Pathological phimosis. What you need to know about physiological phimosis in boys

Often, during a preventive appointment with a pediatrician, boys are diagnosed with phimosis. This disease often occurs in infancy and is considered the absolute norm - this is due to the fact that all the baby’s structures are still developing. Therefore, there is no need to worry and take urgent therapeutic measures.

What is phimosis, what are the reasons for its development, how to treat it, and in what case should you consult a doctor? All parents who raise future men should know the answers. Untimely detection of pathology and treatment can lead to complications, problems with urination and sexual life in the future.

Phimosis in infancy is considered an absolute norm.

What is phimosis and why does it occur in boys?

Phimosis is a pathological condition in which the head of the penis is not completely exposed. This situation does not always indicate that the child has a disease, so there is no need to try to open the head on your own, because your actions can only cause harm.

Before reaching 6 years of age, the reproductive system in boys is still developing. If after this time the condition remains unchanged (the head does not appear, the baby complains of pain when urinating and discomfort in the intimate area), you should seek help from a specialist.

There are several reasons for the development of phimosis:

• congenital pathology resulting from disorders of intrauterine development;
• injury to the penis, causing narrowing of the prepuce or scar formation;
• inflammatory processes in the intimate area, including balanoposthitis;
• improper restoration of tissue structure after surgery on the genital organ;
• a small number of elastic connecting structures.

At what age can this problem occur?

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This condition is observed in the majority of newborn boys (almost 95%): the head of the penis comes out partially, since the foreskin is connected to it by synechiae. Therefore, phimosis in children aged 2-3 years is the absolute norm - this condition is called the term “physiological phimosis in boys.”

By the age of 4, many children return to normal without outside intervention. The skin surrounding the reproductive organ becomes mobile, and the head is completely exposed. It is believed that opening can take up to 6 - 7 years - this depends on the general physiological development.

Some experts do not recommend starting treatment for phimosis before the age of 10, unless, in addition to the main symptom, other accompanying symptoms are observed (pain, itching, difficulty urinating, etc.). In any case, it is necessary to consult with a pediatrician to prevent complications from occurring and not to aggravate the child’s condition.

Classification and symptoms of pathology

Phimosis in boys is divided into 3 types - cicatricial, hypertrophic and congenital. Depending on the type of pathology, a treatment regimen is determined. The characteristics of the disease of each type are discussed in the table.

Forms of phimosis

Type of phimosis	Reason for development	Symptoms	Method of treatment
Scarred	the main factor provoking the appearance of cicatricial phimosis is neglect of the rules of personal hygiene; inflammation of the genital/urinary organs; congenital pathology.	With cicatricial phimosis, the foreskin is longer and prevents the free exit of the head. Cracks and scars appear on the skin, swelling appears, resulting in a narrowing of the genital opening. Carrying out hygiene procedures is almost impossible. Often the course of cicatricial phimosis is accompanied by inflammation of the area (paraphimosis).	Drug therapy or surgery.
Hypertrophic	There is only one reason for the occurrence of hypertrophic phimosis - excess weight, including obesity in the intimate area (the surrounding tissues in this condition have an excessive accumulation of fat cells).	The pathology occurs not only in young children, but also in adults. Due to the excess fat layer, the prepuce lengthens and a large amount of moisture accumulates under the skin. The foreskin is tightly wrapped around the head of the penis, which is why it cannot come out. Increased humidity contributes to the development of inflammation, so the child may experience pain.	If the disease is detected early, surgery can be avoided. Therapy can be carried out at home, but it is necessary to adjust the child’s nutrition.
Congenital	may occur for no reason; genetic predisposition; developmental pathologies during pregnancy.	Physiological phimosis manifests itself in a narrowing of the foreskin, due to which the head cannot extend beyond the boundaries of the surrounding skin. In some cases, fusion of the prepuce and the genital organ is observed.	Treatment is carried out after the boy reaches a certain age. Drug therapy is used; if it fails, surgery is indicated.

The main symptom of phimosis is the inability to open the head of the penis (narrow foreskin) or its complete closure (the photo shows what phimosis looks like).

Manifestations of pathology also include:

• problematic urination - small children often cry or are capricious, urine is released in droplets (a thin stream) with slight delays;
• pain during erection;
• radiating pain in the upper region of the penis;
• if phimosis is accompanied by an inflammatory process, then pus may ooze from the opening of the genital organ, body temperature rises, and the head of the penis swells and turns blue.

Diagnostic methods

The pathological condition is easy to detect by visual examination. An experienced urologist determines the degree and form of the disease by the appearance and complaints of the patient. Sometimes additional diagnostic procedures are required - ultrasound, Dopplerography, OAC, OAM. Based on all available information, an accurate diagnosis is established and a treatment plan is drawn up.

A urologist can diagnose phimosis after a visual examination

Features of treatment

Treatment can only be carried out after consultation with a doctor. The initial stage of phimosis is treated with medication and other methods; the specialist gives recommendations on changing the daily diet, if necessary.

If the disease is advanced, then surgical intervention is indispensable. Physiological phimosis, as a rule, goes away on its own, but sometimes it is necessary to eliminate the problem promptly.

Surgery with before and after photos

Surgical intervention is indicated only when conservative therapeutic methods are ineffective. The operation is carried out in several ways:

• traditional - the surgeon makes axial incisions in the foreskin, then stitches it together (thus increasing the diameter of the pulp ring);
• Shkloffer operation - a zigzag dissection is performed, after which the edges of the wound are connected with sutures (local anesthesia is required before the procedure);
• circumcision - complete removal of the skin around the head of the genital organ (the result is in the photo).

Circumcision result

One alternative to surgery is laser removal of the foreskin. This method has a number of advantages - absolute painlessness, absence of blood, quick recovery.

Therapy at home

Phimosis in children is eliminated in several ways, which, as a rule, are combined. During the treatment period, you need to monitor the child’s hygiene; doctors recommend taking baths with the addition of herbal decoctions (chamomile, celandine, calendula, etc.), manganese solution or sea salt.

After bathing, the upper skin of the genital organ is lubricated with cream or a special ointment and stretching movements are made (with two fingers, the tissues are spread apart). You cannot do this too quickly and sharply - manipulations should not cause pain to the child. This method allows you to achieve good results within two months. It takes 10 minutes a day to complete the procedure.

Doctors also often prescribe corticosteroid ointments - Betamethasone, Triderm, Diprosalik, Budesonide, Clobetasol and others. They have antimicrobial and antibacterial effects, promote rapid healing of scars and microcracks.

Corticosteroid ointment Triderm

If the use of ointments is contraindicated, you can replace them with Vaseline. Any medications should not be used without a doctor's prescription.

Possible complications

In addition to possible discomfort and difficulties during hygienic procedures, additional problems and pathologies often appear that require immediate treatment. These include diseases:

• Balanoposthitis is an inflammatory process that occurs in the foreskin and the end of the penis. Occurs due to poor hygiene. The patient develops the following symptoms: itching, discharge of purulent accumulations, hyperemia, pain.
• Paraphimosis occurs when parents try to expose the head of the penis on their own. Sudden and incorrect movements lead to forced stretching of the foreskin and subsequent compression of the genital organ. Blood vessels and tissues suffer from this. The patient experiences severe pain, the tip of the penis increases in size and swells. If the disease is not treated in time, necrosis or gangrene of the genital organ may develop. The way out of this situation is amputation of the affected area.
• Fusion of the foreskin and the head occurs if no measures are taken for a long time to eliminate phimosis - synechiae (fusions) gradually form (we recommend reading:). In this condition, it is impossible to fix the problem on your own.

Prevention of phimosis in children

The physiological form of phimosis does not require therapy. To prevent the development of the disease in boys, it is enough to carefully monitor the regular implementation of hygiene procedures and visit a pediatrician for preventive examinations. If a child is prone to obesity, then it is necessary to adhere to a special diet.

The foreskin of the male penis is a fold of skin covering the mucous membrane. This structure is necessary for the free sliding of the skin relative to the head. With the development of phimosis, such sliding is difficult because the fold is narrowed. The degree of narrowing of the skin fold depends on:

Subtypes of phimosis

There are the following subtypes of phimosis:

1. . Normal until three years of age and is associated with underdevelopment of the foreskin. Natural elimination occurs by the age of 5-6 years, when the head begins to open on its own. If this does not happen, phimosis is considered a pathology and requires the intervention of a urologist.
2. Hypertrophic. The epithelium of the foreskin thickens and protrudes beyond the head. A kind of proboscis appears on the penis. Without treatment, hypertrophic phimosis leads to hypogonadism. This disease is a deficiency of the function of the gonads and a violation of the synthesis of sex hormones.
3. Atrophic. The foreskin becomes thinner and gradually completely atrophies.
4. . Scars form on the edges of the foreskin, which leads to pain during sexual intercourse.

Why is phimosis dangerous?

What happens if you don’t have surgery for phimosis?

The narrowing of the foreskin does not always bring discomfort to a man, so most of them do not pay attention to the problem and do not consider it necessary to consult a doctor.

Meanwhile, if phimosis is not treated and neglected, some related problems may develop.

• difficulty in mobility of the skin on the head of the penis leads to a decrease in its sensitivity, which leads to difficulty achieving orgasm;
• during sexual intercourse, a man experiences pain and discomfort;
• sexual desire decreases;
• Premature ejaculation often occurs.

Can phimosis affect a man's sex life? In some cases, fear of pain leads to psychological problems in sexual intercourse. A man ceases to experience sexual desire, and gradually such abstinence leads to complete sexual dysfunction.

An additional incentive for a man is the appearance of the penis after phimosis, which develops real complexes that interfere with normal sexual life.

Phimosis of the fourth stage can cause infertility due to impaired ejaculation.

Don't neglect visiting your doctor! After examination and consultation, a qualified professional may recommend a circumcision procedure. On our website you will find many useful articles on this topic:

• : including, features and;

The diagnosis is phimosis, what to do? A diagnosis has been made of penile phimosis, how this disease manifests itself is worth talking about and understanding. Men have a system in the body that may not function quite correctly - this is the genitourinary system, namely, disorders of the external genital organs. So phimosis is a kind of defect based on some characteristics. Phimosis is considered to be a narrowing of the ring of the foreskin, which, in turn, contributes to untimely or difficult removal of the head of the penis beyond the so-called “skin” of the penis. The foreskin is also called the preputial sac in medical literature. In pathology - phimosis - a reproductive glandular secretion (smegma) accumulates inside the preputial sac; this secretion should not be confused with sperm, since the purpose of these secretions is completely different. On the head of the penis in men there are glands that produce a whitish fluid that cannot be fully excreted during phimosis. When secretions accumulate in the sinuses of the foreskin, smegma thickens and becomes encrusted with salts, and if this condition is accompanied by a genitourinary tract infection, which happens quite often, in such cases an extensive inflammatory process occurs.

Phimosis of the penis has appeared - this indicates that this manifestation of the disease can have a different nature: both congenital and acquired. Phimosis with which a boy is born manifests itself as a narrowing of the opening of the foreskin, or it is also called physiological phimosis (phimosis of the year) or another literary name, congenital phimosis. Acquired phimosis may develop over the years. As practice shows, it is formed as a result of chronic diseases of the hollow organ, extensive swelling of the glans or infiltration of the penis, the presence of injuries to the penis, and we should also not forget that cicatricial changes help to reduce the ring of the foreskin and prevent the head of the male penis from being fully exposed. Incomplete phimosis of the foreskin is a condition that is manifested by a dense narrowing of the skin around the head of the penis, but it can be moved with great difficulty and severe discomfort. This course of the disease is characterized by several initial stages:

1st stage. The skin flap can be freely moved from the tip of the penis, but only in a non-excited state; during an erection this is impossible to do due to severe pain.

2nd stage. Under resting conditions (i.e., in a relaxed state), opening the head is quite difficult and uncomfortable, and during periods of excitement or a rush of blood it is completely impossible.

With phimosis, the head of the penis is not completely brought out beyond the skin flap, which makes it difficult to release sexual secretions beyond the foreskin and can subsequently lead to an unpleasant odor, itching, discomfort and an inflammatory reaction. In boys, incomplete phimosis is considered the age norm up to three years of life; if by these years the disease does not resolve itself, then pediatricians recommend contacting a specialist to determine further tactics for managing such patients. Physiologically, dilation of the glans begins at two months of life, and by the age of seven, the head of the penis is completely removed. Why does incomplete phimosis develop at an older age? from a medical point of view, the prerequisites for phimosis in adult men can arise in childhood; Genetic predisposition plays an important role. Infection of the genital tract leads to scarring of the tissue, which can subsequently cause cicatricial phimosis. Incomplete phimosis of the foreskin is not a fatal disease, but it significantly reduces a man’s standard of living; due to discomfort, sexual life can be disrupted, which will lead to psychological disorders and complexes, due to the structural features of the organ.

Phimosis disease ICD-10. There is a classification recognized throughout the world, which has been revised several times and is constantly being supplemented - this is ICD 10. This classification contains all epidemic diseases, constitutional and general in their anatomical location, all injuries, diseases that develop with intrauterine development and its defects . Diseases are described in detail and systematized. To study pathology, you need to know which system the disease belongs to and what nomenclature number it has. Phimosis belongs and is encrypted in a large group - diseases of the genitourinary system, diseases of the male genital organs. In the classification it is numbered N47 - excess foreskin, phimosis and paraphimosis (tight foreskin).

Code phimosis penis grows. With the onset of puberty and age-related changes in a man, the disease takes on a different character and can be complicated by a number of unpleasant diseases. Depending on the classification code, ICD-10 contains complete information about the possible aggravation of the situation and the severity of the course.

How to remove phimosis of the glans penis? Taking into account age and severity, treatment techniques can be determined differently.

