Phimosis and Paraphimosis in Children

Phimosis and Paraphimosis in Children - Cuddles Child Clinic

In simple words, it is a condition in which there is inability to retract the foreskin of male genitalia leading to local infection under the skin which may lead into infection of urinary tract i.e urinary bladder, urethra, and in severe cases may ascend up to kidneys too. This is a condition of male penile area and is commonly seen in young boys.

• After birth, the foreskin is adherent to glans penis i.e soft part of male genitalia which separates with time and the foreskin is retractable.
• At 1 year of age, 50% boys have adherent foreskin
• By 4 years of age, it is declined to 10% and by 1 years to just 1%

Mother need to clean the area is forcefully retracting the foreskin to maintain hygiene. It helps to resolve the partial adhesions of foreskin to glans.
• Patients presents with complaint of
• Pain while micturition
• Swelling over penile area
• Penile discharge
• Sometimes symptoms of urinary tract infection ie fever, chills etc
• Bulging of foreskin while urinating

Treatment:
• At home trying to retract skin for the purpose of changing and relief prepuce adhesions in small babies, preventing from surgical procedures and infection
• Surgical approach- is advisable in resistant cases where a surgical incision is given to relive the adhesions.

Paraphimosis:- is a condition in which the tight retracted foreskin is unable or difficult to return causing paraphimosis. It is an emergency medical condition.
Child presents with:-
• Swelling at penile tip
• Pain over penis tip
• Tip of skin turns dark red or bluish
• Painful passage of urine
• Decreased/slow urinary stream

It causes obstruction in and around penile area due to obstruction of venous and lymphatic drainage system and can cause serious problem Patient needs to seek surgeon opinion for management.
• Ice packs over the area involved
• Gentle manual compression
• Sometimes need circumcision
• Sometimes only need is mild surgical procedure in local anaesthesia

Phimosis and paraphimosis are problems of foreskin of penis. Both can cause problems with urination, pain, infection. Proper treatment and understanding of the condition is important.
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