Penis & scrotum
Inflammatory
Phimosis
Authors: Alcides Chaux, M.D., Antonio L. Cubilla, M.D.
Last author update: 1 February 2010
Last staff update: 15 August 2023 (update in progress)
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Phimosis[TI] penis
Table of Contents
Definition / general | Etiology | Clinical features | Case reports | Treatment | Clinical images | Microscopic (histologic) description | Differential diagnosis | Additional referencesCite this page: Chaux A, Cubilla AL. Phimosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/penscrotumphimosis.html. Accessed September 21st, 2023.
Definition / general
- Condition in which the foreskin cannot be retracted due to a small orifice
Etiology
- Usually due to scarring from repeated bacterial infections, lichen sclerosis (Medicina (Kaunas) 2008;44:460), congenitally abnormally long foreskin or chronic graft versus host disease (Bone Marrow Transplant 2007;40:335)
Clinical features
- Smegma (desquamated epithelial cells, debris) may accumulate, causing secondary infections and possibly carcinoma
- Must liberally sample foreskin to rule out other pathology
- Most young boys who present with tight foreskins have physiologic phimosis, which will generally resolve by adolescence with proper foreskin hygiene (Can Fam Physician 2007;53:445)
Case reports
- 30 year old with leprosy presenting as phimosis (Indian J Dermatol Venereol Leprol 2009;75:312)
Treatment
- Circumcision
- Also sutureless prepuceplasty in children (BMC Urol 2008;8:6), betamethasone ointment (Int Braz J Urol 2005;31:370)
Clinical images
Images hosted on other servers:
Leprosy presenting as phimosis
Tight preputial orifice
Erection with phimosis
Phimotic foreskin
Treatment
Microscopic (histologic) description
- Fibrosis of lamina propria associated with nonspecific lymphocytic and lymphoplasmacytic infiltrate
- Occasionally mucinous metaplasia in glans and foreskin
- May be associated with underlying lichen sclerosus
- May be associated with epithelial hyperplasia, dysplasia, penile intraepithelial neoplasia or occult early invasive carcinoma
Differential diagnosis
