Phimosis, Meatal Stenosis and Paraphimosis

Abstract

Phimosis is defined as narrowing of the preputial ring which prevents retraction of the foreskin over the glans penis. Physiological phimosis is almost invariably present at birth. It regresses with age, as the foreskin widens and gradually advances over the glans penis. Pathological phimosis is much more commonly secondary. It may follow recurrent or chronic balanoposthitis, or balanitis xerotica obliterans. It is best managed by circumcision. Meatal stenosis is narrowing of the external urinary meatus. It is uncommon in the pediatric population. The most common natural cause of meatal stenosis in children is BXO. It can also be secondary to trauma, postcircumcision, or inflammation from ammoniacal dermatitis. Severe or recurrent meatal stenosis is best treated by meatoplasty. Paraphimosis is defined as the inability to return a retracted foreskin back over the glans. This results in swelling of the glans and foreskin due to oedema from the resultant constriction. Paraphimosis can occur at any age after the foreskin becomes retractable over the glans. Paraphimosis is an emergency, requiring prompt reduction.