Phimosis

Phimosis is often "physiologic" (normal) in infants and young children, as the foreskin is naturally attached to the glans at birth. It usually resolves on its own by age 7. 

• Causes: Scarring from forceful retraction, chronic inflammation, or skin conditions like Balanitis Xerotica Obliterans.

• Symptoms: Foreskin "ballooning" during urination, pain, or inability to retract for cleaning.

• Treatment:

  • Gentle manual stretching.

  • Topical steroid creams to thin and loosen the skin.

  • Circumcision or preputioplasty if conservative methods fail.

Paraphimosis

This occurs when a tight foreskin is retracted (e.g., during cleaning, intercourse, or medical procedures like catheterization) and is not immediately returned to its forward position. 

• Causes: Forgetting to pull the foreskin forward after a medical procedure or forceful retraction.

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• Why it is an Emergency: The tight band of skin acts as a tourniquet, cutting off blood flow. This causes severe swelling and can lead to permanent tissue damage (necrosis) or autoamputation if untreated.

• Treatment:

  • Manual Reduction: A doctor applies pressure to reduce swelling and slides the skin forward.

  • Emergency Procedures: A "dorsal slit" (a small cut in the foreskin) to release the pressure.

  • Follow-up: Circumcision is often recommended later to prevent recurrence.