Phimosis
Circumcision is the default answer, but… steroids have been shown to be effective in cases of mild scarring and can help avoid circumcision - Sean M. Fox
image by: Sam.K Tween & Teens
HWN Suggests
Phimosis: What is it?
Like fever, parents will not overlook a “problem with the penis,” so becoming well versed in the normal and abnormal and emergent conditions is helpful.
The rate of circumcisions has declined and, hence, the number of patients with physiologic phimosis has increased.
Look for scarring. Look exposed glans when no retractile force is applied. These are consistent with pathologic phimosis and require urologic follow-up.
Articles of Interest
EM@3AM: Paraphimosis and Phimosis
Consult urology urgently for circumcision... if urinary retention in phimosis.
Information for patients
Phimosis affects only boys and is normal in infants and toddlers. If an infant’s foreskin has not been removed surgically (circumcision), it is attached to the glans for the first few years. The foreskin typically separates between ages 2 and 6. Forcing your child’s foreskin back can cause pain and damage. In most cases, it will detach naturally on its own.
Paraphimosis and Phimosis
If causing acute urinary retention, call urology for likely dorsal slit procedure. If patient is able to freely urinate, educate patient on how to properly clean their foreskin and show them how to retract the foreskin (3 months of this exercise has been shown to lead to resolution of phimosis in 76% of patients). Topical steroids (triamcinolone for 4-6 weeks) also improve or completely resolve phimosis.