It should be noted that phimosis can be treated without surgical treatment methods. The easiest way is the conservative method. It is quite simple for any man: gradual manual stretching of the foreskin is recommended, using soap or ointments, gels. It is possible to use special devices and tools that help stretch the tissues on the head.

Drug treatment is often used using steroid ointments. If the severity is high and the disease itself is advanced, it is possible to resort to more radical methods of treatment - surgery, laser excision.

In addition, we can apply the method of tension, exposing the head of the penis through masturbation, however, it is worth considering that it is not worth causing pain, this manipulation must be done daily and gradually increase the procedure time to 15 minutes. Stretching, as a method of eliminating the problem, is used in the shower while bathing; with this method, it can lead to mild pain. You can also resort to more radical methods through surgical manipulation.

What does phimosis look like, video?

The disease is phimosis, reviews. On the Internet you can find a lot of information on this topic and, as life practice shows, many men have had or have had this problem. However, it is surprising that the topic of urological profile is also relevant today, although medicine has stepped far forward. If you look closely at this issue, you can see the following pattern: the problem concerns not only men, but also women, since many have sons. The problem of phimosis is a problem of any age; children before puberty are most often affected. One of the main questions that women ask is whether phimosis interferes with the forum and the majority believe that this disease reduces the standard of living in married couples due to lack of sexual intimacy or, more simply put, reduces the level of self-esteem in a man, which will subsequently lead to the formation of complexes and psychoemotional disorders. As for childhood, it brings discomfort and pain.

The reasons for the development of phimosis as a separate disease can be quite varied. Just because the disease did not develop in infancy does not mean that the disease cannot occur in adulthood. This pathology is observed in men in all age categories. Most often, men experience congenital phimosis; this process will not go away on its own. Pathological phimosis can form as a result of independent intervention to correct physiological phimosis. If you influence the pathology mechanically, the mucous membranes of the penis and sac grow together and adhesions form, which will ultimately lead to a narrowing of the cavity and the development of secondary phimosis.

Phimosis - causes. Probably the most important reason for the occurrence of the disease, both in infancy and in adulthood, is insufficient care for the organs of the male reproductive system, the consequences of poor hygiene measures and, as a result, fusion of the foreskin. With insufficient hygiene measures, inflammatory processes (balanitis, balanoposthitis) can occur in the foreskin and lead to a decrease in the skin ring.

The next important reason is genetic predisposition factors: the skin flap in men may be inelastic, which will subsequently lead to a mechanical narrowing of the preputial sac. It is worth considering that injuries to the genital organ also increase the risk of developing phimosis.

Phimosis is the cause of diseases of various etiologies, such as balanoposthitis, thrush and other sexually transmitted diseases. Pathology also manifests itself as a congenital defect with associated problems in general.

Can phimosis cause infertility? Today, medicine does not stand still and scientists have long proven that phimosis and male reproductive health are not at all related to each other. But complications of phimosis can still cause problems with fertility in men.

If the problem is not corrected in a timely manner, the disease can cause a number of side effects:

• Erectile dysfunction;
• Balanoposthitis or balanitis;
• Paraphimosis;

Infertility with phimosis is most often psychosomatic in nature. Men with this condition avoid sexual intercourse due to discomfort, pain and unaesthetic appearance.

Treatment of phimosis directly depends on the causes. In most cases, phimosis is treated surgically, but there are also conservative treatment methods. The narrowing of the cavity of the preputial sac can be stretched using mechanical action; this method consists of gradual stretching of the foreskin, masturbation with maximum retraction of the epithelium. The inflammatory processes that lead to phimosis can be treated with drug therapy, using corticosteroid ointments to reduce swelling and inflammatory symptoms. Protracted forms of phimosis are treated with surgery.

Symptoms

Phimosis symptoms treatment. The clinical picture of phimosis is not as bright and extensive as with other diseases of the genitourinary system, but signs of phimosis can be seen visually. In solving the pressing question “how to find out whether there is phimosis or not?” Complaints and the first external changes of the head of the genital organ are important. Parents and adult men should pay more attention to hygienic procedures of the genital organs (this disease manifests itself partly due to improper care and insufficient hygiene), paying attention to their external changes. It is worth talking to the child about the correct removal and care of the organ. Depending on the severity of the fusion of the foreskin or the narrowing of the prepuncial sac, different variations of phimosis (congenital or acquired) can be distinguished. Many experts are confident that physiological (congenital) phimosis occurs in boys under seven years of age, but so far urologists have not come to a consensus on this matter; doctors recommend that mothers begin to remove the glans penis on their own at the age of three. Today, scientists believe that by the age of 7 the head of the penis should be completely removed; if this does not happen, you should consult a urologist for quality medical care. If you understand the etiology of phimosis in adulthood, then phimosis can persist from childhood, and not bother you until puberty, develop slowly, in accordance with age and sexual function. During puberty, organs are characterized by intensive growth: an increase in size, often during this period of time there is uneven development of the genital organ and foreskin, which fits tightly to the head of the penis. In such situations, the problem is that the foreskin is much smaller than the head itself, due to this there are difficulties in its further rolling out. As for adolescents who have reached puberty, phimosis can occur much more often, this is determined by more frequent erections, masturbation and vigorous sex life. With a physiological erection, the head enlarges and the foreskin tightens, and as a result of this, microcracks may appear in the skin, which will subsequently lead to scarring of the tissue and an extensive adhesive process. One of the first manifestations of the problem at any age is pain when the head of the penis is removed from the foreskin during sexual intercourse (in the erectile state of the penis). In the future, as the condition worsens, the foreskin may not open at all, and then difficulties arise with its removal at rest. The next feature of the lesion is difficulty urinating, urine is excreted in small portions with accompanying pain in the urinary canal, and its remains accumulate in the foreskin sac, the stream of urine can be very small, and sometimes it comes out in drops. Due to the fact that secretions and urine residues collect in the penis cavity, a serious inflammatory process may soon develop. Another striking manifestation of the disease is severe pain with phimosis in the area of ​​the foreskin and glans penis. The head of the penis itself becomes swollen, hyperemic and very hot, these are manifestations of the inflammatory process. The pain component intensifies with stimulation of the genital organ and increases sensitivity when the penis increases in size and the foreskin is pulled over the head.

Temperature with phimosis can manifest itself as a consequence of an inflammatory reaction in the body, this is a normal reaction of the body to the ingress of foreign microflora, in this case the disease has a protracted violent nature, which will subsequently cause complications in the urinary system: cystitis, pyelonephritis and other, not the most pleasant diseases . Also, temperature can be one of the first symptoms of enlarged lymph nodes due to inflammation.

Phimosis, the patient complains after some time, when the process is very advanced. As with all diseases and pathologies, the intensity of the entire symptomatic picture will increase and increase not immediately, but gradually. Patients will complain of sharp, severe pain that increases when touching the head, pain and discomfort when walking or mechanical pressure. The patient notes a change in the appearance of the penis (resembles a proboscis), the foreskin swells and thereby compresses the head of the penis, pain manifests itself even at rest.

Phimosis differs from paraphimosis quite slightly. Paraphimosis is a greater infringement of the head by the ring of the foreskin. The whole point is the severity of the course; in paraphimosis, in frequent cases, tissue necrosis may occur due to mechanical compression of the tissue due to dense edema.

The macro picture of phimosis manifests itself quite extensively and well, so the disease is difficult to confuse with another pathology; sometimes the manifestation of the disease can be observed only in certain cases and under certain circumstances. In these cases, a decrease in erectile function in a man occurs due to discomfort and pain. All these factors influence the subconscious reactions of a man during the disease process.

The psychosomatics of phimosis in adult men largely lies in the fact that they focus on the problem, which is absolutely not worth doing, since this can lead to problems of a psychological nature.

If we talk about young men, in this situation the child’s behavior pattern depends on the mother, who helps her boy cope with his illness or, on the contrary, ridicules his problems. It is much more difficult for doctors to deal with the psychological problems of sick people than with the physical ones.

How to open phimosis without consequences for a man’s health? All manipulations should be carried out in a relaxed manner; there are a sufficient number of methods for opening fused tissues, but this will be discussed below.

Diagnostics

Diagnosis of phimosis is carried out according to the standard scheme, just like other diseases of the urinary system, but it is also worth considering that it would be useful to check the reproductive function of the body during the disease itself. As is known, the disease does not occur in a latent form; when the process is considered advanced, experts recommend conducting both instrumental and laboratory research methods.

Phimosis diagnosis is carried out in a complex of measures aimed at identifying and eliminating the problem. To begin with, diagnosing the disease is best done by interviewing the patient; collecting a detailed history will allow the doctor not only to establish the cause, but also to determine at what age this problem has been troubling. It is also worth establishing at what stage (namely, in what age period of time) this situation worsened. Do not forget that there is a congenital form, which until a certain age of a man almost does not appear and is most often not paid attention to. Genetic predisposition to the disease plays an important role in the further course of the pathological process. When talking with a patient, the doctor has the opportunity to fully ask about the clinical picture of the disease and collect a complete list of complaints that bother the patient. A visual examination of the problem organ is carried out exclusively by a specialist who can objectively assess the nature of the pathology and correctly indicate the diagnosis with further prescription of treatment regimens. Examination of the genital organs is more necessary to detail the neglect of the process; if the head of the penis does not emerge from the foreskin at all, then it is worth thinking about the correct treatment tactics. But there are cases when it is possible to remove it, but it is not possible to put it back in, then we should say that the process is complicated by another pathology, which will be discussed below. But one examination is not enough to make a final diagnosis; it is necessary to conduct a full range of laboratory examinations.

Tests for phimosis can determine the presence of infection or assess the degree of the inflammatory process. Probably the most informative method for diagnosing phimosis is a urine test. In a clinical urine test, the doctor may see an increase in total protein, an increase in white blood cells and the detection of a small amount of mucus, which will indicate a general inflammatory process. Urine with phimosis will not change much, no pathological impurities will be found in it. It is also recommended to take a blood test to determine inflammatory processes and discharge from the penis for further diagnosis of the picture of the disease and the type of infectious process. In extreme cases, it is recommended to conduct an ultrasound examination of the urinary organs in order to determine pathological changes.

Bacteria in phimosis in infants indicate that the process is complicated by an infectious component, but this process can be considered physiological due to the anatomical structure of the genital organs in newborns. Until the age of seven, this disease cannot be treated and is considered a normal process; this condition should only be monitored by a specialist and monitor the dynamics of the process. Don’t panic and run to the doctors, asking the question: “What to do and how to treat?”

Phimosis and blood in urine, forum. Mothers are increasingly asking the question whether red blood cells can be detected in a urine test. Based on observational data, scientists came to the conclusion that blood appears in the urine only in cases where the upper parts of the urinary system are involved in pathologies such as cystitis, glomerulonephritis, in rare cases with pyelonephritis, and never with phimosis.

How to determine phimosis in boys? Parents often encounter this problem at an early age, but not everyone knows what to do and how to behave. All newborns have physiological phimosis of the penis. The head of the penis is tightly closed by the foreskin in order to protect it from external damage; an attempt to open it will cause discomfort and a painful reaction in the child. The skin duplication adheres tightly to the structure, which makes it impossible to remove the head prematurely. This process is considered physiological and occurs in most boys before the onset of puberty. This condition will resolve itself by the age of seven; the parents’ task is to perform a daily hygienic toilet of the genitals, wash the perineum and genitals with soap and water. The separation of the mucous membrane and the inner layer of the skin occurs slowly and gradually, mechanical damage can form scars and adhesions.

Phimosis, differential diagnosis of the disease is carried out to exclude adverse consequences. With prolonged stagnation of secretions, carcinogenic substances can accumulate in the skin cavity, which can provoke cancer in men. Phimosis can be complicated by a number of diseases even in cases where it does not manifest itself with any unpleasant symptoms. Doctors recommend diagnostics for paraphimosis, balanoposthitis, malignant tumors and other infectious and inflammatory diseases.

Balanoposthitis and phimosis, differential diagnosis in a child. These are two diseases that can be combined with each other, since physiological phimosis is inherent in all young boys. And, as you know, the disease itself is manifested by the inability to remove the head from the cavity of the foreskin, which subsequently leads to infection and inflammation of the prepuncial sac (balanoposthitis). Even with good hygiene of the external genitalia, microorganisms still get onto the foreskin and head and cause inflammation.

Stages

How to determine the stage of phimosis? The stage of the process is determined by the symptom complex of the clinical picture of the disease, by the appearance of the organ; laboratory tests are also important, which the patient is recommended to do during the illness. As the process of phimosis progresses, it is often associated with the entry and development of an infectious process on the genitals. To date, only four stages of the development of the disease have been described in the literature, each stage is a specific type of phimosis. All four stages depend directly on each other, one follows from the other, taking into account the severity of the clinical picture and the neglect of the process itself.

The first stage of phimosis is an asymptomatic course of the disease, no manifestations will be visible, and there will be no external changes in the organ. A man can only experience discomfort during sexual intercourse when the head of the penis increases in size, but the foreskin remains unchanged, as a result of which tight removal of the head brings discomfort. This, to the first stage, also includes physiological phimosis, which did not resolve on its own in childhood. Phimosis from one to seven years is considered physiological.

Stage I phimosis does not require correction or any method of treatment. As evidenced from the medical literature, it will go away on its own.

The next stage is characterized by visible changes that may alert a man. During sexual arousal, the foreskin almost does not allow the head to be exposed, which leads to minor pain; when the patient is at rest, the narrowed foreskin also does not release the head upward. At this stage, conservative treatment will be sufficient.

Stage III is the most difficult, since at this stage the man feels severe pain during an erection, and the appearance of the organ changes. The patient urinates extremely rarely, with pain and discomfort. Sexual life becomes impossible due to fear and panic, the psyche suffers, and the man begins to feel inferior. Painful sensations may be accompanied by an unpleasant odor, itching and burning, due to the fact that secretions (sebum) and urine accumulate due to insufficient hygiene procedures. This process can be complicated by a number of other pathologies due to inadequate care.

