## What is it? In newborns, the inner layer of the foreskin seals to the glans penis, which protects the urinary tract from infection, inflammation, and trauma. As the penis develops, the glans spreads the foreskin so that in 92 percent of boys, phimosis disappears naturally by the age of 6–7 years. If this does not happen, it is recommended to consult with a urologist. The doctor will do a visual examination, evaluate the clinical picture, and decide if the problem needs medical treatment or ===if it should be given some time. ## What can go wrong? If the glans penis doesn't reveal by the age of 7 years, it could be pathological phimosis that can be induced by several factors: __Penis injury.__ Often, the parents themselves can be the cause of it after trying to "help" the penis glans reveal and cause micro-injuries, which contribute to the formation of synechiae. The injuries may also result from wearing tight underwear with a seam in the middle. __Urethritis or balanoposthitis.__ These can develop in children after wearing pampers if the parents do not maintain the hygiene of the baby's genitals. __Congenital anomalies.__ The anomalies sometimes start developing in the prenatal stage. The foreskin can be underdeveloped (be hypoplastic) and densely attached to the glans or overdeveloped and hang down, resembling a proboscis. __Genetic predisposition,__ characterized by lack of elasticity of connective tissue. __Overheating__, which can lead to glans edema. __Hypothermia__, which leads to lowering immunity and degeneration of the foreskin. ## What should you do? First, don't do anything without consulting a medical professional. If the medical examination shows no complications, the problem can be approached with conservative treatment by ointments with corticosteroid hormones. They help make the connective tissue softer and eliminate swelling and inflammation. The chances for success are approximately 85 %, while all other cases call for surgery. There are two types of surgery that doctors may choose between: __Circumcision:__ removal of the excess foreskin. After surgery, it is easier to maintain the hygiene of the genitals, but the sensitivity of the glans penis is reduced. __Preputioplasty:__ this technique presumes partial incision of preputium and stitching its edges in other directions. The foreskin cavity is expanded, which lets the glans come out. Of course, parents are concerned about the safety of these procedures. The preputioplasty is less traumatic, while circumcision is more common. The complications occur in 0.1-0.2 % of cases. These can include severe swelling with pain, purulent discharge from the wound, increased redness around the seam, difficulty urinating, or fever. In such a case, the doctor will recommend medicines that will help reduce discomfort. ## Can it heal by itself? Many parents are afraid of surgery. When the child has no complaints, they think they can let nature do its work. However, this is a very risky path. The consequence of neglected phimosis is paraphimosis (when the foreskin ring squeezes the glans penis). In this case, the boy may need immediate surgery since penis ischemia leads to losing sensitivity and tissue necrosis. When the boy reaches adolescence, he may experience sexual problems such as acute pain during erection and not being able to ejaculate easily.