Phimosis and Paraphimosis

Also known as: Physiological phimosis, pathological phimosis

What are phimosis and paraphimosis?

A normal uncircumcised male penis has a foreskin/prepuce that can be retracted over the end/tip of the penis. With phimosis the foreskin cannot be retracted.

In physiological phimosis which occurs naturally in the new born baby, the skin cannot be retracted because of adhesions between the inside lining of the foreskin and the tip of the penis. 10% of infants will have physiological phimosis at age 3 years which disappears as the attachments dissolve over time.

Pathological phimosis results from small tears at the tip of the foreskin when it's forcibly retracted or from poor hygiene and infections which lead to scarring of the foreskin.

Paraphimosis is a related condition where the foreskin of an uncircumcised or partially circumcised penis gets stuck behind the head of the penis. This can be a medical emergency as it first prevents blood leaving the penis causing it to swell which then prevents needed blood getting into the penis. This can lead to severe damage and even amputation of the head of the penis.

What causes phimosis and paraphimosis?

Damage to the foreskin from retracting, pulling, stretching, vigorous sex during adolescence or recurrent infections and scarring.

What are the symptoms of phimosis and paraphimosis?

Phimosis often causes no symptoms other than the stuck foreskin. Bulging/ballooning of the foreskin with urinary voiding may be seen.

Paraphimosis can cause swelling of the tip of the penis, pain, and a change in color of the tip of the penis as the blood circulation to the head of the penis is obstructed.

What are phimosis and paraphimosis care options?

Physiological phimosis usually resolves over time and doesn’t require treatment; however for phimosis which occurs often, the foreskin can also be loosened over time with the use of a steroid cream. If ballooning is still present by age 10 years a circumcision may be performed.

Paraphimosis requires emergency medical treatment (lubricating the foreskin and tip of the penis); if this doesn't work a small cut in the foreskin may relieve the pressure or an emergency circumcision may be performed.

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: September 12, 2019 01:52 PM