Foreskin Retraction Problems (Phimosis): Causes & Treatments
Phimosis = inability to retract foreskin over glans. Causes:
- Physiologic: Normal in infants/children; resolves by adolescence.
- Pathologic: Balanitis (inflammation), scarring (BXO – balanitis xerotica obliterans), trauma, forced retraction.
Complications
- Hygiene difficulty → recurrent balanitis.
- Painful erections/intercourse.
- Urinary obstruction, ballooning.
- Paraphimosis (retracted foreskin traps glans – emergency).
Treatment
- Topical corticosteroids (0.05% betamethasone): 4–8 weeks; first-line, high success.
- Preputioplasty: Dorsal slit preserving foreskin.
- Circumcision: Definitive; for BXO, failed conservative, or preference.
Never force retraction. Urologist evaluates and tailors approach.
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