Phimosis

Phimosis is a urologic condition characterized by the inability to retract the penile prepuce (foreskin) ( Figure 1).  It is a normal finding in infants and young children that is caused by congenital adhesions between the prepuce and glans (physiologic phimosis); it is typically a benign, self-limited condition that resolves by adolescence.  However, phimosis is considered pathologic when chronic inflammation leads to scarring and fibrosis of the preputial opening.  Pathologic phimosis causes symptoms (eg, painful erection, chronic urinary tract infections) and often requires surgical repair.

Physiologic phimosis is caused by congenital adhesions between the inner layer of the prepuce and the glans penis.  It is a normal clinical finding at birth and throughout early childhood.  Over time, penis enlargement, physiologic erections, and gentle manual retraction loosen these adhesions and allow greater mobility of the prepuce.  The time to achieve complete retraction varies, but most physiologic phimosis resolves by puberty.