Five Levels of Phimosis Severity- Which stage are you in currently?

Your phimosis can be categorized into one of these five stages as we will outline here. It is always helpful to know the severity level of your phimosis so that you can utilize the appropriate tools and methods to solve it.

Way back in 1995 a research article was published by a group of Japanese researchers in which phimosis was classified into 5 stages as shown below.

However, we realized that the Kayaba classification is still very loosely defined and we wanted to provide more specific metrics and details for each stage that will help you in understanding your current state of phimosis. We will also go through some pros and cons of each stage. So, let’s get right down to the classification-

Level 1- Pinhole Phimosis (Upto 4mm)

Pinhole phimosis is not very common. Chances are that you don’t belong in this category but if you do, you can surely solve it! You will just need to work a little bit more than the rest. The name itself is self-explanatory but the below sketch hopefully makes it clearer -

It is the most severe form of phimosis in adults. In this category, your phimotic ring diameter can range from the diameter of a pinhole (extremely rare) to up to 4mm. 

If you have pinhole phimosis, you may need to do some stretching by other means before you can start wearing the smallest of the Phimostretch rings that starts with 3mm diameter.

Check out the below stretching guide that explains the stretching process

• Complete guide to Phimosis stretching

Disadvantages of pinhole phimosis

• Orgasm and climaxing can take a while- Sexual intercourse can be a bit tricky and you may find that it takes a while to climax during intercourse since your glans is always completely covered with your foreskin and you can’t experience the gliding action of your foreskin
• More work to resolve it- You have a longer journey than the rest to cure your phimosis since you will be starting out with a small phimotic ring diameter.
• Looks unpleasing to the eye- This may not be a huge deal if your partner is comfortable with it but it does look a bit weird.
• Urination- Ballooning during urination and it takes more time to urinate. If you have always had phimosis, you won’t find this to be a big hindrance. But it does take longer to urinate since you only have a small hole to work with. 

Advantages-

• No need to worry about paraphimosis- This is a big advantage as you can still have a normal sexual intercourse without needing to worry about your foreskin getting stuck behind your glans.
• No need to worry about glans-sensitivity- Since your glans has not been exposed yet, you don’t need to worry about painful glans during sexual intercourse.
• No need for cleaning the interior of penis foreskin as the urine cleans it out with ballooning effect. 

What should you do if you are at level 1?

If you have pinhole phimosis, your short term goal should be to increase your phimotic ring diameter up to an extent that allows you to start wearing the smaller phimostretch rings. Since the phimostretch rings start at 3 mm you may need to do a little bit of stretching manually or by some unconventional methods, consistently, until you reach a stage where you can fit in 3 mm or 4 mm rings.

From there, your journey becomes similar to the rest where you try to keep moving up to bigger ring sizes.

Example of an unconventional method to stretch-

• Use Q-tips- Cut the cotton part out. Use the PTFE tape over it to start and change diameters gradually until you can get to 3 mm ring.
• Try retracting your foreskin with two fingers every day. You will find that over time your hole will start getting bigger eventually.

Level 2- Glans visible (5mm to 16/18 mm) but can’t retract behind corona when flaccid

If you can put on a 5 mm phimostretch ring or higher, you have now entered into level 2 category. At this stage, you can now see your glans as well as meatus. You may also find that your glans is quite sensitive to physical touch.

Challenges-

• Sensitive glans- You will have to deal with your sensitive glans which hasn’t been regularly exposed as you start increasing your Phimostretch ring sizes. Check out our guide that deals with improving Glans sensitivity
• Still a long path ahead to cure phimosis- If you are in this category, you are obviously better off than folks who have pinhole phimosis but the path towards full phimosis cure is still long and requires consistency and patience.
• Urination- Peeing with accuracy- You may find that your aim may not be as good as you would like it to be. 
• Two-finger stretches not possible until the transition to level 3- Aside from phimostretch rings, you may want to use two fingers to complement your stretching process. However, you may find that your phimotic ring is still small enough that it doesn’t allow you to insert two fingers to do your stretching. However, you can just grab the sides of the phimotic band to do your stretching.
• Anxiety with sex because of possible pain- On an erect penis, you now have to worry about two things. Sensitive glans and tearing of your foreskin during intercourse. Since your foreskin is still not able to retract fully over your glans, the thrusting movement during sexual intercourse may lead your foreskin to be pulled beyond its normal surface area which increases the chance of tears on the foreskin. This is a problem since not only this is a source of additional anxiety but having wounds on your foreskin sets you back on your phimosis stretching progress. So, you should always make sure that your foreskin is well lubricated before intercourse.
• Paraphimosis during sex is very unlikely at level 2 phimosis as foreskin won’t move all the way back on an erect penis. Nevertheless, you should be cautious about this possibility as well. 

What should you do if you are at level 2?

