Phimosis

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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

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