Phimosis: Difference between revisions
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==Background== | ==Background== | ||
*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 | ||
== | ==Clinical Features== | ||
* | [[File:Fimosis perfil.jpg|thumb|An erect penis with phimosis and inability to retract foreskin.]] | ||
*Unable to retract foreskin over glans | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Nontrauma penile DDX}} | {{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 | ||
**[[Dorsal Slit (Penis)|Dorsal Slit]] / circumcision is definitive | **[[Dorsal Slit (Penis)|Dorsal Slit]] / circumcision is definitive treatment | ||
==Disposition== | ==Disposition== | ||
Discharge with follow-up ( | *Discharge with follow-up (primary care/urology) | ||
==See Also== | ==See Also== | ||
*[[ | *[[Penile dorsal slit]] | ||
*[[Penile diagnoses]] | *[[Penile diagnoses]] | ||
*[[Paraphimosis]] | |||
==References== | |||
<references/> | |||
[[Category: | [[Category:Urology]] | ||
[[Category: | [[Category:Pediatrics]] | ||
Latest revision as of 19:45, 1 July 2021
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)