Phimosis

Phimosis is inability to retract the foreskin of the glans penis

Types

• Physiologic phimosis- in newborns
• Pathologic phimosis- due to scarring secondary to infection, inflammation or trauma

Clinical presentation

1. New-onset non-retractability of the foreskin
2. Ballooning of prepucal skin on urination
3. Painful erection
4. Bleeding from the foreskin orifice
5. Recurrent inflammation
6. Dysuria
7. Discharge

Investigations

1. Urinalysis- look for evidence of infection
2. Full blood count- leukocytosis in infection

Management

1. Dilatation with artery forceps
2. Incision of the dorsal hood
3. Circumcision
4. 0.5% betamethasone cream applied bd for 6 weeks around the phimotic ring
5. Stretching exercises of the foreskin

Complications

Increased risk of;

1. Paraphimosis
2. BXO( Balanitis Xerotica Obliterans)
3. Severe balanoposthitis
4. Recurrent urinary tract infection