Phimosis

Phimosis is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • True phimosis is the pathologic inability to retract the foreskin over the glans of the penis as a result of scarring.
  • The inability to retract a normal, supple foreskin is not true phimosis.
  • The foreskin is rarely retractable at birth due to normal adhesions between the glans and the inner prepuce.
  • ∼90% are retractable by 3 yr of age, and 99% are retractable by 17 yr, as the epithelial cells that comprise smegma are shed.
  • Parents should be instructed not to forcibly retract the foreskin.

Etiology

Possible causes of true phimosis include:
  • Trauma from forcible retraction of the foreskin
  • Repetitive bouts of diaper dermatitis
  • Recurrent balanoposthitis
  • Poor hygiene
  • Poorly performed circumcision
  • Congenital anomalies

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