Urol. praxi. 2020;21(1):6-10 | DOI: 10.36290/uro.2020.016

A urologist's approach to unretractable foreskin in children

MUDr. Jan Šarapatka, Ph.D., FEBU, MUDr. Jan Vrána, doc. MUDr. Oldřich Šmakal, Ph.D.

Urologická klinika Fakultní nemocnice a Lékařské fakulty Univerzity Palackého v Olomouci

There can be a number of causes of unretractable foreskin. It can be due to a congenital narrowing of the foreskin (primary phimosis) or adhesions between the internal lamina of the prepuce and the glans penis. On physical examination, the general paediatrician should distinguish physiological causes of unretractable foreskin (primary phimosis, adhesions) from pathological ones (secondary phimosis). When preputial pathology is suspected, conservative treatment fails, or phimosis persists into puberty, it is advisable to refer the patient for specialist investigation. The treatment of phimosis can be initiated after the second or third year of life, or even earlier in the case of complicating factors. Conservative treatment with a corticoid ointment is the first choice; if it fails, circumcision can be considered. However, circumcision is necessary in secondary phimosis, particularly if balanitis xerotica obliterans is suspected. Complications associated with adhesions can be managed with dissolution. Acute conditions require immediate therapeutic intervention, preferably in the catchment facility.

Keywords: foreskin, adhesions, phimosis, paraphimosis, balanitis xerotica obliterans.

Published: April 17, 2020  Show citation