II. Definition

  1. Foreskin Stenosis prevents retraction over glans penis

III. Causes

  1. Physiologic Phimosis
    1. Newborn: Phimosis is normal in infants
    2. School age: 90% of boys can fully retract foreskin
    3. Puberty: Nearly 100% of boys fully retract foreskin
  2. Pathologic Causes
    1. Trauma
    2. Dermatitis
    3. Balanitis

IV. Signs

  1. Unable to retract foreskin over glans penis

V. Complications

  1. Urine retention
  2. Balanitis
  3. Dyspareunia in males
  4. Pain on Erection
  5. Urinary Tract Infection

VI. Management

  1. Treat Balanitis or Balanoposthitis if present
  2. Temporizing measures until Urology evaluation
    1. Hemostat dilation
    2. Foley Catheter
    3. Topical Corticosteroids (age 5 years and older)
  3. Emergent Urology referral indications
    1. Urinary Retention refractory to above (unable to void)
    2. Associated Cellulitis of foreskin
  4. Circumcision indications
    1. Persistent or recurrent Phimosis
    2. Recurrent Balanoposthitis or Balanitis

VII. References

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Ontology: Phimosis (C0031538)

Definition (NCI) A condition in which there is constriction in the tip of the foreskin resulting in inability to fully retract the foreskin over the glans penis. Causes include balanoposthitis, balanitis xerotica obliterans, and untreated diabetes.
Definition (MSH) A condition in which the FORESKIN cannot be retracted to reveal the GLANS PENIS. It is due to tightness or narrowing of the foreskin opening.
Concepts Finding (T033)
MSH D010688
ICD10 N47.1
SnomedCT 449826002, 52743003, 155921009, 198005005, 198007002, 310861000009108, 266571009, 198006006
English Phimoses, Phimosis, PHIMOSIS, phimosis (diagnosis), phimosis (physical finding), phimosis, Phimosis [Disease/Finding], tight foreskin, phimoses, Phimosis (disorder), Tight frenulum, Tight foreskin, Tight prepuce, Tight foreskin (finding), Phimosis (disorder) [Ambiguous]
French PHIMOSIS, Prépuce serré, Phimosis
Portuguese FIMOSE, Prepúcio apertado, Acrobistite, Fimose
Dutch stugge voorhuid, Phimosis
German verengte Vorhaut, Phimose, Vorhautverengung
Italian Prepuzio stretto, Fimosi
Spanish Prepucio tirante, fimosis (trastorno), fimosis, tirantez del prepucio, fimosis (concepto no activo), prepucio tirante (hallazgo), prepucio tirante, Fimosis
Japanese 緊張性包皮, キンチョウセイホウヒ
Swedish Förhudsförträngning
Czech fimóza, Těsná předkožka
Finnish Esinahan ahtaus
Russian FIMOZ, ФИМОЗ
Croatian FIMOZA
Polish Stulejka
Hungarian Szűk ((fityma))
Norwegian Trang forhud, Fimose