Urology: Foreskin Pathology (Phimosis/Paraphimosis)

Phimosis

Definition

  • Definition: Inability to Retract Foreskin Over the Glans

Causes

  • Physiologic – Common in Young Children Between Ages 2-4 Years
  • Inflammation
  • Infection/Balanitis
  • Edema

Treatment

  • Do Not Forcibly Retract – Risk for Paraphimosis
  • Immediate Treatment: Stretching/Dilation or Topical Corticosteroids
    • If Fails: Dorsal Slit
  • Definitive Management: Circumcision
  • *Physiologic Phimosis is Usually Self-Limiting, Resolves by Age 16 & Requires No Treatment

Paraphimosis

Definition

  • Definition: Retracted Foreskin Trapped Over the Glans

Complications

  • Urologic Emergency
  • Causes Venous/Lymphatic Obstruction
  • Risk for Strangulation or Necrosis

Treatment

  • Primary Treatment: Manual Reduction
  • If Fails: Dorsal Slit for Reduction
  • Consider Elective Circumcision to Prevent Recurrence

Paraphimosis 1

References

  1. Konan PG, Vodi CC, Dekou AH, Fofana A, Gowé EE, Manzan K. Cancer of the penis associated with HIV: a report of three cases presenting at the CHU cocody, ivory coast. BMC Urol. 2015 Nov 16;15:112. (License: CC BY-4.0)