American Urological Association - Phimosis and Paraphimosis


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Phimosis and Paraphimosis


  • When the foreskin cannot be retracted behind the glans penis (which is a normal finding in children < 5 yrs).
  • May be congenital or acquired; acquired is much more common and is caused by accumulation of smegma beneath the foreskin due to poor hygiene; may also be secondary to BXO or balanoposthitis.
  • Histologic features: chronic inflammation, fibrosis, edema, and vascular congestion.
  • Treatment: circumcision.


  • When the foreskin has been retracted but now cannot be advanced back over the glans.
  • Cause: most often iatrogenic, following urinary tract instrumentation.
  • Treatment: circumcision or emergent dorsal slit procedure.