Stage IV phimosis develops more often in those men who are unable to assess their condition on their own or are embarrassed to talk about it. Stage IV phimosis is manifested by sharp pain when the head is exposed; urination at this stage will be difficult, although urine will be excreted, but in scanty portions or even drop by drop; most of it will accumulate in the cavity, thereby filling the preputial sac. Scientists compare this stage to an “elephant’s trunk.” The process can regress and worsen quite quickly; it is necessary to act quickly and decisively. This process can develop into cancer of the genital organ. . This is what the stages of phimosis look like, photo.

The forms of phimosis are very different, they depend on the anatomical structure of the genital organs and the foreskin itself. In all boys under seven years of age, phimosis is physiological. All other forms belong to pathological forms of the disease and are regarded, to a greater extent, as acquired, due to a number of reasons.

The next form includes hypertrophic phimosis (a case where there is a lot of foreskin and it is quite loose). This form is associated with an anatomical feature of the foreskin or obesity, in which the skin epithelium thickens.

Atrophic phimosis - in this form, everything happens the other way around - the tissue becomes significantly thinner or completely absent. The scar form is formed due to mechanical damage with a predominance of adhesions.

Degrees

The degree of phimosis in boys most often depends on the narrowing of the foreskin; The more advanced the process, the more the foreskin grows to the head of the penis and does not allow it to come out.

The fourth stage is the most advanced, and the only treatment option is surgical; at this stage, a sufficient number of severe complications occur.

So, there are only four stages of severity of the disease. The first stage refers to the physiological course of phimosis, so to speak, a very minor change, which will subsequently resolve on its own. Only close monitoring of changes in condition is recommended.

The second stage is regarded as mild, where changes are not always visible, but the manifestations of the disease are symptomatically more noticeable. This stage requires specialist supervision and conservative treatment.

The third stage is manifested by a complex of symptoms and external changes in the genital organ, the clinical picture is of moderate severity.

And the fourth stage is the most advanced, where changes will have serious complications. This is a severe form of the disease, which can only be treated surgically by completely excising the foreskin.

The degrees of phimosis (photo) are set only for pathological phimosis; if a child was diagnosed with phimosis at an early age, then such phimosis (physiological) will not be divided into degrees.

By what criteria are the degrees of phimosis divided? Scientists make a division according to anatomical structures; below is an analysis of the degrees of phimosis from an anatomical point of view.

Phimosis degree I (photo). This degree is characterized by minor changes, which men most often do not pay any attention to. With this type, almost physiological, it is possible to freely remove the head of the penis when not in an erectile state, but in a state of excitement it is much more difficult to do this, this sign can make a man a little wary. Phimosis of the first degree is not life-threatening, but its presence can significantly reduce the quality of a man’s sexual life. At the very beginning of the disease, painful sensations will occur only at the time of sexual intercourse, or in the state of arousal of the penis, which in the future can significantly affect relationships with the fair sex. Even at the first initial stage, the process can result in serious complications, such as paraphimosis or balanoposthitis.

Treatment at home for stage I phimosis does not take much time and effort. In modern medicine, there are many methods of influencing a mild form of the disease; along with surgical manipulations, you can also resort to conservative methods. Men are recommended to mechanically stretch the foreskin every day, remove the glans on their own until it feels unpleasant, you can use various dilators for this manipulation, you can use lubricants or ointments to soften the skin. You can also use baths with a decoction of string. Phimosis of the first degree, photo.

Phimosis II degree, photo. Further, the condition will only worsen, the symptoms will increase, the removal process will become difficult in any condition, and you will no longer be able to remove the head completely without pain. During sexual intercourse, semen may not be released at all, and if you want to go to the toilet, urination will be difficult. These manifestations will bother men much more often; pain will occur, and not only with excitement, but also with physiological bowel movements.

phimosis II degree treatment. At this stage, you can still try to resort to conservative treatment methods using stretching. Steroid ointments will help soften and stretch the foreskin tissue. The third stage of the process is more advanced than the previous one, the head of the penis does not open at all and does not come out from under the edge of the foreskin, it is completely impossible to remove it, the pain is sharp and strong. Patients experience discomfort with any mechanical irritation. With this type, urination is almost impossible or urine is released in small portions. The pain will be strong and sharp. During sexual intercourse or strong arousal, bleeding may occur, so experts do not recommend having sex during the period of diagnosis and diagnosis. Sexual life can injure the skin and mucous membrane of the foreskin and form deep scars or necrosis.

Stage III phimosis should not be treated at home, much less on your own. This is a form that can lead to complex consequences and complications. At this level, it is urologists who will help avoid trauma and infectious and inflammatory complications. Surgical assistance consists of partial or incomplete excision of the foreskin. In case of phimosis of the third degree, and even complicated by acute forms, an exclusively longitudinal dissection of the foreskin is performed.

Phimosis IV degree (photo). The problem is not only that sexual function is difficult, but physiological function is also impossible, due to obstruction of the lumen of the foreskin due to fusion. Urine will accumulate in the bag and only after some time will it begin to be separated in partial small portions, or drips, while the sensations of discomfort will increase, and the pain will become sharp and throbbing. Such an organ will look swollen and inflamed; doctors also compare it to an “elephant’s proboscis.”

Treatment consists of excision of the entire sac completely (this operation is called circumcision) in order to reduce the risk of strangulation of the head of the genital organ or the occurrence of inflammatory diseases. Probably the most effective method of treatment is surgical, although many experts do not immediately recommend resorting to such radical methods, but still, in order to preserve the organ and prevent complications, everything must be done in a timely manner. Don’t neglect your health, contact specialists on time. Be healthy! Phimosis degree, photo

Classification

Phimosis - classification.

If you pay attention to the degrees and stages of development of the pathology, you can identify a sufficient number of varieties of phimosis: according to the degree of occurrence of the pathology (its nature), according to the mechanism of damage to the organ itself, according to the severity of the disease, according to the anatomical nature and structure of the foreskin, according to the rudiments of intrauterine development , as well as by the structure of the changed tissue around the head of the penis. There is even a separate subgroup of consequences associated with phimosis as complications.

The disease may be primary in nature; this pathology is more common in newborns (it is considered to be a congenital pathology). This condition is considered physiological, since the fusion of the foreskin in newborns protects the organ structures from the entry of unfavorable microflora and the further development of inflammatory and infectious problems. Since it is not possible to establish the cause of the onset of diseases in infancy, this condition is considered normal. Experts tend to consider the main reason that contributes to the development of such phimosis to be true synechiae (embryonic adhesions), which appear during intrauterine development to reduce trauma to the head of the penis. This disease does not go away on its own immediately, but closer to school age. When the physiological constrictions expand, the skin becomes elastic and the boy can painlessly remove the head of the penis on his own. But you should try to do this from the age of three, gradually developing the foreskin.

Secondary phimosis occurs in adulthood due to a number of reasons; such phimosis is called acquired. It occurs as a result of long-term or chronic infectious and inflammatory diseases, frequent injuries to the genital organ; Genetic predisposition also plays an important role. Mechanical damage leads to the appearance of scars and adhesions, which will further lead to a narrowing of the foreskin. Depending on the cause, the process is divided into physiological and pathological. The physiological type of phimosis is a condition that occurs normally in infants and children in the first years of life; it does not require treatment at an early stage; only if the process takes a long time, experts recommend that the child consult a urologist every six months and use medicinal ointments , allowing you to soften and stretch the tissue around the head.

In childhood, partial phimosis can also form, which may not bother you throughout life; it is manifested by incomplete removal of the head from the preputial sac. With this type of phimosis, there will be no clinical symptoms, this condition does not cause discomfort, up to a certain stage, and does not affect the life of a man. The pathological type of phimosis develops somewhat later and is eliminated exclusively with the help of long-term conservative and drug treatment, and there are often cases when these methods do not help, doctors recommend using surgical procedures. Types of phimosis photo.

Types of phimosis in boys are classified according to the violation of the technique of exposing the head of the penis. Young boys often experience a narrowing of the tip of the sac, which makes it difficult to remove the head; this condition is considered physiological. In childhood and preschool age, fusion of the inner layers of the sac and the head can be observed; such phimosis is called false phimosis. In order to prevent the appearance of phimosis at different periods of life, you should be attentive to the personal hygiene of the external genitalia, visit a specialist doctor, consult in a timely manner and do not neglect your health. The reasons that contribute to the formation of various types of disease are partly the genetic predisposition of the male body, and partly arise from latent infectious diseases and early injuries to the genital organ. Neglecting your health is fraught with serious consequences; If you do not take the necessary personal hygiene measures, acute phimosis may develop.

Purulent phimosis occurs due to the advanced course of the disease, when unfavorable microflora or infections associated with the organs of the reproductive system are added. Often purulent inflammations are caused by fungi of the genus Candida. This disease manifests itself with an unpleasant odor, yellow-green discharge, itching, and increased local and local temperature. This process is accompanied by hyperemia of the organ, pain on palpation, and severe (bluish) swelling.

There are cases when men complain of repeated phimosis; experts often associate its occurrence with untimely surgery, when adhesions grow deep into the tissue, and the operation for incomplete excision of the foreskin is not extensive enough. The operation should be carried out with complete excision (circular) of the foreskin, then the disease will not be able to recur. Repeated phimosis can also occur in preschool children. It would seem that the specialist helped to move the head of the penis beyond the foreskin, the mother did all the necessary hygienic manipulations, took regular baths, applied ointments, followed all the doctor’s instructions, but, alas, the problem returned again. This depends on the anatomical structure of the organ, on the physiological characteristics of the structure of the foreskin and the organs themselves as a whole. At an older age, when this problem causes discomfort in a man, urologists will offer him to get rid of phimosis once and for all with the help of a circular excision of the foreskin (the operation is called circumcision).

Physiological phimosis

Physiological phimosis in children. The male genital organs and reproductive system are of quite great importance, no less than the female reproductive system, primarily for the reason that it ensures reproductive function. In men, the genital organs are closely connected with the urinary organs, which are necessary for the normal functioning of the entire body as a whole. There are cases when men have their own structural features of the genital organs, which leads to the formation of physiological phimosis. Photo of physiological phimosis.

Physiological phimosis in infants is due to genetic predisposition and physiological characteristics of the structure of the genital organs. At birth in males, the head of the penis is tightly covered by the foreskin. The foreskin begins to develop from the coronary groove, which forms the preputial cavity (pouch). In normal condition, the cavity should be easily retracted and expose the head of the penis. At the very beginning, the foreskin is represented by a duplication of skin; it has two leaves, and they are fused at birth. The inner layer of the foreskin fuses in the posterior area with the tissue of the glans and forms the frenulum of the foreskin. All these structures are of great functional importance - they cover the urethra, protecting it from the penetration of pathogenic microorganisms, the skin protects from mechanical damage and irritation, maintaining sensitivity, and takes part in the production of secretions (smegma).

Mothers often ask the question: physiological phimosis until what age does it last? It should be noted that in children at birth, non-opening of the foreskin is a physiological process. The lack of ejection of the head in infants is not due to pathological narrowing of the skin, but to its own physiological characteristics. Therefore, urologists do not recommend forcibly removing the head, thereby mechanically injuring the tissue - this will lead to the appearance of erosions. If nothing bothers the child, the child urinates on his own without pain, the skin is of normal color, there are no visible changes, then there is no need to intervene. You only need to perform daily care of the genital organ, wash it with soap under running water and, if possible, carefully remove the head and preputial sac. Independent removal of the head occurs closer to preschool age; this process is gradual; separation occurs due to desquamation of the epithelium and stretching of the skin of the foreskin. Modern medicine describes cases where phimosis is considered physiological even before the age of 14, but it is generally accepted that until the age when a boy begins to grow up and enters puberty, physiological phimosis should pass and the head should be completely removed. A large number of classifications for this disease are described in the world literature, but the most complete picture of this disease can be seen in the description included in the international classification with a diagnosis of physiological phimosis ICD-10. Enlarged foreskin, phimosis of the glans penis and a number of complications such as paraphimosis - all these problems belong to the same group of diseases and are coded under one nomenclature number in the section “Genitourinary system” with the number N47 assigned.

Phimosis, a physiological code according to ICD 10, is used from the point of view of practical medicine for differential diagnosis among all diseases in this section, to determine the pathogenesis and etiology of the disease, to further determine the treatment regimen. By referring to the ICD classification, the specialist receives complete information about the disease and the further development of complications due to this pathology. Physiological phimosis in boys, photo.

Physiological phimosis, Komarovsky - there are many statements by Dr. Komarovsky on the issue of physiological phimosis. Thus, he argued that all these problems are mostly related to physiology. Physiological phimosis is a normal, natural process - the inability to bare the head before puberty, all boys go through this. According to Dr. Komarovsky, phimosis is considered normal until the age of 15 (this period lasts until the process of puberty). Physiological phimosis in boys, Komarovsky video

Pathological phimosis

Pathological phimosis in boys, photo.

