Phimosis and Paraphimosis
Basics
Description
- 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.
Epidemiology
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
Pathophysiology
- 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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Citation
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 MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618176/all/Phimosis_and_Paraphimosis. Accessed January 24, 2025.
Phimosis and Paraphimosis. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618176/all/Phimosis_and_Paraphimosis
Phimosis and Paraphimosis [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2025 January 24]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/618176/all/Phimosis_and_Paraphimosis.
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