studies which show less than 2.4% and this statistic was the result of a seven year long selected test study. For accurate information on statistics, please see The Encyclopedia of Phimosis Statistics.