If a problem with the genital organ occurs after puberty, if the head of the penis is not completely exposed or the foreskin fits tightly to the head of the penis and causes discomfort during removal, then such phimosis is called pathological. The reasons for the formation of such a process are often external factors: infectious problems and diseases, trauma to the genital organs due to previous diseases, such as balanoposthitis or balanitis. Another important cause of pathological phimosis is neglect of personal hygiene rules. Pathological phimosis can change in tissues and cause such types of disease as hypertrophic and atrophic phimosis. This type is characterized by the growth of the foreskin and thickening in the area of ​​the prepuce. There is a hanging of the foreskin from the genital organ, this type of organ resembles an “elephant trunk”, there is a narrowing downwards, which does not allow the head to be removed. Atrophic phimosis is manifested by thinning of the skin in all layers, the skin becomes flabby, dry and thin, pale in color. The ring of the foreskin looks shortened and fits tightly to the head; mechanical removal with this form is not recommended at all, since it can injure adjacent tissues. For this reason, in the medical literature it is also called cicatricial. The problem can arise from physiological phimosis if parents did not pay attention to the problem in a timely manner or did not observe the necessary hygiene measures, if they handled the foreskin carelessly when bathing. Pathological phimosis in any of its manifestations requires an individual approach to treatment, regardless of the severity and mechanism of formation. Drug therapy should be carried out immediately; if therapy does not help, a conservative method must be resorted to, and in extreme cases, a radical surgical method is required - complete excision of the foreskin.

Congenital and acquired phimosis

Phimosis is a common disease of the male genital organs, which occurs in men at different periods of life; it can even be a congenital pathology - this is due to the fact that the glans penis and foreskin are formed from the same rudiment during intrauterine development. The development of the reproductive system itself continues until puberty, so congenital phimosis in boys (photo) manifests itself in most newborns. After one year of life in boys, the head does not open completely; it is necessary to carry out proper care of the external genitalia; hygiene measures help prevent the disease. As a rule, congenital physiological phimosis regresses in preschool age.

During the newborn period, the foreskin protects the sensitive head from mechanical damage, since it is dense and insufficiently stretched, fits tightly to the head and does not allow the head to be removed from the sac. In adulthood, closer to puberty, due to the increased level of sex hormones, the foreskin stretches and softens; due to involuntary erection, the foreskin moves and its displacement occurs, which allows the head of the penis to be completely removed. If the head of the genital organ is not completely exposed during puberty, such phimosis is called pathological, acquired phimosis. Factors in the formation of the disease can be considered insufficient hygiene, carelessness in washing the child’s genitals, genetic disorders, injuries, and inflammatory diseases. A diagnosis of acquired phimosis can be made only after 13–14 years of life with the help of instrumental studies. And treatment for such pathology will be more radical and extensive.

Hypertrophic phimosis

There are a large number of types of phimosis; due to different types of disease, treatment tactics vary, and the method of disposal will be chosen individually.

Hypertrophic phimosis in boys (photo) - this form of the disease is more typical for young boys with large body weight. Obesity, in principle, entails a large number of health problems. The cause of the development of hypertrophic phimosis can be considered a large deposition of adipose tissue in the area of ​​the preputial sac, as a result of which the penis increases significantly in size, the foreskin becomes dense and tight. This type of phimosis is described in the medical literature as proboscis. This situation has a beneficial effect on the development of the infectious and inflammatory process due to the accumulation of excess moisture in the secretion. When trying to expose the head of the penis, the child experiences pain and discomfort, may get a wound surface, and subsequently scars and adhesions form at this place.

Hypertrophic phimosis in boys, treatment. If you consult a doctor in a timely manner, the problem can be treated conservatively and with medication. At the present stage, there are a sufficient number of methods to eliminate hypertrophic phimosis. Doctors do not recommend everyone to resort to such treatment methods; methods are selected individually.

The method of tension is daily attempts to stretch the foreskin and expose the head. This method is used at an early stage of the development of the disease, before the severe pain experienced by boys. Along with the first method, corticosteroid ointments can be used to increase the elasticity and stretching of the bag. Ointments based on hormonal drugs will reduce the risk of inflammation. But conservative treatment is not always successful, so experts recommend surgical treatment methods - stretching with the help of certain instruments, excision of the internal layers of the preputial sac, plastic surgery of the foreskin, laser correction, full or partial. Each method is selected individually, depending on the type and severity of the disease. The disease is not critical and has a favorable outcome, especially if the patient promptly seeks help from a specialist and receives quality medical care. Photo of hypertrophic phimosis.

Atrophic (scarring) phimosis

Cicatricial phimosis is a disease associated with thinning of the foreskin due to a decrease in skin elasticity due to the appearance of scars and adhesions. It looks like whitish areas, coarser than the surrounding tissues, these are a kind of dying tissues, they do not have elastic fibers and therefore cannot be stretched, which is why phimosis is manifested by the inability to remove the head of the penis from the cavity of the foreskin. Atrophic phimosis appears as a result of injury; an attempt to remove or expose the head of the penis by force leads to traumatization of the foreskin, and subsequently a scar appears, which itself will not physiologically stretch. Many inflammatory problems of the genital organs can lead to scarring, which will also entail persistent growth to the head itself, hence the disease - cicatricial phimosis. In another case, swelling and inflammation of the preputial sac appears, the skin that has grown in is torn, and a scar gradually forms in the place where the mechanical tear occurred.

Cicatricial phimosis in an 11-year-old child is most often formed due to mechanical traumatic damage to the foreskin and head when the child is not bathed carefully, or when they try to move the tissue abruptly, without giving it the opportunity to stretch and soften. Cicatricial phimosis brings a lot of inconvenience to the child - pain during normal hygienic activities, and in advanced forms it can lead to problems with urination. Due to insufficient hygienic measures, a large amount of smegma accumulates in the preputial sac, which allows bacteria to quickly multiply and cause a number of the following diseases: balanitis, balanoposthitis, urethritis, prostatocystitis, orchiepididymitis, pyelonephritis.

How to determine cicatricial phimosis ICD 10. There are many symptoms that characterize this type, all of them are described in the ICD 10 classification. Urologists can diagnose cicatricial phimosis based on typical signs after a physical examination, finding the following symptoms: the inability to open the head independently with the help of hands, the external appearance of white or gray cicatricial changes, pain when removing the head or even when moving the foreskin. With this form of phimosis, sexual intercourse is impossible due to unpleasant painful sensations. This occurs due to blood supply to the cavernous bodies of the penis and enlargement of the penis, while mechanical compression of the phimosis ring occurs. Due to trauma and poor elasticity, tears appear in the foreskin. Nocturnal physiological erection is manifested by painful sensations, and the addition of a bacterial component leads to purulent discharge and an unpleasant odor. What cicatricial phimosis looks like in boys, photo.

It is worth noting that cicatricial phimosis in a man cannot regress on its own; in this case, consultation with a urologist and his medical assistance are necessary. Cicatricial phimosis without surgery, treatment is possible only in the initial stages, when there is still no pain, you can try to treat it with conservative methods. But it is worth remembering that in the future, men with this form of the disease, even if the outcome of the problem is positive, will be at risk for relapse of the disease, since there is a high risk of developing adhesions; a more positive effect of treatment will be with surgical intervention.

Cicatricial phimosis in adults, surgery. Before surgery for cicatricial phimosis in adults, doctors recommend stopping the inflammatory process, and you can use aseptic solutions: chlorhexedine, dioxedine, miramistin. Such preparations are used for baths and lotions; they can be combined with herbal decoctions that have an anti-inflammatory effect: chamomile, calendula and many others. It is also recommended to use ointments with an antibacterial effect before a planned operation; they inhibit the growth and reproduction of bacteria; corticosteroid ointments will also relieve the inflammatory reaction and increase the elasticity of the skin, and relieve swelling of the foreskin. Laser surgical manipulation is performed exclusively in the early stages of the disease. The operation is performed as a photodestructor to solve a delicate problem; the manipulation is low-traumatic and does not require long-term postoperative rehabilitation. This method has a sufficient number of advantages: quick recovery after surgery, the ability to preserve the foreskin and not affect the sensitivity of the head; with this method there is no massive bleeding, the risk of scar development is reduced to zero. For more protracted forms and advanced stages, doctors resort to circumcision surgery - a radical method of excision of the foreskin. This is a complete dissection and removal of the foreskin with the application of self-absorbing sutures.

Cicatricial phimosis after surgery. Postoperative rehabilitation is carried out in a hospital setting, the recovery period is up to a month, if the operation was successful and the tissues heal safely, you can have sexual activity a month later, but given the fact that the sensitivity of the head is increased, then sexual intercourse will be fleeting and the sensations will be slightly changed. ICD code cicatricial phimosis photo in men.

Cicatricial phimosis in boys, surgery, reviews. Many parents worry about the outcome of the operation in boys, as they are concerned about the child’s reproductive function. There are many opinions on this matter, but experts are sure of one thing - this will not affect reproductive function in any way. You should take proper and high-quality approach to caring for your genitals. Many mothers whose children have undergone surgery express gratitude to the doctors who saved young men from problems quickly and painlessly. The child will get used to his peculiarities of the genitals and will control his future sexual life. For young boys, many experts recommend laser surgery and further proper care of the reproductive organ.

Cicatricial phimosis, surgery, reviews Most men complain about the strong sensitivity of the penis and the inability to provide the partner with the proper sensation during sexual intercourse, but it is worth noting that this only happens at the very beginning, immediately after the operation, in the future the glans will be less sensitive and sexual life will improve . Men's opinions about the operation differ, but the majority still believe that it is necessary to use a radical technique to ensure that the disease does not develop further.

Treatment

In most cases, experts recommend treating phimosis surgically, considering this method the most rational, but there are also non-surgical treatment methods - conservative or medicinal. The latter method is used in very rare cases at the initial stage of the disease. Many people use traditional medicine in the hope that it will alleviate their condition. The use of baths with herbal decoctions of chamomile, string, calendula, oak root will reduce the inflammatory process and alleviate the condition, but for a short period of time, you can also use ointments based on plantain and nettle.

Cicatricial phimosis, conservative treatment. However, this method of treatment does not always give the expected result. The main and quite good method is the method of stretching the foreskin. It is based on independent gradual stretching of the foreskin, daily with the help of masturbation, with maximum retraction of the preputial sac until the head of the penis is completely exposed. This manipulation is carried out several times until moderate pain appears; it is recommended to carry out this procedure after taking a bath or during. There is another type of stretching, using the fingers. Two little fingers are inserted into the preputial sac and the foreskin is stretched in different directions until it feels uncomfortable. Cicatricial phimosis in adults, treatment. The most commonly used method in adults of stretching the foreskin through masturbation, the man himself can control the degree of tension and pressure and in this way gradually expose the head.

Treatment of cicatricial phimosis in children is carried out quite delicately and in a timely manner; the choice of method depends on the age at which this pathology was discovered, as well as the degree of the disease. The two-finger method is more often used, in which stretching occurs; it is considered less traumatic and painless for the child. Doctors recommend taking a warm bath before this procedure to make the skin softer and more elastic.

Cicatricial phimosis at 7 years of age is treated only if it is complicated by other diseases. Complications can occur due to an inflammatory-infectious disease, with insufficient hygienic care in boys. If the foreskin is injured and inflamed due to insufficiently careful procedures during bathing, then such a pathology requires medical treatment. In children, you can try to partially correct cicatricial phimosis with massage. Extract the head, albeit not completely, but only to some part. Daily massage exercises will slightly stretch the foreskin and thereby improve the condition of phimosis.

There is another method of influencing phimosis - drug treatment. How to treat cicatricial phimosis, ointments? Today, this is a pressing question for all parents who do not want to injure boys. Corticosteroid ointments are used to improve the extensibility and elasticity of the skin, prevent an inflammatory reaction, and eliminate tissue swelling. In such cases, it is best to use Clobetasol and Betamethasone once daily, applying to the skin of the foreskin.

Treatment of cicatricial phimosis in boys without surgery takes quite a long time and requires considerable effort and patience. You can use different methods of stretching, mechanical or medicinal with the use of hormonal ointments.

Cicatricial phimosis in adults can be treated without surgery using a conservative method. Patients respond positively to this treatment; stretching the foreskin is the main therapeutic method of treatment at home.

Cicatricial phimosis laser surgery, price. This method of new technologies has become quite popular in medical practice. The method has proven itself to be operationally easy. The advantages of this method are: a short rehabilitation period, no side effects, minimal blood loss, no pain, postoperative tissue swelling does not form. The effectiveness of the laser method is increasing every year, but if the effect is lower than expected, surgery is required.

Cicatricial phimosis circumcision in children forum reviews.

Many mothers, when confirming the diagnosis of phimosis in their child, consider only conservative treatment methods, fearing to disturb the child’s psyche, and many risk trying surgical treatment methods and are satisfied. This is how it is with circumcision of the foreskin, a large number of mothers are satisfied with the outcome of the operation and say that this technique allows you to forget about phimosis forever. Yes, the child later has his own peculiarity, but one can live with this and it does not affect the standard of living in any way. The sensitivity of the organ increases slightly at first, but in the future this will pass when the skin gets used to it and becomes less sensitive.

Relative phimosis

Relative phimosis is rather a pathology that requires quick intervention. With this pathology, the patient cannot completely remove the head of the penis, this gives him a lot of unpleasant sensations. Sexual life with such a pathology is impossible. When the disease is advanced, the patient often complains of the inability to fully go to the toilet and urinate, there is a urge to urinate, but there is no urine. The further manifestation of phimosis will vary somewhat, it all depends on the neglect of the process, on the form and causes of its occurrence. Therapeutic tactics for relative phimosis are selected in the same way as in other cases. In mild forms, in the first and second stages, it is possible to use medicinal or conservative treatment, and in the third and fourth stages, in severe forms, immediate surgery is required.

Complications of phimosis

Complication of phimosis. With any pathology of the genitourinary system, different types of complications can be observed, depending on the reasons for the formation of the disease and the neglect of the process. With timely, high-quality treatment, the outcome of the disease is favorable, recovery occurs in all cases. But consequences after phimosis can still occur, these include paraphimosis, balanoposthitis, anuria, accretion of the glans to the foreskin, and in more severe degrees - cancer of the glans penis. Paraphimosis can be complicated by necrosis and gangrene, which ultimately leads to complete removal of the organ.

