Children's Hospital Colorado

Phimosis and Paraphimosis

What are phimosis and paraphimosis?

Phimosis occurs when the foreskin is tight and narrow, making it impossible or painful to pull back over the head of the penis. This may cause pain or could lead to infections. If this condition continues beyond the average age of 4 to 5 years old, or causes pain with erections, medical or surgical intervention may be necessary.

Paraphimosis is where the foreskin is able to be pulled back fully behind the ridge of the glans but is unable to be pulled back over the glans (head). It can cause swelling and irritation, requiring urgent medical attention.

What causes phimosis and/or paraphimosis?

No one knows exactly why some boys get phimosis or paraphimosis.

Who gets phimosis?

Any boy could have phimosis, but it is commonly seen in males up to 10 years of age. Intervention is typically required if there is pain or discomfort with retraction of the foreskin.

Additional resources

Learn about the Department of Pediatric Urology at Children's Hospital Colorado. 

What are the signs and symptoms of phimosis/paraphimosis?

Phimosis: A child may experience bulging of the foreskin during urination (called ballooning), pain with retraction of the foreskin and infections of the head of the penis. If these signs and symptoms are present, contact the Children's Hospital Colorado urology team.

Paraphimosis: A child may experience pain, discoloration and swelling of the penis with full retraction of the foreskin. The foreskin may not be able to be pulled back over the tip of the penis. This is a medical emergency and requires immediate visit to your primary care doctor or the Emergency Department.

What tests are used to diagnose phimosis/paraphimosis?

A careful physical examination by your child’s physician normally provides satisfactory information to make a diagnosis.

How do doctors at Children’s Hospital Colorado make a diagnosis?

A medical history and physical examination is performed in order to diagnose this condition.

How is phimosis/paraphimosis treated?

Phimosis: Medical and surgical treatment are both options. Medical intervention involves the use of a steroid cream. This is applied for 4 to 6 weeks, and the child is re-evaluated. In about 80% of boys this simple treatment is sufficient. Typically, if the foreskin is unable to be retracted and the skin is scarred, a surgical intervention called circumcision may be necessary.

Paraphimosis: This condition may require urgent medical attention. Treatment may include lubricating the foreskin and tip of the penis and then gently squeezing the tip of the penis while pulling the foreskin forward.

Why choose Children’s Hospital Colorado for your child’s phimosis/paraphimosis?

Our urologic surgeons perform hundreds of evaluations of phimosis and paraphimosis, as well as circumcision surgeries each year. Circumcisions are performed on new born infants and older children. We focus on maintaining a parents and child’s beliefs in this matter, and are intent on keeping your child’s health at the forefront. Learn more about the Department of Pediatric Urology. 


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