Phimosis is a constriction of the opening of the foreskin so that it cannot be drawn back over the tip of the penis. This condition is a normal occurrence in the newborn boy, but over time the skin that adheres to the tip of the penis can be retracted as the foreskin loosens. By age 17, around 99 percent of males will be able to completely retract their foreskin. Phimosis can also occur if the foreskin is forced back before it is ready. This can cause a fibrous scar to form, which may prevent future retraction of the foreskin.
Paraphimosis occurs when the foreskin is retracted behind the corona (or crown) of the penis and cannot be returned to the unretracted position. This can cause entrapment of the penis, impairing the drainage of blood, and may be serious.
The following are the most common symptoms of phimosis and paraphimosis. However, each child may experience symptoms differently. Symptoms may include:
The symptoms of phimosis and paraphimosis may resemble other problems or medical conditions. Always consult your child's doctor for a diagnosis.
A careful physical examination by your child's doctor normally provides satisfactory information to make a diagnosis.
Specific treatment for phimosis or paraphimosis will be determined by your child's doctor based on:
Your child's age, overall health, and medical history
The extent of the condition
The type of condition
Your child's tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
Treatment may include the following:
For repeated phimosis, it may involve application of a steroid cream to the foreskin up to three times a day for about a month to loosen the adhesive ring. If the child has ballooning of the foreskin during urination after age 10, a circumcision (surgical removal of all or part of the foreskin) may be recommended.
For paraphimosis, it may involve lubricating the foreskin and tip of the penis and then gently squeezing the tip of the penis while pulling the foreskin forward. If this is ineffective, a small incision to relieve the tension may be performed. An emergency circumcision (surgical removal of all or part of the foreskin) may be recommended.
Please consult your doctor with any questions or concerns you may have regarding your child's condition.
At Children’s National in Washington, DC, our pediatric urologists provide comprehensive care for disorders affecting reproductive and urinary organs.
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Craig Peters, MD, is the chief of Surgical Technology and Translation and Principal Investigator in the bioengineering initiative at the Sheikh Zayed Institute for Pediatric Surgical Innovation.
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