A disease such as balanoposthitis occurs due to inflammation of the inner layer of the foreskin and the head of the penis. The secretion that is produced in the pouch accumulates there, a favorable microflora is formed, and due to irregular care, inflammation occurs, a white color and a specific unpleasant odor appear. This pathology is characterized by itching, redness of the head, irritation around the lesion, pain, swelling of the soft tissues, and subsequently, the release of pus from the preputial sac.

Paraphimosis is a problem that often manifests itself in boys at a young age; if the head is pulled out sharply enough, the preputial ring can tightly clasp under the head and become pinched, which will cause pain and swelling after phimosis. After squeezing the blood vessels of the penis, their functional ability is somewhat lost; necrosis begins in the soft tissues of the glans due to lack of oxygen and nutrients. If you do not seek help in a timely manner, necrosis of the glans penis may occur.

Why is phimosis dangerous? It is a known fact that phimosis is not a fatal disease; it is dangerous only for its consequences and an unpleasant long recovery period. At the initial stage of the disease, there is a risk of stagnation of secretions, impaired urine outflow, pinching of the head of the penis by the foreskin, inflammation of the head and preputial sac, and synechia. Subsequently, the most dangerous manifestation may be cancer of the genital organ.

Complications after phimosis in a child are extremely rare, since before puberty, phimosis is considered a normal natural process in the life of every boy. It will be enough to closely monitor the condition of the child’s genitals and consult with specialists, preferably regularly. Many parents worry that phimosis is the cause of infertility in boys, but we can say with confidence that the prognosis for this disease is favorable, and the risk of developing negative consequences is minimal.

Is phimosis dangerous? Consequences in children can only be associated with strangulation of the head, when it is necessary to resort to a radical method of treatment - surgery. Phimosis in adults is a pathology. This condition must be treated under the supervision of an andrologist and urologist. The most unpleasant situation that a man can experience is psychological depression associated with impaired sexual function of the body. A man may lose the desire to have sex due to embarrassment, unattractive appearance, and painful sensations during erection. Does phimosis affect the size of the penis? Definitely not, the disease will not affect the size of the penis in any way.

Surgery, phimosis, complications.

It is also worth not forgetting about the postoperative period, since complications often arise during this period of time. In the postoperative period, both children and adult men may experience various types of complications; young boys, of course, are less susceptible to complications, since the body is young and the ability of tissue to regenerate is much higher than that of an organism that is quite depleted.

Phimosis is a complication after surgery; swelling of the foreskin after phimosis occupies a significant place. Surgical excision of the pouch can be accompanied by chronic complications: bleeding, acute anuria, wound suppuration, scarring and extensive adhesions. A side result is observed after poor-quality surgery in unsanitary conditions. You should choose a reliable medical institution; it is better to trust the operation to a qualified specialist. You should worry about your health and not let the disease develop into pathological forms.

Treatment

Several years ago, most doctors were convinced that treatment of phimosis was possible through surgical procedures, i.e. circumcision of the foreskin. Many people ask questions, how to cure phimosis without circumcision?

Today there are a sufficient number of treatment methods:

• Daily exposure of the head of the penis. It is important to do this systematically, for 7-12 minutes two or three times a day, and not skip it.
• Stretching of the foreskin. This procedure is performed on an empty bladder. The main thing is to do this every day, but carefully, for 2-3 months.
• Stretching the preputial sac with simultaneous insertion of the fingers.
• Drug treatment. Ointments help a lot. They have an anti-inflammatory and analgesic effect, stretch the foreskin. With the above methods, they have a positive effect in the fight against the disease.

Many experts do not believe in the positive effect of these treatment methods. Since after many attempts at self-medication, most patients come to doctors with complications, and besides the surgical method, doctors have nothing to offer them. And all this happens due to the fact that competent consultation with specialists was not carried out and many mistakes were made in carrying out conservative therapy. For example, the scar form of phimosis can only be treated with surgical intervention, due to the inability of scar tissue to stretch.

The good thing about the above methods is that they are natural.

And yet, before starting treatment for phimosis, you need to consult a doctor, and if there are no contraindications, then conservative methods can have a positive effect.

• Exposure of the head of the penis.

General principles of this technique:

• Carry out the stretching process smoothly, gradually, avoiding pain.
• Frequency. Every day for 7-17 minutes, two to three times a day, and do not allow any omissions.
• The essence is daily exposure of the head of the penis.
• Stretching the prepuce. The essence of this method is to stretch the prepuce until unpleasant sensations appear. This method is also effective in children if the spontaneous process of eliminating phimosis has not occurred. Duration up to several months.
• Stretching the foreskin with the simultaneous insertion of the fingers and their subsequent separation. Before this, you need to treat your hands with an antiseptic, take a warm shower, then the skin will become soft and supple, and lubricate the foreskin with nourishing cream or Vaseline. Then gradually insert your fingers into the preputial sac and stretch the skin with smooth movements. This method is used in children and adolescents. To treat phimosis in adults of the first and second degree, a special glansha tool is used. The essence of the method remains the same.

Phimosis photo, treatment

If phimosis is diagnosed, treatment without surgery is possible. It is important to follow all recommendations of specialists. But all these methods are good, for the first or second degree of phimosis, in children and adolescents. In men, the chances of eliminating the disease using these methods are sharply reduced.

How to get rid of phimosis without surgery?

There are also traditional methods of treating phimosis. They use herbal decoctions that have anti-inflammatory and antiseptic effects. The most commonly used herbs are:

• Chamomile. One of the most effective herbs in the treatment of phimosis. It relieves irritation well and has an antiseptic effect.
• Calendula. Also has a calming effect. To prepare the decoction, you need 1 tablespoon per glass of boiling water, leave and strain. Apply as compresses.
• A series. Has regenerative abilities, restores the body.
• Agave juice. It is injected directly into the preputial sac overnight. Has a pronounced anti-inflammatory effect.
• Barley. 3 tablespoons of barley, pour 400 ml of boiling water, and leave for an hour. Use as baths.

Herbs can cause adverse reactions, such as irritation, redness, or the development of allergies. If you want to avoid such complications, then you should perform manipulation with these herbs on an open area of ​​skin and monitor the result.

These herbs are used in the form of decoctions, both individually and together. Warm baths are made from the prepared broth. They soften the skin well, and then stretching methods are easy and painless. It is important to note that herbs should be used in complex therapy.

Another way is to knead the penis using sea buckthorn or viburnum oil. Massage movements cause the head to slide, which accelerates its separation from the skin of the preputial sac.

Salt baths help a lot. Sea salt is often added, which steams the skin and makes it more elastic. But the drying effect of salt is pronounced, so this procedure is not worth doing often.

How to treat phimosis without surgery?

It happens that the penis hurts at the site of phimosis, and the patient experiences discomfort. There is no need to endure such discomfort in the groin. In this case, treatment is carried out symptomatically. What can be done in such a situation? First, take a warm shower/bath. Antipruritic and antihistamine ointments/creams will help relieve symptoms in a few minutes. They contain substances that soothe the skin.

Treatment of phimosis without surgery in children, reviews. If the mother suspected a problem in time and consulted a doctor in a timely manner, then conservative methods of treating phimosis are ideal for getting rid of this disease. Treatment of phimosis, reviews from the methods discussed above are positive. 90% of patients or their parents noticed positive dynamics after treating phimosis with non-surgical treatment methods.

Phimosis treatment, price. Conservative treatment will not require large expenses, the main thing is to follow all the doctor’s recommendations, daily and without failure, and within a month the result will not be long in coming.

Drug treatment of phimosis

All drugs intended for the treatment of phimosis are divided into the following groups:

• Ointments with a stretching effect. Most often they are prescribed to children and adolescents.
• Ointments with added antiseptics. Prescribed if an infection occurs against the background of a general illness.
• Ointments with anti-inflammatory and hyposensitizing effects.
• Solutions that relieve itching, inflammation, and discomfort. They are usually multi-component.

For the treatment of phimosis, herbal decoctions that can be made at home are very helpful. They relieve redness, burning and itching. Ointments are prescribed for stages 1-2 of phimosis. If conservative therapy is ineffective, surgical treatment is resorted to.

Phimosis in men, treatment, ointments

What do you need to know when choosing an ointment?

• Before going to the pharmacy and buying the drug, be sure to consult your doctor in order to avoid complications.
• Not in every case can ointments have the desired effect. So, for example, with stage 3-4 phimosis, they do not help.
• Hormonal medications in ointment form are prescribed only to adults. It is strictly prohibited for children to use them.
• All drugs are used in a course. Its duration is up to 2-3 months.

One of the most popular drugs is Diprosalik ointment; for phimosis, it relieves redness, burning sensation, itching, and stretches the foreskin. It consists of two components: salicylic acid and the hormonal drug betamethasone. Apply the ointment after taking a shower, on softened skin. Once the ointment is applied, gently stretch the foreskin with your fingers. The duration of this manipulation is 10-15 minutes, 2-3 times a day for 1-2 months.

Diprosalik, reviews for phimosis

The effectiveness of this drug is 90% in the initial stages of the disease. For the second and third degrees, about 50-60%. In general, the reviews are positive if you carry out this procedure regularly.

Drug phimosis, hormonal treatment

Hydrocortisone for phimosis is used 2-3 times a day. The ointment contains the active substance of the same name. With regular use, the foreskin tissue begins to stretch after two to three weeks. Hydrocortisone acetate kills the infection and accelerates the process of restoring normal microflora. To increase efficiency, you need to massage the penis with light, smooth movements and stretch the foreskin with your fingers.

This way you can easily cure phimosis. The exercises and manipulations that need to be carried out must be shown to you by a specialist.

Betamethasone also has a good effect for phimosis. The main substance of this drug has an anti-inflammatory, anti-edematous effect, and is involved in the process of skin stretching. The ointment must be applied 2 times a day for two to three weeks. In this case, you need to lubricate the end of the penis and gradually stretch the foreskin, about five to seven minutes.

Levomekol has a similar effect. It contains an antibiotic and methyluracil. The latter accelerates regenerative processes and has a local immunostimulating effect. The ointment heals formed cracks and wounds on the foreskin. You need to lubricate 2 times a day, preferably in the morning and before bed. Regeneration processes are noticeable after a couple of weeks. Apply the ointment only to softened skin, after a shower.

Furacilin helps treat phimosis well in the initial stages. It also relieves redness, heals cracks and wounds, and has an antimicrobial effect. The furatsilin solution is diluted in equal proportions with water. A bandage or piece of gauze soaked in the solution is applied to the affected area for 15-20 minutes, for 10-14 days.

Phimosis can also be treated with a solution of potassium permanganate. Add a couple of drops to warm water until a light pink color appears. Use in the form of baths, 15 minutes each, for 14 days, every other day.

In addition to medications, dilator rings are used to treat phimosis. They are inserted into the foreskin, and a process of gradual stretching occurs. To do this, rings of various diameters are used; they are changed as the foreskin stretches and removed when the head can be freely exposed. They are worn two to three times a day, for one hour at a time. The duration of this course is 2-3 months, and depends on the stage of the disease.

At the very beginning, the doctor selects the first ring of the desired size. At the same time, the foreskin is pulled and the diameter is measured using a compass. The ring is replaced with a larger one when the tension process felt by the patient stops. You need to insert the ring carefully, while squeezing it, pulling back the foreskin and inserting it. Material of manufacture: silicone. You can buy rings for the treatment of phimosis at the pharmacy. Sold in sets of 6 pieces of different diameters. This treatment method is popular in foreign countries. It began to be used relatively recently in the CIS countries.

Laser treatment of phimosis involves the use of modern technologies, namely laser equipment. Its essence is as follows. The foreskin is excised using a laser, due to the photodestructive component. The temperature of the beam is about three hundred degrees, due to this the tissue evaporates. This method has many positive aspects:

• Anesthesia is not required for this procedure; local anesthesia is sufficient.
• Due to the high temperatures, all blood vessels are cauterized, and blood loss is completely eliminated.
• After the operation, patients do not experience any complications. The penis does not swell, as happens with classical surgical interventions.
• Short recovery period. Healing occurs quickly. Observation in the clinic after this manipulation is not necessary. Patients can go home.
• Painless.
• The duration of laser treatment is up to half an hour.

How exactly is laser treatment performed?

• A local injection with an anesthetic is given.
• The doctor uses a marker to mark where the incision will be made.
• A laser, or rather its beam, makes an incision.
• Unnecessary tissue is excised.
• Treating the surgical wound with an antiseptic solution.

When all methods of conservative treatment of phimosis have been tried, or complications develop, then specialists resort to surgical treatment.

Indications for surgical treatment:

• Inflammatory changes in the head of the penis, poorly controlled with medication. It develops due to stagnation of secretory fluid, due to such a strong narrowing of the preputial sac.
• Paraphimosis. It is a serious complication. In this case, the preputial sac is so narrowed that it leads to pinching of the head of the penis, poor circulation and, as a result, tissue necrosis.
• Cicatricial forms of phimosis.
• Urinary dysfunction. The patient cannot go to the toilet normally and experiences pain and cramps.

Preparation for surgical treatment.

First of all, the patient who has given consent to the operation (if it is a child, then the parents give consent in writing) will have a meeting with an anesthesiologist. A thorough conversation is conducted with the patient, his anamnesis and medical documentation are studied. After this, the most optimal method of anesthesia is selected, which depends on the patient’s age, his physical parameters, and the equipment of the clinic.

When performing an operation on children, especially if they are a newborn or a preschool child, preference is given to local anesthesia, while the child’s body is firmly fixed. Since general anesthesia can lead to serious consequences.

Mask anesthesia is performed for older children. Their body is able to tolerate small doses of anesthesia without developing consequences.

Men can easily undergo the operation under general anesthesia. The difficulties of general anesthesia lie in the fact that patients need to undergo high-quality preoperative preparation, for example, 10 hours before the intended operation, do not eat or drink.

