Phimosis, Paraphimosis, Frenulum breve (P, ParaP, FB)

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When There’s Pain at the Tip of Your Penis

It may look like a rubber band or tight ring of foreskin around the tip of your penis. Phimosis or paraphimosis, which can occur in uncircumcised men, makes it difficult and painful to retract your foreskin.


What is P, ParaP, FB?

In uncircumcised males, the foreskin normally covers the head of the penis, but is retracted for urination or sexual activity. If the foreskin cannot be retracted, or is difficult or painful to retract, the condition is known as phimosis. If the foreskin is retracted but cannot be placed back over the head of the penis, the condition is known as paraphimosis, which is a medical emergency.

A related condition is frenulum breve. The frenulum is the fold of skin that connects the head of the penis (glans) to the foreskin. With frenulum breve, that fold of skin is too short and tight. It can cause painful, uncomfortable erections.


What are the symptoms of P, ParaP, FB?

You may experience the following symptoms:

  • Pain with erections
  • Increasing debris under the foreskin
  • Recurrent episodes of inflammation (balanitis)
  • Difficulty urinating
  • Changes in appearance of the foreskin (i.e. red, white, scarred, bleeding)


What causes P, ParaP, FB?

Most of the time there is no identifiable cause for phimosis. It can occur with increasing age, but it can be lifelong, associated with recurrent infections of the penis, scarring from surgery, or a penile lesion.

Frenulum breve is caused by the fold of skin being too short and tight.


How is P, ParaP, FB diagnosed?

What to know before your visit to MidLantic Urology in Philadelphia and surrounding counties:

  • During your visit, your doctor will ask you questions regarding your medical history, surgical history, smoking history, medication history and will perform an exam with focused attention to the groin and genitalia.

Tests that may be performed during or after your visit:

  • Urinalysis: This test evaluates for any blood in the urine or infection.
  • Post-void residual: The physician will often ask you to void and then check to make sure you are emptying your bladder.


How is P, ParaP, FB treated?


  • Behavioral changes: For certain conditions, simply retracting the foreskin and cleaning with gentle soap and warm water can work. Make sure to return your foreskin to its normal position afterwards.
  • Topical creams: Steroid or antifungal creams may be used for certain inflammatory/infectious conditions.


  • Circumcision: This involves the surgical removal of the foreskin of the penis.
  • Dorsal slit: For those that want to maintain the majority of their foreskin, this involves a small incision on the upper surface of the foreskin to allow for easier retraction.
  • Penile frenulectomy: Cuts and removes the frenulum to prevent the painful tightening it causes.
  • Frenuloplasty: Uses dissolvable stitches to repair the frenulum lengthwise, which subtly increases its length.

Schedule an appointment with a MidLantic Urology Physician near you today!

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