Abstract
<jats:p>Background. Acquired phimosis is a cicatricial narrowing of the foreskin in a man whose glans penis had previously been freely exposed. Unlike physiological phimosis observed in childhood, acquired phimosis does not resolve spontaneously, responds poorly to conservative therapy, and requires surgical treatment — circumcision. Purpose. To analyze elective and emergency surgical interventions in patients with acquired phimosis hospitalized in the urological department No. 1 of the Stavropol City Clinical Emergency Hospital for the period 2020–2025. Materials and methods. A retrospective analysis of 124 patients with phimosis was performed, divided into two groups: elective hospitalization (n=98; 79.0%) and emergency hospitalization (n=26; 21.0%). The degree of phimosis, etiological factors, and the scope of surgical intervention were evaluated. Results. In the group of patients admitted electively, grade I–II phimosis predominated (90.8%), with recurrent balanoposthitis (57.1%) being the leading etiological cause. Circumcision was performed in all 98 (79.0%) patients, with no complications recorded (0%). In the emergency group, all patients (100%) had grade IV phimosis with urination disorders. The most common cause of phimosis in patients seeking emergency medical care was diabetes mellitus (46.2%). In these patients, circumcision was performed in 92.3% of cases; 3.8% required delayed surgery due to purulent balanoposthitis, and 3.8% required cystostomy due to irreversible detrusor atony. Patients with diabetes mellitus were hospitalized emergently for phimosis 2.36 times more often than patients without diabetes (RR = 2.36; 95% CI: 1.21–4.60). Conclusion. Elective circumcision for grade I–III phimosis is safe (0% complications) and prevents the development of terminal grade IV phimosis, paraphimosis, and irreversible functional disorders of the urinary bladder. Diabetes mellitus, detected in 46.2% of patients in the emergency group, serves as a key risk factor for complicated phimosis and requires mandatory screening in all adult men with this pathology.</jats:p>