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Phimosis and Paraphimosis, Pediatric

Kara N. Saperston, MD and Michael DiSandro, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Phimosis is the inability to retract the prepuce (foreskin) after puberty due to a narrow preputial opening.

  • Infants and prepubertal children rarely have true phimosis but rather a no...

DIAGNOSIS

HISTORY

  • Phimosis

    • Parent may report ballooning of the prepuce during voiding.

    • Parent may report having to squeeze the prepuce to clear all the trapped urine.

  • Paraphimosis

    • Parent will report cleani...

TREATMENT

GENERAL MEASURES

  • Phimosis

    • Refer to pediatric urologist if patient fails 2 months of medical management.

  • Paraphimosis

    • Refer to pediatric urologist immediately if unable to return the foreskin to ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Phimosis

    • Follow-up in 2 months after use of steroids

  • Paraphimosis: if foreskin is back in normal position:

    • Follow up with pediatric urologist in 2 weeks.

    • There should...

ADDITIONAL READING

CODES

ICD9

605 Redundant prepuce and phimosis 

ICD10

  • N47.1 Phimosis

  • N47.2 Paraphimosis

SNOMED

  • 449826002 Phimosis (disorder)

  • 13758004 paraphimosis (disorder)

  • 253854008 congenital phimosis (disorder)

FAQ

  • Q: Can a child have phimosis as a newborn?

  • A: Physiologic phimosis (inability to retract the foreskin) is normal in prepubertal children. It occurs because of incomplete separation of skin between ...

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