General preparation, both for local anesthesia and general anesthesia, is as follows:

• The genitals need to be washed.
• Remove pubic hair.

This operation is called circumcision of the prepuce. Total or subtotal removal of the foreskin occurs. The surgeon uses a scalpel to make a circular incision in the skin near the head of the penis. Next, the edges of the resulting skin flaps are stitched using catgut. A bandage is applied, which the doctor changes approximately once a day until complete healing. Patients should avoid getting urine on the wound and not be sexually active for one month. At home, experts recommend taking baths with a solution of furatsilin or potassium permanganate to speed up wound healing.

Treatment of phimosis, surgery in adults

Types of circulation:

• Subtotal or partial. There is a problem in the form of phimosis, but the patient does not want to completely expose the head.
• Total. Complete removal of the prepuce.
• Not tight. The head is freely exposed, but the folds of skin in the area of ​​the coronary sulcus remain.
• Moderate. Similar to the previous type of circumcision, but a small fold of skin remains in the area of ​​the coronal sulcus.

Circumcision using a dorsal suture. The skin flaps are fixed with clamps. Skin excision is carried out at the twelve o'clock position in relation to the marking line. Using scissors, a section of skin is cut along the dotted line. Stitches are placed on the remaining area of ​​flesh.

Phimosis in men surgery, video

Circumcision without removal of the foreskin. In this case, the inner layer of the foreskin is dissected, and suture material is applied to the leaves of the prepuce.

Operation phimosis in children, video

Roser's method. A probe is inserted into the cavity of the preputial sac, and two layers of the foreskin are cut along it. The inner layer is cut less than the outer one. Next, the sheets are sewn together with knots.

Phimosis operation, photo

When synechia forms in the area of ​​the preputial sac, a surgical treatment method is used - prepucioplasty. Its essence is to dissect the synechiae and release the head of the penis. The skin of the foreskin is not removed. The operation does not cause complications, the discomfort goes away soon.

Phimosis in boys surgery, video

Meatoplasty is an operation to correct the size of the outer part of the urethra. This method is used for some types of phimosis.

Phimosis before and after surgery, photo

After all of the above treatment methods, phimosis never recurs.

Phimosis in boys, surgery, photo

Rehabilitation.

After surgery, patients may experience pain for some time. They are especially pronounced during urination. The postoperative wound requires careful care. Dressings are carried out every day. The dressing should be dry and uncontaminated. Urine should not come into contact with the bandage. If this happens frequently, the urine can cause irritation and inflammation, and thus the wound healing process slows down.

Wearing underwear is prescribed, which will hold the penis in one position, which will create conditions for rapid healing of the wound.

Complications.

Adverse reactions after phimosis, or rather operations to eliminate it, occur extremely rarely. It all depends on the postoperative period. If the patient violates and neglects personal hygiene and does not monitor the wound surface, then complications such as swelling and inflammation cannot be avoided. But, nevertheless, the following undesirable consequences may occur:

• Hematomas and cicatricial changes in the suture area.
• Infection.
• Inflammatory changes in the urethra. The first signs are pain during urination.
• In the postoperative period, erections often occur in the morning and evening. In this regard, the edges of the surgical wound may diverge, and the recovery period will lengthen. It causes pain and poor circulation in the organ.
• Decreased sensitivity of the glans penis. Over time it recovers.

Contraindications.

• Wounded or ulcerated surface of the penis.
• Hemophilia.
• Oncological process.
• Chronic process of the genitourinary system.
• Anomalies of the development of the penis.
• The last stages of paraphimosis.

Phimosis in men, photo after surgery

Treatment of phimosis - surgery, price. In private clinics, this operation costs about 15,000 rubles.

Prevention of phimosis in boys

Preventive measures consist of certain principles:

• Preventative examinations with a pediatric surgeon.
• Children and their parents must observe the rules of personal hygiene.
• Use baby soap to wash your genitals.
• As soon as wounds, ulcers, and cracks are discovered, treatment with antiseptics is important.
• Change your underwear every day.
• If this is a small child, then change diapers/diapers frequently and use wipes with antiseptics.
• And under no circumstances should the foreskin be exposed to small children.

If parents are attentive to their children and adhere to all the above rules, this will help avoid or eliminate pathology in the initial stages of development.

Phimosis (from the Greek phimosis - tightening, compression) is a narrowing of the foreskin that prevents the removal of the head of the penis. This condition is the norm for the smallest representatives of the stronger sex, but it becomes a pathology if it lingers beyond the prescribed time. Let's try to figure out where the border between these states lies.

To clearly understand the problem of phimosis, let us recall the features of the anatomical structure of the foreskin of “manhood”.

The penis (aka penis) consists of a body, head and root. The head of the penis is hidden by skin - the foreskin (prepuce), which in an adult man is easily displaced, exposing the head. The foreskin consists of two layers: the outer one, which is no different from the skin of most other parts of the body, and the inner one, tender and soft, reminiscent of a mucous membrane. Between the head and the inner layer of the foreskin there is a preputial space (another name is the preputial sac). The secretion of the glands located under the foreskin and forming a special lubricant (smegma) is secreted into this cavity, thanks to which the sliding of the head is facilitated. Along the lower surface of the penis, the foreskin is connected to the head by the frenulum of the foreskin - a fold of skin in which blood vessels and nerves are located. On the head there is an external opening of the urethra (meatus).

Physiological phimosis

In newborn cavaliers, the head of the penis is fused with the prepuce by peculiar adhesions (synechias), which do not allow the head to be freely withdrawn. This physiological feature is a kind of protective mechanism that reduces the likelihood of infection entering the preputial space and the development of inflammation - and is called physiological phimosis. For boys under 3-7 years old, physiological phimosis is a completely normal condition! Statistics show that at the age of 1 year the head of the penis opens in 50% of boys, and by 3 years of age - in 89%. The incidence of phimosis in 6-7 year old children is 8%, and in 16-18 year old boys it is only 1%.

As the head of the penis grows, it gradually moves apart the prepuce, and the physiological synechiae are destroyed. Well, during puberty, starting from 12-14 years, when male sex hormones are activated, making the tissue of the foreskin more elastic and stretchable, the head opens completely.

Physiological phimosis does not require any treatment, but obliges parents to pay close attention to the condition of the child’s external genitalia. The condition of the glans penis, foreskin and preputial sac (space) is most easily monitored during daily washing, as well as when the baby urinates. If the foreskin is swollen and red, and the child continually reaches out with his hands to the causal site (and even more so if urination is difficult), you must immediately consult a pediatric andrologist, and if there is no such specialist, a pediatric surgeon or urologist.

Pathological phimosis

People begin to talk about phimosis as a medical diagnosis (that is, a pathological narrowing of the foreskin) in the case when it is not possible to remove the head of the penis in a boy after 6-7 years.

Phimosis, depending on the condition of the foreskin, can be atrophic and hypertrophic. With atrophic phimosis, the skin of the foreskin is very thin and extremely susceptible to microtrauma, which results in scarring. With hypertrophic, the prepuce, on the contrary, is quite thick, and in the form of a “proboscis” protrudes far beyond the boundaries of the head of the penis.

In addition, phimosis is usually distinguished by degrees. Depending on the severity of the narrowing of the foreskin, there are 4 degrees of phimosis:

• 1st degree. In a calm (relaxed) state, the head of the penis is exposed without problems, and during an erection this requires little effort.
• 2nd degree. During an erection, the head does not open at all; in a calm state, it opens with effort.
• 3rd degree. The head of the penis either does not open at all, or this is only possible with considerable effort and only in a calm state of the penis, but phimosis does not cause problems with urination.
• 4th degree. When urinating, the preputial sac swells first, and only then urine (in a thin stream or drop by drop) is released out. The head of the penis cannot even be opened slightly.

The main causes of phimosis are:

• Genetic predisposition to the formation of phimosis as a result of insufficiency of the elastic component of connective tissue in the body;
• Trauma to the penis, which may result in the formation of scar tissue leading to narrowing of the foreskin;
• Inflammation of the foreskin of the penis, also leading to scarring and phimosis.

It should also be noted that phimosis itself is a factor in the development of further narrowing of the foreskin. The fact is that in the presence of even a slight narrowing, constant injury to the leaves of the foreskin occurs when the head is exposed. This situation is especially typical during puberty and the appearance of erections. During an erection, the size of the head and body of the penis increases, which causes tension in the foreskin and the formation of microtears in it. During the healing process, scar tissue is formed in places of micro-tears, which is not capable of stretching, which leads to the progression of phimosis.

Why is phimosis dangerous?

Since phimosis somewhat complicates hygienic procedures, if the baby is not carefully cared for, stagnation of smegma is possible. Unfortunately, it serves as an excellent breeding ground for bacteria, which, in turn, can cause the development of inflammatory processes. Moreover: with prolonged stagnation, the formation of dense formations - smegmolites (literally “smegma stones”) is even possible.

Phimosis of the 4th degree is especially dangerous, in which there are obstacles to the outflow of urine. Increased pressure in the preputial sac at the end of urination, when pressure in the bladder decreases, leads to reverse flow of urine and dissolved smegma through the urethra. This leads to the development of infectious complications in the urethra.

Complications of phimosis

Generally speaking, the main danger is not phimosis itself, but its complications. The most formidable of them is paraphimosis- pinching of the head of the penis by the narrowed foreskin as a result of its forced opening. This can happen when relatives or the child himself, as they say, “finished the game” - they exposed the head, but were unable to return the foreskin to its place. Paraphimosis can also occur later in life, during sexual intercourse or masturbation. Pinching leads to swelling of the head of the penis, which at a certain stage makes its reverse reduction impossible. As a result of poor circulation, the head turns blue and becomes sharply painful. And if emergency assistance is not provided, necrosis (necrosis) of the head may occur, leading to its amputation.

As you yourself understand, only a specialist doctor can provide assistance in this case. Call an ambulance immediately! Delay, as well as an attempt to cope with this problem on your own, is fraught with the loss of precious time and serious consequences.

A dangerous complication of phimosis can be balanoposthitis- inflammation of the foreskin and glans penis. It develops due to poor genital hygiene and infection of the preputial space. The chance of developing balanoposthitis increases in children with reduced immunity or against the background of other infectious diseases. Inflammation of the foreskin is characterized by swelling, redness (hyperemia), pain, and purulent discharge from the preputial space. The result of inflammation can be cicatricial degeneration of the skin of the foreskin and, as a consequence, the further development of phimosis. Balanoposthitis is a disease that requires emergency medical attention. The doctor inserts a special probe between the head of the penis and the skin of the foreskin, which carefully separates the existing synechiae, thereby creating conditions for the outflow of accumulated pus.

Another complication of phimosis that requires immediate medical attention is acute urinary retention. This condition is more common in young children and is reflexive in nature, as a reaction to pain. The child cannot urinate for a long time, becomes restless, complains of pain in the abdomen and above the womb, where an enlarged bladder can be felt. During the treatment process, the baby is given painkillers, a cleansing enema is given (so that the intestines, filled with feces, do not additionally put pressure and impede the outflow of urine), and then a warm bath with potassium permanganate is given, during which the child tries to urinate. If this does not help, urine is removed using a catheter.

A complication of phimosis of degrees 3 and 4 can also be accretion of the foreskin to the glans. As a rule, at first a small area grows, then the area of ​​fusion expands and eventually the foreskin grows to the head of the penis along its entire length. In this case, attempts to open the head are accompanied by severe pain and bleeding. This condition is not an emergency, but it should not be started. For foreskin accretion, only surgical treatment is possible. But, since with a large area of ​​fusion, intervention can be difficult, the earlier the problem is detected, the easier it is to eliminate it.

Treatment of phimosis

When treating phimosis, both conservative and surgical methods can be used.

Conservative methods of treating phimosis

With hypertrophic phimosis, if there are no complications, conservative treatment is possible, which consists of gradual stretching of the foreskin. The manipulation can be performed by parents at home. Three times a week, while bathing with herbal decoctions (chamomile, chamomile), the foreskin is displaced until the child begins to feel pain, after which a few drops of sterile vaseline oil are injected into the preputial space. The duration of treatment is several months. The procedure should be performed very carefully to avoid paraphimosis. Success depends on the persistence of the parents and the severity of phimosis.

In recent years, correction of phimosis has been used with hormonal ointments, which are placed in the preputial space. They make the fabric easier to stretch. Treatment is carried out by parents with mandatory medical supervision.

For atrophic (cicatricial) phimosis, conservative treatment is not very effective. In this case, surgical methods are used.

Surgical methods for treating phimosis

Indications for surgery are paraphimosis, severe cicatricial changes in the prepuce, repeated repetitions of balanoposthitis, and urinary disturbances.

Circumcision (circumcision)

The fastest and most effective way to treat phimosis is an operation called circumcision, or circumcision. With this intervention, the foreskin is removed, which completely eliminates any problems with exposing the head of the penis. This operation lasts 10-15 minutes and is usually performed under general anesthesia. The foreskin is cut off circularly (in a circle), while preserving the frenulum. The inner and outer layers of the foreskin are sewn together with catgut (a suture material that does not require the removal of sutures in the future, as it dissolves on its own). After the operation, a bandage with Vaseline oil is applied. A few hours after this surgical intervention, the child can walk and independent urination is restored. Circumcision is indicated for any degree of phimosis.

Contraindications for circumcision surgery are balanoposthitis and paraphimosis.

Longitudinal incision of the foreskin

This operation is used in cases where full circumcision cannot be performed. As a rule, her help is sought for two types of complications of phimosis - acute balanoposthitis and paraphimosis. In the first case, longitudinal dissection of the foreskin is resorted to because circumcision cannot be performed to open the inflamed glans penis, since infection can lead to failure of the sutures. Well, in case of paraphimosis, when acute circulatory disorders do not allow for full circumcision, longitudinal dissection of the foreskin remains the only way to “separate” the ring compressing the head of the penis.

