We need you! Join our contributor community and become a WikEM editor through our open and transparent promotion process.
Phimosis
From WikEM
Contents
Background
- Most uncircumcised infants have normal, physiologic phimosis
- Nearly all cases resolve by 5yr of age
- Only emergency if causes acute urinary retention
Clinical Features
- Unable to retract foreskin over glans
Differential Diagnosis
Non-Traumatic penile diagnoses
- Phimosis
- Balanoposthitis
- Paraphymosis
- Priapism
- STDs
Penile Trauma
Evaluation
- Typically a clinical diagnosis
- Ensure that patient able to urinate
Management
- Dilation of foreskin with hemostat
- Foley cathether if urinary retention is present
- Topical steroids - Triamcinolone 0.025% BID x4-6 weeks
- Can avert need for circumcision after phimosis
- Dorsal Slit / circumcision is definitive treatment
Disposition
Discharge with follow-up (primary care/urology)
