TY - CHAP M1 - Book, Section TI - Phimosis Reduction A1 - O’Rourke, Kevin A2 - Reichman, Eric F. PY - 2018 T2 - Reichman's Emergency Medicine Procedures, 3e AB - A phimosis is a condition in which the foreskin cannot be retracted proximally to the glans penis.1-18 The presence of a phimosis can interfere with cleaning under the foreskin, allows the accumulation of secretions and debris (i.e., smegma), and may predispose the patient to infections and possible malignancy.18 It is classified into two subgroups as physiologic and pathologic. Physiologic phimoses occur naturally in newborns. In males younger than 4 years of age, it is normal for the foreskin not to be retractable and it should not be forcibly retracted.19 In older boys and adults, the foreskin can usually be retracted without difficulty.1A pathologic phimosis is the inability to retract the foreskin after it was previously retractable or after puberty, usually secondary to scarring of the foreskin (Figure 180-1).20,21 Surgical treatment for a phimosis has been known for hundreds of years.2 A Byzantine surgeon by the name of Oribasius, in the fourth century AD, gave a seemingly well-acquainted description of a technique involving forced dilation of the constrictive foreskin, scalloping out of its inner surface, then stretching it over a parchment-wrapped lead tube placed between the filleted skin and the glans.2 Current techniques for the management of a phimosis in the Emergency Department are simple and remain an important intervention directed at relieving urinary obstruction. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1159807687 ER -