Disease: Phimosis and Paraphimosis
(Penis Disorders)

    Phimosis facts

    • Phimosis is the inability to retract the foreskin behind the head (glans) of the penis.
    • Symptoms of phimosis may include:
      • difficulty or pain during urination,
      • painful erection, or
      • paraphimosis.
    • Phimosis is usually divided into physiologic and pathologic phimosis.
    • Physiologic phimosis is the normal condition in which children are born with a tight foreskin and separation occurs during late childhood and early adolescence.
    • Pathologic phimosis occurs due to infection, inflammation, or scarring and is usually found in uncircumcised adult men.

    What causes phimosis?

    Physiologic phimosis is present at birth and resolves without intervention. Most children will not have a fully retractable foreskin at birth, but do so as they get older with the majority having a fully retractable foreskin by early adolescence.

    Pathologic phimosis is caused by scarring, balanitis, and underlying medical risk factors.

    What are the symptoms of phimosis?

    The inability of the foreskin to retract can lead to difficulty cleaning of the area which can cause balanitis. Other symptoms include:

    • difficulty urinating,
    • painful urination,
    • painful erection, or
    • paraphimosis.

    How is phimosis diagnosed?

    Your doctor can diagnose phimosis based on a thorough history and physical examination. Additional tests are usually not necessary.

    How is phimosis treated?

    Treatment depends on the age of the male, severity, and resulting symptoms.

    The first choice of treatment is usually a steroid ointment that is locally applied. This treatment has shown a success rate of over 70%. The ointment softens the foreskin and is applied for 4 to 6 weeks. Once full retraction is possible the ointment is discontinued.

    If the steroid treatment is not successful, a circumcision might be beneficial. This depends on the underlying symptoms.

    What is the definition of paraphimosis?

    Paraphimosis occurs when the foreskin is retracted behind the glans penis and cannot be returned to its original position. This turns into a urologic emergency as blood flow is decreased to the glands penis.

    What causes paraphimosis?

    Paraphimosis is an uncommon condition usually inadvertently caused by retraction of the foreskin by the individual, or in a hospital or nursing home setting by a healthcare professional inserting a Foley catheter, or preparing the patient for a procedure.

    What are the symptoms of paraphimosis?

    Once the skin is trapped, edema occurs and the restriction worsens, often forming a very tight tissue ring. This causes pain and worsening swelling (edema).

    How is paraphimosis diagnosed?

    Your doctor will diagnose paraphimosis based on a thorough history and the physical examination. Additional tests are usually not necessary.

    What is the treatment of paraphimosis?

    Manual reduction is usually the first treatment option. To help with the pain, your doctor might apply a local anesthetic cream, give you pain medication by mouth, or apply a local anesthetic block to your penis.

    Applying ice to the local area can help with the edema during manual reduction.

    Local injection of hyaluronidase is effective in decreasing the swelling and allowing reduction.

    If none of the above techniques are successful or if the doctor feels a faster reduction is necessary, a small surgical slit can be made in the back side (dorsal region) of the constrictive skin. This should usually be followed by a circumcision at a later date to avoid a recurrence.

    What is the definition of paraphimosis?

    Paraphimosis occurs when the foreskin is retracted behind the glans penis and cannot be returned to its original position. This turns into a urologic emergency as blood flow is decreased to the glands penis.

    What causes paraphimosis?

    Paraphimosis is an uncommon condition usually inadvertently caused by retraction of the foreskin by the individual, or in a hospital or nursing home setting by a healthcare professional inserting a Foley catheter, or preparing the patient for a procedure.

    What are the symptoms of paraphimosis?

    Once the skin is trapped, edema occurs and the restriction worsens, often forming a very tight tissue ring. This causes pain and worsening swelling (edema).

    How is paraphimosis diagnosed?

    Your doctor will diagnose paraphimosis based on a thorough history and the physical examination. Additional tests are usually not necessary.

    What is the treatment of paraphimosis?

    Manual reduction is usually the first treatment option. To help with the pain, your doctor might apply a local anesthetic cream, give you pain medication by mouth, or apply a local anesthetic block to your penis.

    Applying ice to the local area can help with the edema during manual reduction.

    Local injection of hyaluronidase is effective in decreasing the swelling and allowing reduction.

    If none of the above techniques are successful or if the doctor feels a faster reduction is necessary, a small surgical slit can be made in the back side (dorsal region) of the constrictive skin. This should usually be followed by a circumcision at a later date to avoid a recurrence.

    Source: http://www.rxlist.com

    Treatment depends on the age of the male, severity, and resulting symptoms.

    The first choice of treatment is usually a steroid ointment that is locally applied. This treatment has shown a success rate of over 70%. The ointment softens the foreskin and is applied for 4 to 6 weeks. Once full retraction is possible the ointment is discontinued.

    If the steroid treatment is not successful, a circumcision might be beneficial. This depends on the underlying symptoms.

    Source: http://www.rxlist.com

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