BXO and Tight Foreskin (Phimosis)

By: Dr. Khan

Published: August 30, 2024

Phimosis, a condition characterised by the tightening of the foreskin, leading to difficulty in retracting it over the head of the penis, can appear at birth (congenital) or later in adult life (acquired).

This blog also discusses the correlation between acquired tight foreskin and balanitis xerotica obliterans (BXO), also known as lichen sclerosus et atrophicus, a chronic inflammatory condition primarily affecting the genital area.

Correlation Analysis of Phimosis and BXO

  • The association between acquired phimosis and BXO is more pronounced than congenital phimosis.
  • BXO is identified as the primary causative factor for acquired phimosis in both adults and children.
  • The inflammatory nature of BXO triggers scarring and constriction of the foreskin, leading to diseased and acquired phimosis.
  • While the relationship between congenital phimosis and BXO is less explicit, BXO can also be present in cases of congenital phimosis.

Significance and Treatment Modalities

The heightened risk of BXO linked to acquired phimosis underscores the critical importance of timely diagnosis and effective management.

  • Early intervention for BXO is paramount in preventing complications such as extensive scarring and urethral stricture.
  • Treatment approaches vary based on severity and cause:
  • In mild cases of acquired phimosis, topical corticosteroids and non-surgical interventions may be required.
  • In severe cases of phimosis or BXO, surgical intervention (particularly circumcision) may be warranted, especially when symptoms cause discomfort, hygiene problems, or interfere with sexual function.

Recent Study on BXO and Phimosis

A contemporary study analysed the correlation between BXO and phimosis using histological samples from 120 subjects who underwent circumcision for phimosis.

Findings:

  • 45.1% of subjects with congenital phimosis had BXO.
  • 62.3% of subjects with acquired phimosis had BXO.

This strongly indicates a robust association between BXO and acquired phimosis.

Key Message

The study distinctly underscores a strong correlation between BXO and acquired phimosis.

  • The type of phimosis (congenital or acquired) emerged as the pivotal factor linked to BXO development.
  • Further research is warranted to validate and strengthen these observations.

Consultation with Our Urological Specialist

Individuals experiencing difficulty retracting the foreskin are advised to seek consultation with our consultant urologists for accurate diagnosis and tailored treatment options.

Note

This blog is intended solely for informational purposes and should not be taken as medical advice. For specific concerns, please consult with our consultant urologists.

Dr. A.R Khan

Paediatric Surgeon/Urologist

Bio

BSC, MBBS, FRCS, FEBPS, FRCS (PAEDS)
Dr. Khan is a highly experienced and respected paediatric surgeon and urologist with a distinguished career that spans over three decades. He has performed more than 7,000 circumcisions in the UK and is recognised for his expertise in treating foreskin problems, buried penis, and hypospadias. Dr. Khan is also pioneering new techniques in circumcisions for adults, children, and infants, ensuring the highest standards of care for his patients.
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