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Phimosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Phimosis is the inability to retract the foreskin because of a narrow preputial ring. It affects about 1% of boys.

Causes:

  • primary (physiological): without sign of scarring (1):
    • congenital - rare
  • secondary (pathological): due to scarring from conditions such as (1)
    • recurrent balanitis
    • traumatic retraction of the foreskin
    • Balanitis xerotica et obliterans (2)

Presentation is with:

  • poor stream
  • ballooning of foreskin on micturition
  • 'spraying' on micturition
  • recurrent attacks of balanitis
  • pain on intercourse in adults
  • in severe cases, hydronephrosis

Treatment

Physiological phimosis -

  1. since the foreskin becomes retractable with time these patients can be managed conservatively
  2. topical steroids can be applied to the preputial ring may be useful (2)

Pathological phimosis -

  1. circumcision
  2. a short course of topical corticosteroids may be beneficial in mild scarring (2)

Reference:

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