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- When the foreskin has been retracted but now cannot be advanced back over the glans.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.