UROLOGY · CONDITIONS
Phimosis / Paraphimosis
Tight foreskin causing discomfort and voiding difficulty (phimosis) or a urological emergency with trapped foreskin cutting off blood supply (paraphimosis).
ABOUT THIS CONDITION
What is Phimosis / Paraphimosis?
Phimosis is the inability to retract the foreskin over the glans due to scarring or a tight preputial ring, causing pain, difficulty voiding, and recurrent infections. Paraphimosis is a urological emergency , the retracted foreskin becomes trapped behind the glans and constricts blood supply, risking glans ischaemia. Dr. Vipin manages both conditions expertly , conservative topical therapy for simple phimosis, foreskin-preserving preputioplasty, or definitive circumcision, and urgent paraphimosis reduction when required.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Lichen sclerosus (BXO) , scarring inflammation
- Recurrent balanitis causing progressive scarring
- Forceful retraction causing injury and scarring
- Physiological tight foreskin persisting into adulthood
- Previous trauma or surgery to the foreskin
- Skin conditions , eczema, psoriasis, lichen planus
CLINICAL DETAILS
KeyFacts
Topical betamethasone cream resolves physiological phimosis in up to 80% of adults.
Foreskin-preserving surgery , widens the preputial ring while keeping the foreskin intact.
Definitive permanent solution , recommended for pathological (BXO) or recurrent phimosis.
A urological emergency , requires immediate manual reduction or emergency dorsal slit.
All procedures performed as day-care operations under local or general anaesthesia.
Lichen sclerosus requires circumcision , topical steroids cannot reverse established scarring.
HOW WE TREAT IT
Treatment Approach
Circumcision
Definitive surgical removal of the foreskin , provides permanent cure for pathological phimosis, recurrent balanitis, and prevention of paraphimosis recurrence.
- 1
Assessment
Severity of phimosis is graded. Lichen sclerosus and other skin conditions are identified. Paraphimosis is recognised as an emergency requiring immediate action.
- 2
Conservative Therapy
Topical betamethasone applied twice daily for 4–8 weeks can resolve mild to moderate phimosis without surgery in many adult patients.
- 3
Surgical Repair
Preputioplasty (foreskin-preserving) or circumcision (definitive) is performed as a day-care procedure under local or general anaesthesia.
- 4
Paraphimosis
Manual compression to reduce oedema followed by foreskin reduction is attempted first. Emergency dorsal slit is performed if manual reduction fails.
AVAILABLE TREATMENTS
Treatment Options
Circumcision
Complete surgical removal of the foreskin , definitive cure for pathological phimosis and prevention of paraphimosis recurrence.
Preputioplasty (Dorsal Slit Transverse Closure)
Foreskin-preserving widening of the preputial ring , suitable for men who wish to retain the prepuce.
Emergency Dorsal Slit (paraphimosis)
Urgent longitudinal incision in the constricting foreskin to release a trapped paraphimosis and restore blood supply to the glans.
Y-V Plasty
Y-shaped incision at the preputial tip converted to V-closure , foreskin-sparing technique for isolated tight preputial ring without diffuse scarring.
COMMON QUESTIONS
Frequently Asked
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