Phimosis: Difference between revisions

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==Background==
==Background==
*Unable to retract foreskin over glans
*Most uncircumcised infants have normal, physiologic phimosis
*Most uncircumcised infants have normal, physiologic phimosis
**Nearly all cases resolve by 5yr of age
**Nearly all cases resolve by 5yr of age
*Only emergency if causes acute urinary retention
*Only emergency if causes acute urinary retention


==Work-Up==
==Clinical Features==
*Ensure that pt able to urinate
*Unable to retract foreskin over glans


==Treatment==
==Differential Diagnosis==
{{Nontrauma penile DDX}}
{{Penile Trauma DDX}}
 
==Evaluation==
*Typically a clinical diagnosis
*Ensure that patient able to urinate
 
==Management==
*Dilation of foreskin with hemostat
*Dilation of foreskin with hemostat
*Foley cathether if urinary retention is present
*Foley cathether if urinary retention is present
*Topical steroids - Triamcinolone 0.025% BID x4-6 weeks
*[[Topical steroids]] - [[Triamcinolone]] 0.025% BID x4-6 weeks
**Can avert need for circumcision after phimosis
**Can avert need for circumcision after phimosis
*[[Doral slit]] / circumcision is definitive tx
**[[Dorsal Slit (Penis)|Dorsal Slit]] / circumcision is definitive treatment


==Disposition==
==Disposition==
Discharge with follow-up (PMD/urology)
Discharge with follow-up (primary care/urology)


==See Also==
==See Also==
*[[Dorsal Slit (Penis)]]
*[[Dorsal Slit (Penis)]]
*[[Paraphimosis]]
*[[Penile diagnoses]]
 
==References==
<references/>


==Source==
Tintinalli


[[Category:GU]]
[[Category:Urology]]
[[Category:Peds]]
[[Category:Pediatrics]]

Revision as of 22:38, 15 September 2019

Background

  • Most uncircumcised infants have normal, physiologic phimosis
    • Nearly all cases resolve by 5yr of age
  • Only emergency if causes acute urinary retention

Clinical Features

  • Unable to retract foreskin over glans

Differential Diagnosis

Non-Traumatic penile diagnoses

Penile trauma types

Evaluation

  • Typically a clinical diagnosis
  • Ensure that patient able to urinate

Management

  • Dilation of foreskin with hemostat
  • Foley cathether if urinary retention is present
  • Topical steroids - Triamcinolone 0.025% BID x4-6 weeks
    • Can avert need for circumcision after phimosis
    • Dorsal Slit / circumcision is definitive treatment

Disposition

Discharge with follow-up (primary care/urology)

See Also

References