MSD Manual

Please confirm that you are a health care professional

Loading

Phimosis and Paraphimosis

By

Patrick J. Shenot

, MD, Sidney Kimmel Medical College at Thomas Jefferson University

Last full review/revision Aug 2019| Content last modified Aug 2019
Click here for Patient Education
NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
Topic Resources

Phimosis is inability to retract the foreskin. Paraphimosis is entrapment of the foreskin in the retracted position; it is a medical emergency.

Phimosis

Phimosis is normal in children and typically resolves by age 5. Treatment is not required in the absence of complications such as balanitis, urinary tract infections (UTIs), urinary outlet obstruction, unresponsive dermatologic disease, or suspicion of carcinoma.

Betamethasone cream 0.05% two to three times a day applied to the tip of the foreskin and the area touching the glans for 3 months is often effective. Stretching the foreskin gently with 2 fingers or over an erect penis for 2 to 3 weeks with care not to cause paraphimosis is also successful. If conservative measures are ineffective, circumcision is the preferred surgical option.

In adults, phimosis may result from balanoposthitis or prolonged irritation. Risk of UTI, penile cancer, HIV, and sexually transmitted diseases is increased. The usual treatment is circumcision.

Paraphimosis

Paraphimosis can occur when the foreskin is left retracted (behind the glans penis). Retraction may occur during catheterization or physical examination. If the retracted foreskin is somewhat tight, it functions as a tourniquet, causing the glans to swell, both blocking the foreskin from returning to its normal position and worsening the constriction.

Pearls & Pitfalls

  • Always remember to reduce the foreskin after urethral catheterization.

Paraphimosis should be regarded as an emergency, because constriction leads quickly to vascular compromise and necrosis of the glans penis. Firm circumferential compression of the glans with the hand may relieve edema sufficiently to allow the foreskin to be restored to its normal position. If this technique is ineffective, a dorsal slit done using a local anesthetic relieves the condition temporarily. Circumcision is then done when edema has resolved.

Click here for Patient Education
NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
Professionals also read

Also of Interest

Videos

View All
Overview of Membranous Nephropathy
Video
Overview of Membranous Nephropathy
3D Models
View All
Male Reproductive System
3D Model
Male Reproductive System

SOCIAL MEDIA

TOP