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Phimosis

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Phimosis, Tight Foreskin, Foreskin Stenosis, Physiologic Phimosis, Foreskin Does Not Retract

  • See Also
  • Definition
  1. Phimosis
    1. Foreskin Stenosis prevents retraction over glans penis
    2. Contrast with the emergency Paraphimosis in which the foreskin cannot be reduced
  • Causes
  1. Physiologic Phimosis
    1. Newborn: Phimosis is normal in infants
    2. School age: 90% of boys can fully retract foreskin
    3. Puberty: Nearly 100% of boys fully retract foreskin
  2. Pathologic Causes
    1. Trauma
    2. Dermatitis
    3. Balanitis
  • Signs
  1. Unable to retract foreskin over glans penis
  • Complications
  1. Urine retention
  2. Balanitis
  3. Dyspareunia in males
  4. Pain on Erection
  5. Urinary Tract Infection
  • Management
  1. Treat Balanitis or Balanoposthitis if present
  2. Temporizing measures until Urology evaluation
    1. Hemostat dilation
    2. Foley Catheter
    3. Topical Corticosteroids (age 5 years and older)
  3. Emergent Urology referral indications
    1. Urinary Retention refractory to above (unable to void)
    2. Associated Cellulitis of foreskin
  4. Circumcision indications
    1. Persistent or recurrent Phimosis
    2. Recurrent Balanoposthitis or Balanitis
  • References