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You cannot expose the glans
The foreskin will not retract, retracts only partly or becomes extremely tight behind the glans.
Phimosis and circumcision
When the foreskin will not retract, feels tight or becomes injured
Phimosis is difficulty or inability to retract the foreskin and expose the glans. It may cause pain, cracking, inflammation, hygiene problems or discomfort during erection. Surgery should only be recommended after examination and identification of the cause.
What it is
A foreskin that does not retract normally
The foreskin may appear to retract when flaccid but form a tight, painful ring during erection or fail to expose the glans fully. In other cases retraction is difficult even without an erection.
Tightness may have been present from childhood or develop after repeated inflammation, infection, small tears, scarring or skin disease. The cause affects treatment.
Not all pain on retraction is phimosis. A short frenulum, active inflammation, a skin lesion or a combination may cause similar symptoms.
Common signs
When assessment is advisable
A routine appointment does not replace emergency care when the foreskin becomes trapped or an acute complication occurs.
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Pain, cracking or bleeding
Discomfort during erection, penetration or hygiene, with small splits that may heal with further narrowing.
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Repeated inflammation
Recurring redness, discharge, itching, odour or difficulty maintaining comfortable hygiene.
Assessment before surgery
Circumcision should not be sold automatically
Examination distinguishes true phimosis from a short frenulum, inflammation, scarring or a skin lesion. It also identifies foreskin disease that may require specific assessment.
Some non-scarred cases may have conservative options that primary care or a general urology service should assess. Askabide does not provide general urology consultations; our urologist operates on phimosis when a surgical indication has been established.
What we review
- When the tightness began and whether it occurs only with erection or also when flaccid.
- Pain, cracks, bleeding, inflammation, hygiene problems or difficulty urinating.
- Diabetes, healing problems, allergies, medication and previous surgery.
- A short frenulum, scarring or lesions that change the indication.
Do not force a tight foreskin. Tears may bleed, become infected and heal with scarring that makes the ring even less flexible.
The operation
Circumcision when it is indicated
Circumcision removes the tight foreskin so the glans remains exposed and the constricting ring cannot recur. It is an outpatient operation performed by the urologist.
The technique, anaesthesia, sutures, expected anatomical result and aftercare are explained individually. We do not publish a “universal method” because anatomy, scarring and the cause of phimosis may alter the plan.
If the problem is confined to a short frenulum, frenuloplasty may be indicated instead of circumcision. When both coexist, the urologist will explain the appropriate option.
After surgery
The area needs time to heal
Tenderness, swelling, bruising and discomfort are expected in the early period. Night-time erections may pull on the wound. You will receive instructions on hygiene, wound care, clothing, pain relief and warning signs.
Return to work, sport, cycling, swimming, masturbation and sexual intercourse depends on healing and the activity involved. We do not publish one fixed number of days because doing so may encourage premature strain on the wound.
Appearance changes after removal of the foreskin. Informed consent must explain this change and allow questions before you decide.
A genuine emergency
If the foreskin becomes trapped behind the glans, do not wait
Paraphimosis occurs when a retracted foreskin cannot be returned forward and forms a constricting band around the glans. It may cause pain, swelling and colour change. Urgent assessment is required to avoid compression injury.
Attend an emergency department or call 112. This is not resolved by requesting a routine WhatsApp appointment. Inability to urinate, heavy bleeding, high fever or sudden severe pain also require urgent care.
Risks and limitations
What should be discussed before circumcision
Possible risks include pain, bleeding, haematoma, infection, wound separation, scarring, persistent swelling, altered sensation, an unexpected cosmetic result, too much or too little skin removal and the need for further treatment. Frequency and relevance depend on the individual case.
Surgery cannot guarantee that all sexual pain will disappear if another cause was present. Correctly identifying the source of symptoms is therefore essential.
Price
Phimosis surgery or circumcision: €810. This price applies when assessment confirms that circumcision is the indicated procedure. If the problem is confined to a short frenulum, frenuloplasty costs €610.
Focused service
Dr Ramón Ibáñez
Urology specialist and clinical lead for the service at Askabide.
Almost 30 years performing these procedures in our clinics. The service does not include general urology consultations for other conditions.
Contact a centrePhimosis surgery or circumcision: €810
Assessment distinguishes phimosis, short frenulum, inflammation and scarring before the procedure is confirmed.