Phimosis and Paraphimosis (Penis Disorders)

  • Medical Author:
    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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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:

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.

Medically Reviewed by a Doctor on 3/23/2016

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