Phimosis and Paraphimosis in Children

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Phimosis (aka a tight foreskin) can potentially occur at any time during life.  Nevertheless, both phimosis and paraphimosis are most common among younger boys. Phimosis refers to a condition where it is painful or impossible to retract the foreskin, whereas paraphimosis occurs secondary to phimosis, when the foreskin is retracted but cannot be returned to its natural position.

In both instances, the condition can cause major discomfort and affect normal blood flow in and around the penis. Paraphimosis is considered to be a medical emergency as the risk of preventing blood flow to the glans is high, and intervention should be sought to return the foreskin to its natural position. Various phimosis products for foreskin stretching are available, but it’s important to know when to seek help.

What Causes Phimosis in Children?

Both conditions are characterised by a tight foreskin, which can make it difficult or impossible for it to be retracted and/or returned comfortably. For younger children, this is common and perfectly normal – often the foreskin remains attached to the glans and cannot be retracted for many years. Around the time a boy reaches 16, it should be possible for the foreskin to be retracted fully and replaced to its normal position comfortably.

There are no specific triggers or causes for phimosis in children – it is simply a developmental abnormality that is surprisingly common among young boys.

What Are the Symptoms of Phimosis?

Every case of phimosis is somewhat different, therefore the signs and symptoms of the condition can also be unique to the child. In all instances, however, several of the most common warning signs indicative of a tight foreskin include:

• Inability to retract the foreskin (partially) by the age of three

• Bulging of the foreskin when passing urine

• Pain and discomfort around the tip of the penis

• Swelling or discolouration of the tip of the penis when drawing back the foreskin

• Painful urination

One of the biggest problems with phimosis in children being that the child is unaware as to what is and isn’t normal. Depending on their age and developmental stage, they may not be able to tell their parents or caregivers when something is wrong. It is therefore important to keep an eye out for any signs of abnormality of the foreskin your child develops.

When Should I Consult with a Doctor?

Your child will undergo regular medical check-ups throughout the first few years of their life, so you can always ask your doctor to perform an examination for peace of mind. Otherwise, it’s a case of bringing the issue to the attention of a medical professional the moment you suspect there is a problem.

Phimosis and paraphimosis are conditions that are significantly easier to treat and correct when detected and addressed early. They also have a tendency to become more problematic and painful over time, so it’s important to act as quickly as possible.

How is Phimosis Diagnosed in a Child?

Along with a description of the potential signs and symptoms you have noted, your doctor will carry out a simple physical examination of the penis and the foreskin. This will provide a good indication as to whether there is an issue, along with the extent to which treatments may be required.

What Are the Available Treatment Options for Children?

The most appropriate treatment will be determined by the nature and severity of the case. There are various phimosis products for foreskin stretching on the market, which in many cases can eliminate the requirement for surgical intervention.

For example, your doctor may prescribe a steroid cream, which over the course of a few weeks could loosen the foreskin. There are also devices available to gently stretch the foreskin physically over time. Circumcision may be recommended, but is usually not be the only option available, and should only be considered as a last resort. 

Speak to your child’s doctor for more information on the various treatments for phimosis.