Phimosis | |
---|---|
An erect penis with a case of phimosis | |
Pronunciation | |
Specialty | Urology |
Symptoms | Unable to pull the foreskin back past the glans[3] |
Complications | Balanitis,[3] penile cancer [citation needed], urinary retention |
Usual onset | Normal at birth[3] |
Duration | Typically resolves by 18 years old[4] |
Causes | Normal, balanitis, balanitis xerotica obliterans[5] |
Risk factors | Diaper rash, poor cleaning, diabetes[6] |
Differential diagnosis | Hair tourniquet, lymphedema of the penis[6] |
Prevention | Steroid cream, stretching exercises, circumcision[7] |
Frequency | 1%–2% (in uncircumcised males 18 years or older)[8][4] |
Phimosis (from Greek φίμωσις phimōsis 'muzzling'[9][10][11]) is a condition in which the foreskin of the penis cannot stretch to allow it to be pulled back past the glans.[3] A balloon-like swelling under the foreskin may occur with urination.[3] In teenagers and adults, it may result in pain during an erection, but is otherwise not painful.[3] Those affected are at greater risk of inflammation of the glans, known as balanitis, and other complications.[3]
In young boys, it is normal not to be able to pull back the foreskin at all.[7] Over 90% of cases resolve by the age of seven, although full retraction is still prevented by preputial adhesions in over half at this age.[5][7] Occasionally, phimosis may be caused by an underlying condition such as scarring due to balanitis or balanitis xerotica obliterans.[5] This can typically be diagnosed by seeing scarring of the opening of the foreskin.[5]
Typically, the condition resolves without treatment by the age of 18.[4] Efforts to pull back the foreskin during the early years of a young male's life should not be attempted.[7] For those in whom the condition does not improve further, time can be given or a steroid cream may be used to attempt to loosen the tight skin.[7] If this method, combined with stretching exercises, is not effective, then other treatments such as circumcision may be recommended.[7] A potential complication of phimosis is paraphimosis, where the tight foreskin becomes trapped behind the glans.[5]
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