By the way, in both cases, after the end of the acute period (that is, when the worst is over), doctors may recommend circumcision, which will no longer have a therapeutic, but a cosmetic value.

Prevention of phimosis

The development of phimosis is largely due to genetic predisposition, so medicine cannot offer radical measures to prevent this disease. But we can talk about preventing complications of phimosis. Here hygiene plays the first and main role.

During infancy, proper hygiene care is limited to daily bathing of the child and washing after the baby soils diapers or diapers. During bathing, water gets under the foreskin, which naturally washes away the accumulated secretions. At least once a week you should wash your penis and scrotum with soap. To do this, it is better to use baby soap or special baby bathing products. Daily use of bactericidal soaps or gels is not recommended. If used frequently, they can disrupt the balance of the normal microbial environment necessary for healthy skin.

To avoid urinary tract infections, children should be washed from front to back. For boys, the penis is washed without moving the foreskin. If you still try (on the advice of some doctors) to gradually move the skin of the penis and expose the head, then this procedure should be performed very carefully, without causing the slightest pain to the child. It should be remembered that the area of ​​the glans penis contains a large number of pain nerve endings, and rough manipulation of the penis can lead to mental trauma and fear. Immediately after toileting the glans, the foreskin should be returned to its place to avoid the development of paraphimosis.

Genital hygiene should become the same daily habit for a boy as washing or brushing his teeth. Later, and especially at the beginning of puberty, the future man needs to undergo regular medical examinations. Take care of your health!

Every newborn boy has a congenital feature of the genital organ associated with complete coverage of the head of the penis with a fold of skin. Doctors call it physiological phimosis. Young mothers are often not familiar with this diagnosis, so they try to find out more about phimosis in infants (forum) and medical websites. In fact, phimosis of the physiological type does not pose a danger to the baby and disappears as the boy grows older. There are other situations when physiological phimosis, characteristic of newborn male children, transforms into pathological at an older age. The problem develops in children aged 6-7 years. But here, for correct diagnosis, you need to take into account the individual characteristics of the development of the child’s body. In medicine, there have been cases where congenital phimosis disappeared on its own only in adolescence.

What does physiological and pathological phimosis look like in boys in the photo: before and after elimination, how is it classified in the international classification of diseases, what features does the pathology have at different periods of a boy’s life? This article will tell you about this.

ICD code: Phimosis in children (photo), general characteristics

According to medical statistics, in 95-96% of newborn boys the head of the penis cannot be completely exposed. This feature in medicine is called physiological phimosis. Phimosis in a one-year-old child does not require medical intervention and is considered a normal condition. However, if the baby has difficulty urinating or is capricious when emptying the bladder, parents should take him for a consultation with a pediatric urologist, pediatrician or surgeon.

In the international classification of diseases, childhood phimosis is assigned code N47. The disease is included in the category “Diseases of the genitourinary system” and the subcategory “Diseases of the male genital organs” together with pathologies of excess foreskin and paraphimosis.

Phimosis at 1 year and features of pathology in newborn boys

Congenital phimosis is characterized by complete immobility of the foreskin, which physiologically fuses with the surface of the head. Most boys are born with physiological phimosis. Only 4-5% of male babies have a movable foreskin, which can be easily lifted and expose the head of the genital organ. Pediatricians and andrologists call phimosis in the first year of life a normal physiological phenomenon. This feature of the child’s body goes away on its own after several years of life. At the same time, if inflammation of the head of the penis or foreskin occurs, as well as in the event of problems with urination, a child of any age undergoes surgery for medical reasons or uses medication.

Phimosis at 2 years

In little boys under 2 years of age, problems and pathologies of the foreskin do not arise, since it completely covers the head of the penis and is closed quite tightly. Pathogenic microorganisms simply cannot penetrate under it, and, therefore, the inflammatory process in the genital organ does not threaten the baby. But there are exceptions in which the physiological state of the foreskin turns into a pathological process. Phimosis in boys at 2 years of age develops if parents forcefully try to open the head of the baby’s penis. It is impossible to stretch the foreskin in infancy, because such manipulations lead to the appearance of tears, bruises and microcracks in the delicate tissues. If adults neglect this requirement, the child develops pathological phimosis at the age of 2. It happens:

• atrophic (in a boy, the ring of the foreskin critically shrinks, the pathological development of tissues becomes clearly visible, the skin becomes thinner, and its vulnerability to mechanical influences increases);
• hypertrophic (the problem is associated with pathological elongation of the prepuce sac, more often observed in overweight boys, with the accumulation of a large amount of subcutaneous fat in the pubic area);
• cicatricial (appears as a result of mechanical injuries to the delicate tissues of the foreskin, provokes its swelling, as well as the rapid accumulation and stagnation of urine under it; due to unfavorable processes, connective tissue scar adhesions are formed between the inner part of the head and the prepuce).

Phimosis in a 2-year-old boy does not always require surgery. Surgery is recommended by a doctor only if there are risks to the child’s health.

Phimosis at 4 years old

The inability to retract the foreskin from the head of the penis in boys aged 4 years can also be considered a normal physiological phenomenon. If the child does not experience pain when urinating, he is not capricious and does not show anxiety, treatment of phimosis or surgical intervention is not required. Parents should contact a pediatric urologist only if the child has phimosis and complications have developed (the glans penis is inflamed, problems with urination have arisen). Medical statistics show that at the age of 4-7 years, the manifestations of congenital phimosis disappear in many boys. The head begins to freely emerge from under the foreskin. If this does not happen, you can consult a specialist and, if necessary, undergo a course of medication.

Phimosis in adolescents 16 years old

The persistence of congenital phimosis at 5 years of age and at an older age (up to the 16th birthday, when adolescence begins) may be a sign of physiological processes or a pathological abnormality. To understand what type of phimosis a boy suffers from, parents should carefully look at the symptoms. Redness of the skin on the penis, the inability to remove the head of the penis from under the epithelial fold on the skin, swelling and soreness of the foreskin sac, impaired urine drainage and its accumulation under the preputial sac, malaise, weakness, headaches - all these manifestations are a reason for immediate medical intervention .

Doctors begin to classify phimosis as a disease and pathological deviation of sexual development in a child when the boy turns 7 years old. During the diagnostic process, the doctor looks at the state of the prepuce, the degree of narrowing of its outer edges and, based on this information, determines the degree of pathology and the causes of its occurrence.

Reasons

Phimosis in early childhood is dangerous due to the high probability of its transformation into pathology. The mucocutaneous membrane that forms the cap over the head of the penis is tightly closed at the very beginning of a boy’s life. It is impossible to perform hygienic procedures under it, so pathological bacteria can accumulate there, contributing to the development of the inflammatory process. This is the main cause of phimosis in children.

Physiological and pathological phimosis in boys: causes

Factors in the development of phimosis in childhood in boys depend on the type of deviation. For example, doctors cannot accurately determine why physiological phimosis develops in newborn babies. Most often, its causes are associated with genetic predisposition.

The pathological causes of phimosis in boys are as follows:

• insufficient, poor-quality hygiene of the external genitalia in boys, due to which the infection gets under the prepuce and provokes the development of inflammation;
• wounds, injuries, microscopic tears in the skin on the head or foreskin;
• past diseases and inflammatory processes in the genitourinary organs (balanitis, balanoposthitis).

Phimosis: causes in children

Phimosis in boys of different ages can also appear due to the following factors:

• deficiency of connective tissue in the child’s body;
• overly uncomfortable clothing that squeezes and rubs the boy’s genitals;
• injuries to the penis associated with inept actions of parents in the process of bathing a newborn baby.

Often in young boys, the penis and the fold of skin around it grow unevenly. The foreskin develops more slowly and therefore wraps too tightly around the head of the penis, making it impossible to expose it and perform the necessary hygienic procedures. The initial stages of childhood pathological phimosis are accompanied by progressive narrowing of the foreskin, injuries and scarring of its internal part. The situation is aggravated by further narrowing of the skin fold. An acute condition of head entrapment may develop, requiring immediate surgical intervention.

The symptoms of phimosis always help the doctor determine the causes of the pathology. The severity of signs, their number and characteristics contribute to the detection of the causative agent of the disease and the development of an effective treatment regimen.

Symptoms

The question of how to determine whether a boy has phimosis or not worries many parents. Note that the symptoms of this deviation vary depending on the age of the baby and the complexity of the course. If phimosis is diagnosed in boys, the signs and treatment of the disease are determined in accordance with external manifestations, the presence of complaints and acute conditions.

Phimosis in newborn boys: symptoms and features of the disease

Parents who want to know how to determine phimosis in boys (photo) who have just been born should know the physiological features of the structure of the genital organ in infants. For most boys, immediately after birth, the penis has one anatomical feature. His foreskin fuses with the head of the penis, so the latter cannot be exposed. This form of phimosis is not considered a problem; with it, the baby feels good and does not bother him with unpleasant sensations.

The situation is completely different with pathological phimosis of newborns. The disease develops already during the baby’s life and can take on various degrees and types. Signs of phimosis in a child under 1 year of age associated with pathological changes in the foreskin are represented by the following manifestations:

• exposure of the head of the penis is difficult (a symptom of cicatricial phimosis);
• hypertrophy of the foreskin, which is characterized by its excessive thickening and elongation (the skin protrudes beyond the boundaries of the genital organ, hangs from it like a proboscis, the head of the penis does not open because of this, some children have slight problems with urination);
• thinning of the foreskin, accompanied by maximum manifestations of phimosis in newborns (it is impossible to release the head of the penis, the baby has difficulty emptying the bladder, urine comes out in droplets or in a weak stream, its remains accumulate under the skin fold and provoke infection);
• blueness and swelling of the tip of the penis is a dangerous complication of phimosis (paraphimosis), in which the head of the genital organ is pinched by a narrowed fold of skin;
• increased temperature (a symptom of an inflammatory process, balanitis, balanoposthitis or diseases of the urinary system resulting from the penetration of infection from the foreskin into the urethra, ureters, bladder).

All the signs listed above require medical intervention.

Phimosis: symptoms in adolescents

The degree of phimosis in boys, symptoms and treatment of the disease are interrelated with each other. When doctors diagnose “phimosis” in teenage boys, they already call the inflammatory process a disease and pathology that needs to be eliminated with medication. Often in such situations it is impossible to do without surgery.

Phimosis in adolescents is often associated with the onset of puberty. The external genitalia develop intensively, as a result of which the size of the foreskin may not correspond to the parameters of the penis. During this period, the skin fold does not have time to grow behind the head of the penis, strongly tightens it and injures it. Phimosis and symptoms in children manifest themselves in the form of the following deviations:

• the head of the penis does not open well at rest, sometimes it is not exposed at all;
• an inflammatory process develops, the foreskin swells and becomes red;
• the teenager has difficulty urinating;
• sexual desire decreases;
• the size of the genital organ changes, its swelling is observed;
• pus accumulates under the foreskin, which can come out through a narrowed opening;
• pain and discomfort when trying to expose the head of the penis or during urination;
• hanging of the foreskin from the penis, pinching the head with it.

Symptomatic manifestations of pathological phimosis in adolescents can appear complexly or individually. In any case, if there are alarming signs, you should consult an andrologist.

What does Komarovsky say about phimosis (signs of inflammation of the foreskin in children)

Dr. Komarovsky identifies the following signs of phimosis in boys (photo):

• difficulties in exposing the head of the organ;
• pain when urinating;
• the head of the penis does not close completely;
• the color of the head changes;
• the foreskin becomes so inflamed that the pathological process becomes clearly visible;
• the fold of skin hypertrophies and hangs from the penis.

Komarovsky draws parents' attention to the fact that the symptoms of physiological phimosis in newborns look somewhat different. A small child cannot yet say what hurts. However, parents will be able to understand that something is wrong with the baby’s health, because he is constantly capricious, crying and refusing to eat. The list of pathological symptoms is supplemented by external signs in the penis area. The intimate organ swells, becomes edematous, and acquires a bluish tint. Older boys, due to discomfort in the penis, constantly adjust their underwear and try to scratch the area near the pubis.

Evgeniy Komarovsky gives parents of children useful tips to help reduce the severity of symptoms of phimosis, as well as to properly prevent this disorder.

1. Signs of phimosis can always be prevented. The boy's parents simply must carefully monitor the hygiene of his external genitalia.
2. You need to bathe your child every day, paying special attention to the cleansing of the genitals. In the evenings, the genitals should be washed with clean warm water without using soap.
3. Under no circumstances should you forcibly expose the head of your penis. Some parents make a big mistake by trying to pour soap suds under the child’s foreskin to better clean the internal cavity of the “pouch.” This cannot be done, because the chemical components included in the soap can cause irritation, and the water remaining inside will become a favorable environment for the life of pathological bacteria. As a result of such improper actions, an inflammatory process develops under the foreskin, and suppuration may occur.
4. A newborn baby needs to change diapers often. This will help avoid prolonged contact of the glans and foreskin with excrement (feces and urine).

Adults should pay due attention to suspicious symptoms so as not to miss the moment and show the baby to a highly specialized doctor in time. The specialist will not only detect the symptoms and causes of pathological phimosis, but will also prescribe an effective course of treatment.

Treatment

How to treat phimosis in boys, what to do when diagnosing such a pathology? This question is relevant for many parents, who were informed by a pediatrician about this peculiarity of the development of the foreskin in a newborn. Physiological phimosis does not require correction, since it is asymptomatic and goes away a few years after the birth of a boy. Treatment of phimosis in childhood is necessary if the deviation takes on a pathological form.

How is phimosis treated in boys? Basic methods and techniques

Therapy for pathological phimosis in boys is carried out using a variety of methods. The choice of treatment method depends on the following factors:

• severity of the disease;
• degree of disease;
• boy's age;
• presence of complications;
• diagnosing concomitant diseases.

