Complications
The most severe complication of untreated paraphimosis is penile necrosis.
Penile necrosis should be suspected when a firm, discolored glans is present.[41] Prompt recognition of paraphimosis and emergent treatment may prevent necrosis.
All surgical treatments (dorsal slit, circumcision, or puncture techniques) have a small risk of bleeding. Occurs in <0.1% of circumcisions.[73]
All surgical treatments (dorsal slit, circumcision, or puncture techniques) have a small risk of infection.
UTIs occur secondary to inadequate hygiene with phimosis or concealed penis. This is less likely to occur in congenital phimosis.
Risk of infection generally resolves with proper hygiene, or with medical/surgical correction.
Balanitis occurs secondary to inadequate hygiene with phimosis or concealed penis. This is less likely to occur in congenital phimosis.
Risk of infection generally resolves with proper hygiene, or with medical/surgical correction.
In case-control studies, acquired (pathologic) phimosis and balanitis xerotica obliterans have been shown to be a risk factor for the development of squamous cell carcinoma of the penis.[71]
Pain may occur when a scarred, partially retractable foreskin tumesces during intercourse and constricts the glans penis.
In patients who undergo urethroplasty for repair of hypospadias, urethral complications occur in <10% of patients for distal hypospadias. A higher rate of complications (10% to 50%) has been reported for patients undergoing surgery for proximal hypospadias.[72]
There is evidence to suggest that reported complication rates after hypospadias repair may not be accurate, with the true incidence being higher.[74]
Focal erythema may occur sporadically as preputial cysts break through adhesions to allow separation of the prepuce from the glans. These whitish cysts are sometimes mistaken for pus due to infection, but they merely represent sterile collections of desquamated skin. [Figure caption and citation for the preceding image starts]: Small keratin pearlsFrom the collection of Nicol Corbin Bush, MD [Citation ends].
[Figure caption and citation for the preceding image starts]: Large keratin pearlFrom the collection of Warren T. Snodgrass, MD [Citation ends].
Decreased sensation to the penile skin may occur after surgical repair, especially after skin grafting. This typically improves with time.[36]
Partial or complete urinary retention may result from postoperative penile and urethral pain during voiding.
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