Introduction:
Phimosis is a disease entity that society has given negative connotations. Discussions about the foreskin, both in the context of its pathological and physiological conditions have been going on for centuries, and include issues related to religion, hygiene, esthetics and tradition. In 2002, researchers from London recognised that secondary phimosis corresponds to lichen sclerosus et atrophicus, better known as balanitis xerotica obliterans (BXO), constituting it the only absolute indication for circumcision in boys. This study aims to assess the histopathological examinations of patients after the surgical treatment of phimosis in order to ascertain the relationship between BXO and clinically diagnosed phimosis.

Material and methods:
This study analyzed the results of histopathological examinations in patients who underwent surgical methods of phimosis treatment in the period from January 2014 to March 2020. The inclusion criteria of the study were the surgical treatment of phimosis with the accompanying histopathological examination of the specimens collected during the surgery. The data were collected prospectively and randomly.

Results:
There were 106 patients in whom a surgical procedure and histopathological examination were performed. The mean age of the patients was 9.41 ± 3.82 years. In the entire group of patients, the diagnosis of BXO (including BXO focal) was 59% (n = 63).

Conclusions:
The most common cause of secondary phimosis after surgical treatment is BXO, with a patient prevalence ranging from 5.5% to 84%. The results of this study fall within this range. Visible scarring of the foreskin may also be caused by other factors such as chronic inflammation of the foreskin, but also poor hygiene or infections in this area.