Case Report- Pathological phimosis, balanoposthitis with abscess formation
Hsin-Cheng Chu, Kai-Yi Tzou
Department of Urology, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan
Phimosis is defined as the inability to retract the foreskin. Differentiating between physiologic and pathologic phimosis is important, as the former is managed conservatively and the latter requires surgical intervention. Here, we reported a case of pathological phimosis, which was phimosis leading to balanoposthitis with abscess formation.
This 90-years-old male nursing home resident was presented with intermittent fever, accompanied with scrotal pain, dysuria, and penile swelling. At bedside, gangrenous change of prepuce and severe phimosis was noted. (Figure 1.). CT showed scrotal swelling with air and hyperdense content within. Emergent incision and debridment were arranged. During the procedure, yellowish pus was drained out. Severe phimosis was also noted, and circumcision was also performed. The wound was left open (Figure 2-3.) and dressed with wet gauze three time a day. Empiric antibiotic was also applied. At post-operative day ten, split-thickness skin graft was performed to cover the scrotal and penile skin defect. (Figure 4.) The patient was discharged under stable condition.
Differentiating between physiologic and pathologic phimosis is important, as the former is managed conservatively and the latter requires surgical intervention.