RT Book, Section
A1 Reichman, Eric F.
SR Print(0)
ID 57716250
T1 Chapter 149. Phimosis Reduction
T2 Emergency Medicine Procedures, 2e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-161352-1
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=57716250
RD 2024/04/18
AB A  phimosis  is  a  condition  in  which  the  foreskin  cannot  be  retracted  behind  the  glans  of  the  penis.1–19  It  interferes  with  cleaning  under  the  foreskin,  allows  the  accumulation  of  secretions  and  debris  (i.e.,  smegma)  under  the  foreskin,  and  may  predispose  the  patient  to  infections  and  possible  malignancy.18  It  is  classified  into  two  subgroups:  physiologic  and  pathologic.  Physiologic  phimoses  occurs  naturally  in  newborns.  In  males  younger  than  4  years  of  age,  it  is  normal  for  the  foreskin  to  not  be  retractable.  In  older  boys  and  adults,  the  foreskin  can  usually  be  retracted  without  difficulty.1  Pathologic  phimoses  is  the  inability  to  retract  the  foreskin  after  it  was  previously  retractable  or  after  puberty,  usually  secondary  to  scarring  of  the  foreskin.  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  to  relieving  urinary  obstruction.