Phimosis means that the foreskin cannot be completely turned up to reveal the head of the penis. There is a physiological adhesion between the foreskin and the head of the penis, which is normal in infancy, and as the age grows and the penis develops, the adhesion is gradually separated and absorbed, and the foreskin can recede upward by itself. less than 1% of young people have prepuce after the age of 17. It is divided into congenital and acquired prepuce. Circumcision means that the foreskin covers the head of the penis, but can be turned up to expose the head of the penis, which is also normal in children. Paraphimosis means that after the foreskin is turned over to the upper part of the head of the penis, the foreskin ring is tightly strangled in the coronal groove, resulting in obstruction of venous and lymphatic return, causing edema of the head of the penis and making the foreskin unable to recover. Etiology and pathogenesis] Congenital prepuce is caused by the physiological narrowing of the prepuce opening. Acquired prepuce is mostly secondary to circumcision of the head of the penis and injury to the foreskin and head of the penis. The foreskin opening is scarred and loses elasticity, contracture is formed, and the ability to expand disappears. The foreskin cannot retract upward and is often accompanied by narrowing of the urethral opening. This kind of prepuce will not heal on its own. Diagnosis】 (a) Symptoms 1, there can be varying degrees of difficulty in urination, the urine flow is slow and small, the foreskin puffs up when urinating; 2, foreskin scale can cause foreskin inflammation of the head of the penis, acute inflammation of the foreskin mouth red and swollen, there is a purulent discharge; 3, embedded prepuce: pain is intense, foreskin edema, there is difficulty in urination, too long embedded foreskin can occur necrosis. (B) physical signs 1, observe the size of the foreskin mouth will try to turn up the foreskin. In case of prepuce, the foreskin opening is narrow and pinhole-like, and it is difficult to turn it up; 2. If the foreskin is too long, the foreskin can be turned up, but the prepuce consisting of sebaceous secretions and epithelial debris can accumulate under the foreskin; 3. In case of embedded prepuce, the edematous foreskin is turned over in the coronal groove of the penis head, and a narrow ring can be seen at its upper edge, and the penis head is edematous and dark purple. (C) Laboratory tests No special tests. (D) Differential diagnosis The prepuce should be differentiated from the circumcision. Treatment] I. Prepuce The prepuce that has no difficulty in urination and no infection under the age of 5 does not need to be treated. Symptomatic people can try to expand the foreskin mouth first. The foreskin can be turned up repeatedly on a trial basis, so that the foreskin mouth is expanded. Expose the head of the penis, remove the foreskin scale, apply antibiotic ointment or liquid paraffin to lubricate it, and then restore the foreskin. Most children can be cured by this treatment as they grow older. Circumcision is suitable for ① fibrous narrow ring at the foreskin opening; ② recurrent episodes of penile head circumcision; ③ severe narrowing of the foreskin opening after the age of 5 years, and the foreskin cannot be retracted to reveal the head of the penis. The head of the penis foreskin inflammation The acute phase of the application of antibiotics, local soaking several times a day with warm water or 4% boric acid solution. After the inflammation subsides, first try to separate the foreskin by hand, local cleaning treatment, when invalid for circumcision. If the foreskin mouth is wide and easy to turn up, it should be frequently turned up and cleaned to keep the local clean, without surgery. Third, the embedded foreskin with the technique of reset, in the coronal groove of the penis after the application of liquid paraffin, hold the head of the penis and gradually add pressure, two thumbs squeeze the head of the penis, the index and middle fingers of both hands will foreskin back down, so that the reset. Sometimes thick needles can be added to puncture the foreskin in multiple places and squeeze out the watery fluid to help reset. After the reset, circumcision is performed at an optional stage. If the reset fails, urgent dorsal circumcision of the foreskin. Prevention】The upturned foreskin should be pushed down in time after checking the foreskin to avoid imposition.