Tightness of the prepuce, or foreskin, of the penis is called phimosis, which prevents the retraction of the foreskin over the glans. In medical terms, it is also known as preputial stenosis.
There are two types of phimosis known as Physiological Phimosis and Pathological Phimosis. The physiological phimosis occurs naturally in the newborns. On the other hand, Pathological phimosis is more commonly seen in adults.
Physiologic phimosis is seen in all male newborns who are not circumcised. This is the result of tiny adhesions that are present in between the epithelial layer of the inner prepuce, or foreskin, and the glans. This tiny adhesion will dissolve spontaneously over time with sporadic foreskin retraction and erections. As the boy ages and reaches puberty all the adhesion will be dissolved. Hence, there will be no complaint of Physiologic phimosis.
In adults Pathological phimosis is more common; however, Physiological phimosis occurring naturally in the newborn can also continue in the adulthood. On the other hand, Pathological phimosis occurs due to a variety of reasons. Firstly, it occurs because of poor hygiene practices followed by some men. Men who do not wash properly under the foreskin will result in smegma to accumulate. Smegma is a white, cheesy material that is seen. In severe cases, this condition will also cause pain while penile erection.
Furthermore, Pathological phimosis also occurs due to repeated thrush infection of the head of the penis. Thrush is a yeast infection which in repeated cases can lead to phimosis. Furthermore, bacterial infection of the foreskin can also lead to phimosis, which is the result of poor hygiene. Infection of the foreskin is called balanitis. Balanitis results in inflammation and swelling of the foreskin preventing its retraction. Furthermore, if balanitis is not treated on time repeated infection can occur often leading to a condition known as balanitis xerotica obliterans. Balanitis xerotica obliterans is a condition characterized by repeated formations of scar tissue. Eventually, the scar tissue will change into a fibrous, hard, and inelastic ring-like tissue known as cicatrix. Development of cicatrix prevents the retraction of the foreskin known as phimosis.
Moreover, in some cases phimosis can also result due to abnormal masturbation techniques. Some men, during masturbation, will rub penis against something. This results in trauma to the head of the penis. When this heals, it will form a fibrous, scar tissue. As a result, the retraction of the foreskin is prevented and phimosis is produced.