Overview

• Phimosis → non-retractable foreskin (ie. tight foreskin).
  • Physiological at birth. Incidence decreases as age increases.
  • Ballooning during micturition.
  • Mx:
    • <2yo → reassure and review in 6 months. (Advise personal hygeine).
    • >2yo → circumcision or topical steroid creams.
• Paraphimosis (EMERGENCY) → foreskin becomes trapped in the retracted position proximal to swollen glans.
  • Restricts blood flow to head of penis, penis turns dark purple.
  • Mx:
    • 1st Line → analgesia, attempt to reduce foreskin (gentle compression with saline soaked swab).
    • 2nd Line → emergency referral to urologist.
• Hypospadias → opening of urethra not located at tip of penis.
  • Most commonly on distal ventral surface of penis.
  • Associated conditions include cryptorchidism (present in 10%) and inguinal hernia.
  • Mx → refer to specialist services, surgical correction at 12 months of age. Essential that child is not circumcised prior to procedure as foreskin may be used.

Making Diagnosis

Clinical Features

Investigations

Management Plan

Complications →

Prognosis →