Tight foreskin/Phimosis, requiring Circumcision

Symptoms of Tight Foreskin

  • Tight/sore frenulum (banjo string)
  • Difficulty retracting the foreskin to clean the head of the penis
  • Difficulty bringing the foreskin back over the glans if it’s pulled back
  • Painful foreskin when the penis is erect
  • Sore/itchy/red foreskin or glans penis
  • White discolouration of foreskin
  • Cracking  or fissuring of foreskin which can bleed after sex

Treatments for Tight Foreskin

  • Steroid creams (Dermovate for short periods)
  • If above fails or pathological phimosis
  • Consider surgery (Frenuloplasty or circumcision) 


Simple operation that can be performed under local or general anaesthetic

A horizontal incision across the frenulum which is closed vertically

Risks of surgery:Bleeding

  • Infection
  • Altered sensation (rarely numbness or increased sensitivity)
  • Scar formation
  • Failure to resolve the tight foreskin requiring circumcision

Circumcision (removal of foreskin)

Can be performed under local or general anaesthetic.

Day case surgery which takes 30-45 minutes.

Abnormal foreskin is removed.

The wound on the penis is closed with absorbable stitches.


Risks of surgery:

  • Bleeding
  • Infection
  • Meatal stenosis (rarely the external urethral opening can become scarred)
  • Altered sensation
  • 1% poor cosmesis requiring further revision surgery
  • Rarely urethral injury
  • Removing too much skin resulting in skin tightness during an erection

Post circumcision care:

  • Most men take 1 week off work after surgery
  • Can shower as normal but avoid soaking in the bath
  • After drying apply Vaseline to the head of the penis and wound unless given an antibiotic cream instead
  • Avoid sex for 4-6 weeks (until wounds healed)
  • Expect the penis to be swollen and bruised for at least a week