PHIMOSIS clinical features, investigation

Surgery phimosis

1. PHIMOSIS Kavidharshini Roll no 67

2. Anatomy of Penis: Consist of Glans penis Corona glandis two corpora cavernosa(vascular space into which arterioles open) One corpus spongiosum(contains urethra) Crura and bulb Perineal membrane vascular supply Three terminal branches of Internal pudendal artery: Dorsal artery of penis Deep artery of penis Artery to bulb of penis

3. PH IMOSIS Definition: Inability to retract the prepuce over the glans.

4. Causes: 1.Congenital Child has pin hole meatus and ballooning of prepuce occurs when the child urinates. 2.Balanitis ( inflammation of glans)and balanoposthitis ( inflammation of glans,prepuce and sac) It is common in diabetics. Patient with phimosis are more prone for recurrent infection,smegma collection and carcinoma penis.

5. Clinical Features: Inability to retract foreskin Pain during urination or intercourse Ballooning of prepuce during micturition Recurrent infections (balanitis) Post-void dribbling Rarely, obstructive symptoms or urinary retention

6. Complications: Paraphimosis Recurrent infections Obstructive uropathy Increased risk of penile carcinoma

7. Investigations It is diagnosed usually by clinical examination Other test : Urine analysis – for infection or glycosuria (diabetes) Swab and culture – if discharge present Blood glucose – to rule out diabetes Biopsy – if lichen sclerosus or malignancy suspected

8. 1. Conservative Gentle, regular retraction and cleaning Topical steroid creams (e.g., 0.05% betamethasone twice daily for 4 to 6 weeks) 2. Surgical Circumcision – complete removal of fore skin (definitive treatment for pathological phimosis) Management:

9. Thank you!!