Differentials
Balanoposthitis
SIGNS / SYMPTOMS
Inflammation of the glans penis (balanitis) or of the foreskin (posthitis).
INVESTIGATIONS
Clinical diagnosis.
Encircling foreign body
SIGNS / SYMPTOMS
A foreign body wrapped around the penis (such as a hair or thread) can lead to distal swelling and oedema similar to paraphimosis.
INVESTIGATIONS
Clinical diagnosis.
Trapped penis
SIGNS / SYMPTOMS
A trapped penis is a buried penis due to scar tissue, typically from previous circumcision or trauma. This scar is usually palpable around the penis, rather than a smooth transition from pre-pubic to penile skin.
INVESTIGATIONS
Clinical diagnosis.
Diminutive penis
SIGNS / SYMPTOMS
A diminutive penis is a penis that is small due to a developmental abnormality such as epispadias, hypospadias, or a difference in sex development. Meatal location is often abnormal. This should be distinguished from a micropenis (in which the penis is normal in appearance but over 2.5 standard deviations below the mean length for age).
INVESTIGATIONS
Clinical diagnosis.
Webbed penis
SIGNS / SYMPTOMS
A webbed penis is a buried penis due to skin webbing at the penoscrotal junction. A small bridge of tissue connecting the ventral proximal penis to the scrotum is palpable.
INVESTIGATIONS
Clinical diagnosis.
Differences of sex development
SIGNS / SYMPTOMS
Patients with hypospadias and unilateral or bilateral non-palpable gonads (cryptorchidism) may have a difference of sex development.
INVESTIGATIONS
Endocrine evaluation is abnormal.
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