Phimosis is a condition where the foreskin is too tight to be pulled back over the head of the penis.
If the child can pass urine, there is no need to refer, unless unresolved by age 12-13. Ballooning is unlikely to cause the child a problem, so is not an indication for referral.
Referrals are needed if the boy has recurrent balanitis (three or more episodes) if there is scarring, or balanitis xerotica obliterans (a chronic, sclerotic dermatitis).
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