Keep using the Phimostretch rings to progress to the next bigger ring. Your goal should be to move to the next bigger size and continue the same process of stretching as always. At this stage, you may be tempted to ‘jump’ to a bigger ring than what your current phimotic band is capable of wearing. Avoid this temptation. Use a normal-sized ring that is not too tight or too loose and wait for it to consistently come off before moving to the bigger ring. 

You can also complement the rings by stretching with fingers however you may have to hold the phimotic band on the sides to stretch it gently if you are unable to fully insert two fingers inside your phimotic ring.

As you transition from level 2 to level 3 phimosis, you will find that you can now retract behind the corona/ridge of the glans (when flaccid) but it will still be tight over the shaft and create a horseshoe shape

Level 3- Can retract behind corona when flaccid ( 18 mm to 26mm) but not when erect

If you are wearing rings between 18 to 26 mm, you are now in the level 3 stage of your phimosis. Here are some typical features that define this stage-

Characteristics

• Somewhere during the level 3 stage, your foreskin should no longer feel tight behind corona when flaccid and should retract and move forward freely without any tightness (during flaccid state). 
• However, you can’t retract it over the corona when erect. (Only possible with excessive effort to retract back which should be strictly avoided)
• Can now use two-finger stretching technique to supplement your stretching with phimostretch rings
• If two finger stretches are still not possible, you can grab the edges of the phimotic band and stretch lightly
• Anxiety during sex- Intercourse during level 3 can be tricky. There is a chance that the foreskin can get stuck behind the corona during sex which may cause paraphimosis. As you very well know paraphimosis is characterized as a medical emergency and should be avoided at all costs. 
• Will need to work on glans sensitivity - During level 3, you should now start working on your glans sensitivity. Check out our article that goes into detail into how you can gradually improve your glans sensitivity. 
• Hygiene becomes more important at this stage. Make sure to daily wash the glans and foreskin area with water (No soap) to avoid any infections. 

What should you do if you are at level 3?

Keep following the strategies described in level 2 with the Phimostretch rings. Supplement the rings with 2 finger stretching as well as frenulum stretching. Start working on improving your glans sensitivity in order to desensitize the glans. Wearing condoms during intercourse is now going to be more important compared to previous stages in order to avoid risks of paraphimosis (Foreskin getting stuck behind corona). 

Level 4- Can retract freely up to corona when erect (26mm to 34mm)

If you are at this stage that means the final destination of your phimosis journey is near and you can visualize it. This will give you some added drive to keep continuing with the stretching process with the bigger rings. You are not quite there yet when erect but you can now sense that with some more stretching and patience, your foreskin opening will get bigger over time allowing you to move it more freely over the glans. Here are a few things to keep in mind once you are at this stage-

Tips and features 

• In level 4 phimosis, as you move towards bigger ring sizes your glans coverage now gradually improves as well. Around ring sizes 30 to 32mm, over 90% of your glans is now visible (when erect) and around 34mm, you can move your foreskin freely until corona but with some tightness.
• You will need to be a bit patient with the rings. It is okay if you are stuck on one size for a while. Let the ring do its job. As long as you are getting enough stretching, you will be able to move up the next ring size eventually as your foreskin gets looser.
• Chances of paraphimosis during intercourse is even higher than level 3. Hence wear condoms during intercourse to avoid it.
• Keep working on your glans sensitivity using techniques we outlined earlier in our article.

Level 5- Mild phimosis- (34 mm upwards)

At this stage, you can retract behind corona when erect but there is still some tightness and the free back and forth movement over glans and corona is still not achieved.

Tips and features

• You now only need to use 1 or 2 more ring sizes to completely cure your phimosis. Your goal from here on now becomes reaching a stage where there is no tightness in foreskin movement.
• Chances of paraphimosis are very high during normal masturbation or intercourse (without a condom) but the paraphimosis can be more easily resolved by pushing the foreskin forward since the opening is very close to a normal foreskin opening.
• Intercourse with condoms still helps avoid paraphimosis to an extent. However, after sex you should double-check to make sure your foreskin is back to its normal forward position and is not stuck behind the corona since its very easy for foreskin to be pulled back and get stuck.

Level 0- Normal foreskin. No phimosis (Over 36 or 38 mm)

This is where you want to be. At this stage, there is no tightness in your foreskin opening or ridged band and you can now move your foreskin back and forth over the glans and corona freely without the foreskin opening getting stuck anywhere. Once you have reached this stage, you should still lock in the gains by continuing to wear your largest ring for 2 to 3 weeks longer. At this point, you have completely solved your phimosis problem and close this chapter for good!

Which stage are you in currently?

It helps to understand which stage of phimosis you are in as it provides a good mental picture of the work that is ahead of you in getting rid of tight foreskin. Now that we have provided a good overview of the different levels and stages of phimosis, we are curious to know which category do you fall into? You can email us at info@phimostretch.com for any questions related to phimosis.

P.S- If you are ready to kickstart your phimosis stretching journey today, click here to know more about Phimostretch rings kit which has an excellent success rate. If you are ready to purchase it, click the Buy now button below to purchase it today.