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Phimosis and Paraphimosis

Phimosis and Paraphimosis is a topic covered in the 5-Minute Pediatric Consult.

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  • Phimosis is the inability to retract the prepuce (foreskin) after puberty due to a narrow preputial opening.
  • Infants and prepubertal children rarely have true phimosis but rather a normal physiologic phimosis.
  • Paraphimosis is the entrapment of the prepuce in a retracted position.


The incidence of phimosis is 0.4 cases per 100 boys per year.

Risk Factors

  • Phimosis
    • Forced retraction of the prepuce
    • Lichen sclerosis
  • Paraphimosis
    • Prolonged retraction of the prepuce


  • Phimosis
    • As the constriction of the phimosis worsens, urine is trapped in the foreskin and ballooning of the prepuce occurs. In severe cases, urine will fill the entire preputial space and extend down the shaft.
  • Paraphimosis
    • Prolonged retraction of the prepuce around the glans causes edema of the prepuce and the glans. The edema makes it harder to correct the phimosis and causes significant pain for the child.

General Prevention

Boys should be instructed to return the foreskin to covering the glans after cleaning to prevent paraphimosis.

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Cabana, Michael D., editor. "Phimosis and Paraphimosis." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618176/all/Phimosis_and_Paraphimosis.
Phimosis and Paraphimosis. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618176/all/Phimosis_and_Paraphimosis. Accessed April 22, 2019.
Phimosis and Paraphimosis. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618176/all/Phimosis_and_Paraphimosis
Phimosis and Paraphimosis [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 22]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618176/all/Phimosis_and_Paraphimosis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Phimosis and Paraphimosis ID - 618176 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618176/all/Phimosis_and_Paraphimosis PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -