Phimosis: This condition occurs when the foreskin cannot be retracted (pulled back) behind the head (glans) of the penis. This is called phimosis.
It is usually a condition found in children and occasionally adults. Physiological phimosis is the normal condition that occurs mainly during the first year of life when the foreskin is not retractable in these young males. This may occur until about 3 years of age. This condition is not a congenital problem such as buried penis (the penis is located beneath the abdominal skin.
Paraphimosis: This condition, paraphimosis, is somewhat the opposite of phimosis. The foreskin, after being pulled back, becomes trapped and then swollen behind the head (glans) of the penis.
◦The swelling can lead to blockage of blood flow to the penis, which can lead to gangrene of the penile shaft and head distal to the welling.
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Paraphiosis is considered a true medical emergency.
Circumcision (surgical removal of the foreskin) at birth or revision of a prior circumcision can prevent this condition.
Balanitis: A common presentation in general practice, balanitis manifests quickly, often overnight in a previously well child. The penis may be tender, swollen and inflamed from the tip to the base of the penis. Rarely, redness extends onto the suprapubic area. Discharge may also be present.
Swabs reveal a causative organism in about half of cases. Balanitis usually responds to an oral broad spectrum antibiotic.
A severe episode causing urinary retention may require admission to hospital while repeated infections may warrant referral for circumcision.
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