9d • General discussion
👶 Paediatric phimosis – when to refer?
Key point: Most phimosis in young boys is physiological and settles with time. Reassure first 🧘♀️
🚫 Do NOT refer if:
Child is asymptomatic
No infections, pain, or urinary problems
Non-retractile foreskin in boys <10–11 years (normal development)
🧴 Try in primary care first if symptomatic:
Topical steroid (e.g. betamethasone 0.05%)
Apply 1–2× daily for 4–6 weeks
Gentle retraction only (no force!)
📨 Refer to paediatrics / paediatric urology if:
Pathological phimosis suspected (e.g. scarring, white fibrotic ring, BXO)
Recurrent balanitis/balanoposthitis
Recurrent UTIs linked to foreskin issues
Urinary obstruction (weak stream, ballooning with symptoms)
Failure of topical steroids
Painful erections in older children/adolescents
🚨 Same-day urgent referral:
Paraphimosis
Acute urinary retention
✨ Bottom line: Reassure → steroid trial → refer only if red flags or treatment failure.
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👶 Paediatric phimosis – when to refer?
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