After detecting phimosis in boys (photo), treatment is carried out using 2 methods:

• surgical;
• conservative.

If a child is not yet 6-7 years old, his phimosis most often has a physiological nature. It is not worth eliminating it with surgical methods. Pediatricians recommend that parents observe the dynamics of the development of phimosis and prevent its complications using conservative methods at home.

How to cure phimosis in a child using conservative methods?

Caring parents often ask pediatricians what to do if their child has phimosis. When answering questions, specialists take into account the stage of the disease. If the pathology has just begun to develop, there is every chance of getting rid of it without surgery. In general, doctors in many cases try to avoid surgical intervention for phimosis in boys. Radical manipulations are associated with risks, so preference is given to conservative methods of eliminating defects of the foreskin.

The main non-surgical methods of combating phimosis in children:

• gently sliding the foreskin by hand;
• the use of hormonal ointments, which are based on the component cortisone (Betamethasone, Clobetasol);
• using a finger or instrumental method of stretching the foreskin.

Conservative treatment options for childhood phimosis are used to eliminate stages 1 and 2 of the disease. In more severe cases, they are not effective and are replaced by surgery.

Treatment of phimosis in children with surgery

Surgical removal of phimosis in children is a radical method of correcting pathology, which is used in cases of ineffective conservative treatment. The surgical method of eliminating phimosis is considered the most effective, because it is guaranteed to help eliminate the problem and prevent relapses.

Surgical treatment of phimosis in children is mandatory if the disease is complicated by pinching of the head of the penis (paraphimosis). Without surgical intervention, the tissue of the head of the penis will quickly die, and eventually gangrene will develop. In this situation, the genital organ must be amputated.

Surgical treatment of the foreskin involves its complete or partial excision. Surgeons use various surgical techniques, but in most cases circumcision (cutting the foreskin) is used. Circumcision of the foreskin involves partial or complete excision of the fold of skin above the head of the penis. Sometimes, under local anesthesia, a specialist will make a small incision in the foreskin to surgically stretch it. This method includes the following techniques:

• dorsal incision (an incision in the skin of the foreskin, including transverse locks, running along the back of the inflamed ring of the rear flesh; the surgeon subsequently stitches it together using transverse sutures);
• triple dissection of the skin fold (the method helps to expand the foreskin and is based on the surgeon creating 3 longitudinal incisions of small length, expanding the foreskin to the required parameters and suturing the created incisions; the operation is performed using general anesthesia; adolescents can be given local anesthesia);
• lateral incision (analogous to the dorsal incision, but with a small addition in the form of 2 longitudinal notches on the sides, subsequently sutured with transverse sutures).

The above techniques belong to a surgical procedure called preputioplasty (foreskin surgery) and are used to treat phimosis in adolescents. Sometimes, to expand the foreskin, the surgeon makes a zigzag incision on its surface and then sutures it. The effectiveness of this method is quite high. In 99% of cases, surgery is successful and does not cause any complications.

If surgical treatment turns out to be ineffective, the boy develops complications in the form of long-term chronic processes. Against this background, the risks of infectious diseases or cancer of the head of the penis increase. For cicatricial phimosis, conservative treatment methods are ineffective, so with this diagnosis in boys, the doctor advises surgery. Treatment of phimosis after surgery should be effective and correct - this will help avoid complications.

Phimosis in boys: treatment after surgery

Postoperative therapy for phimosis in boys of different ages is aimed at eliminating infection, relieving swelling and inflammation. The task of parents is to provide the baby with quality care after the surgical procedure. If the baby complains of pain during urination in the postoperative period, you can dip his penis in warm water for a few minutes. This method helps relieve tension in damaged muscles. After using it, the boy will no longer be in so much pain. The surgeon who removed the phimosis must prescribe an antibacterial ointment for applying bandages. The need for dressings continues for the 1st week, then they are canceled. Recurrence of phimosis is possible only if the foreskin is not completely excised. With complete removal of the skin fold, the likelihood of complications during the rehabilitation period is minimal.

How to treat phimosis in a child at home

It is possible to treat childhood phimosis at home if the pathology has a hypertrophic form. The therapeutic course takes a long time (up to several months without a break), and treatment procedures are recommended to be performed at least 3 times a week.

The essence of home treatment is to perform certain manipulations when bathing the boy. Parents should gently move the foreskin upward until the child begins to complain of pain. You also need to pour a little Vaseline oil (3-4 drops) inside the preputial sac. But it is worth remembering that treatment procedures performed at home will not help eliminate cicatricial phimosis.

To make the skin with hypertrophic phimosis more elastic and pliable, hormonal ointments (for example, hydrocortisone or prednisolone) must be applied to it. They will soften the foreskin, give it elasticity and facilitate the stretching procedure. Ointments are applied inside the preputial cavity regularly until recovery occurs. The boy’s parents must agree with the doctor on the use of hormonal ointments for home treatment of pathological phimosis.

So, let's summarize. Childhood phimosis, which is physiological in nature and does not cause discomfort to the child, is considered normal. It is not treated until complications occur. If any appear, the boy should be shown to a urologist or andrologist. A visit to a specialist should also be made if the head of the penis has not opened by the age of 13-16. If a child has undergone surgery to eliminate phimosis, parents should definitely ask the surgeon about the specifics of the postoperative period.

Postoperative period

Phimosis in a child after the operation continues for some time with painful sensations. The boy feels discomfort because of the applied bandage with ointments that heal the wounds. The stitches also get in the way and hurt a lot. The process of urination becomes painful and uncomfortable and completely unpleasant. Usually painkillers are not used during this period.

Postoperative period after phimosis in children - what you need to know about its features

After removal of phimosis, the postoperative period in children is associated with regular and frequent changes of protective dressings soaked in antibacterial ointments. It is recommended to change them daily or at least once every 2 days. You should also take the following tips into account.

1. Do not get the bandage wet. If it gets wet from urine, the alkaline environment of this biological fluid will irritate and corrode the postoperative wound. Because of this, the healing and recovery process will take a long time.
2. Surgical sutures may be removed no earlier than 1 week after surgical procedures.

After phimosis is removed from the child, drug antibacterial therapy is carried out using corticosteroid ointments. Normalization of temperature usually occurs on the 2-3rd day after surgery.

Ointment for phimosis in boys

The use of ointments to treat phimosis in boys is permitted only after a preliminary examination of the child and consultation with a doctor. During the examination, the specialist confirms the diagnosis and determines whether the baby has any contraindications to glucocorticosteroid medications. It should be noted that with pathological changes in tissue in the penis area (the appearance of scars and adhesions), the use of ointments is not effective.

Ointment for phimosis in children and its advantages

Ointments against childhood phimosis have the following important advantages:

• help maintain the integrity of the foreskin;
• increase the elasticity of the skin fold over the head of the penis;
• become doubly effective when combined with exercises to stretch the foreskin;
• prevent the development of inflammatory diseases, promote rapid healing of microcracks that appear after stretching of the prepuce.

The list of effective conservative medications for eliminating childhood phimosis includes not only ointments, but also hypoallergenic creams with antiseptic gels.

Ointments for phimosis in boys: list of the best drugs

To successfully cope with phimosis in a child, parents should listen to the recommendations of doctors and give preference to corticosteroid ointments with antibacterial and hormonal components in the composition. The following list presents the best of them.

1. Hydrocortisone. Glucocorticosteroid ointment, which has a suppressive effect on the formation of connective tissues. The product affects the metabolic processes of carbohydrates and proteins.
2. Betamethasone. Effective ointment on a synthetic basis. It is most often prescribed for the treatment of phimosis in boys and men.
3. Budesonide. An ointment from a series of prednisolone drugs, approved for long-term use.
4. Clobetasol. A white ointment that has a mild systemic effect on the affected areas of the genital organ.
5. Diprosalik. Combined ointment against phimosis, which includes salicylic acid and betamethasone dipropionate.
6. Prednisolone. A synthetic-based medicine in the form of an ointment, which is 3-4 times more effective than hydrocortisone and 4-5 times more effective than cortisone drugs.

The listed glucocorticosteroids suppress the formation of connective tissue and prevent the movement of leukocytes to the site of inflammation. Their systemic use helps relieve swelling, eliminate inflammation and allergic reactions.

Levomekol for phimosis in boys, principle of action and tips for application

Levomekol ointment contains the immunostimulating substance methyluracil, as well as the antibiotic chloramphenicol. Doctors recommend using it after operations to remove phimosis. The product perfectly heals microtraumas of the skin, restores damaged tissues of the head, and removes wounds. It is better to use Levomekol 2 times a day, in the morning and evening hours. 2 weeks after regular use of the ointment, wounds in young patients heal completely, the functions of the foreskin are restored, and the inflammation under it disappears. In order for the drug to be as effective as possible, the skin fold above the head of the child’s penis is lubricated with it after bathing. Allergy tests are required before starting treatment with Levomekol. High hypersensitivity to the components of the hormonal drug is the main contraindication to its use for therapeutic purposes.

The hydrocortisone drug Levomekol is widely used to treat constricted foreskin in children. This ointment is a combination preparation and allows you to achieve a pronounced anti-inflammatory effect. Therapy using the product promotes good tissue regeneration.

Diprosalik: ointment for phimosis in a child, its properties and characteristics

Reviews on medical forums about Diprosalik ointment for phimosis in a child are mostly positive. The child’s parents are satisfied with the results of using the medicinal composition. The drug eliminates burning and itching and effectively fights the developed inflammatory process. The active components of Diprosalik quickly eliminate pathogenic bacteria and leave no trace of severe redness around the genitals. The use of this ointment helps to stretch the connective tissue and speed up recovery. The active ingredients of Diprosalik medicinal ointment are salicylic acid and betamethasone dipropionate. Due to them, its effectiveness in the fight against infectious diseases and inflammation increases. To achieve the desired effect from using the drug, the boy’s parents should know how to apply Diprosalik to a child with phimosis. Manipulation involves following such advice.

1. The drug is used only after bathing, when the skin of the foreskin is well softened.
2. Diprosalik is used to treat only damaged areas of skin in the penis area.
3. When the ointment is applied, the prepuce is carefully pulled back, fingers are placed under the foreskin and pushed apart.
4. The procedure is performed for 10 minutes.
5. It is recommended to use the ointment 2 times a day.
6. The duration of therapy is determined individually at a consultation with a doctor. Most often, the course of treatment for phimosis in children using Diprosalic varies from 1 week to 1 month.

Celestoderm for phimosis in children

Ointments for the treatment of phimosis in children, made on the basis of hydrocortisone, provide a good therapeutic effect in a short time. Among such drugs is the drug Celestoderm. This ointment has pronounced antiallergic and anti-inflammatory properties, eliminates itching in the external genital area. Celestoderm constricts blood vessels well and therefore ensures the fastest possible treatment. The ointment is completely odorless and small patients do not complain of an unpleasant aroma when applying the composition. The presence of hydrocortisone in the composition determines the presence of excellent antimicrobial properties. Celestoderm softens the foreskin well, but manufacturers do not recommend using the drug if there are wounds and ulcers on the skin of the penis. Contact of the ointment with the damaged dermis can cause a burning sensation.

Cream for phimosis in boys

Special creams are often used to treat phimosis in boys of different ages. Andrologists recommend paying attention to the composition of Akriderm. Its main component, betamethasone dipropionate, quickly eliminates infection, promotes the healing of wounds, cuts and a speedy recovery of the child. According to the manufacturer's instructions, Akriderm should be used 3 times a day. The thick composition of the cream is applied to the inflamed area of ​​the genital organ and lightly rubbed into the skin. The course of treatment is 3 weeks.

Another good anti-phimosis cream for children is called Lokoid. Its action is aimed at stretching the foreskin, fighting infection and restoring the healthy state of the boy’s genital organ. The ointment is based on hydrocortisone 17-butyrate. It is its active action that helps eliminate infection, inflammation and itching. Akriderm is recommended to be used 1-3 times a day for 2 weeks. Usually this time is enough for the head of the penis to fully recover and the sexual organ itself to return to normal.

The effectiveness of ointments against childhood phimosis depends on the correctness of their selection and application. To eliminate the disease in a boy, his parents should select an ointment in accordance with the instructions presented below.

The application of ointment for phimosis is carried out carefully and taking into account the following notes.

1. It is necessary to wash the head of the penis along with the foreskin with chamomile decoction, furatsilin or a weak solution of potassium manganese before applying the ointment to the pathological area.
2. The wet skin of the penis should be dried with a towel, and then a little medicinal ointment should be applied to the head of the penis (if it opens even a little) and the inside of the foreskin.
3. It is forbidden to forcefully open the head of the genital organ in order to apply ointment over it. Due to such actions, the delicate epithelial tissue is injured and scars form on it.
4. Therapy of phimosis with corticosteroid ointments can be supplemented with baths of herbal decoctions, which will soften the skin of the foreskin well. Also, the inflamed skin fold over the head of the penis can be washed with barley decoction or an infusion of chamomile flowers and leaves.

Ointments against phimosis cannot be used if the boy has concomitant diseases (chicken pox, skin tuberculosis or herpes). Contraindications to the use of ointments are also diseases of the cardiovascular system, diabetes mellitus, and poor functioning of the kidneys or liver. Treatment of pathology in case of detection of concomitant diseases is carried out according to an individual scheme developed by the doctor. If there is no therapy for phimosis, the disease will progress, complications and adverse consequences will appear.

Consequences

A narrowed foreskin does not always cause discomfort to a small child, so parents do not bring him to a doctor for consultation. However, adults should remember that phimosis without medical supervision and treatment often leads to the development of associated health problems. For example, the skin above the head of the penis loses mobility and sensitivity, the penis takes on an unsightly appearance, and more serious diseases appear that pose a danger to the general and reproductive health of a man. This article will tell you why phimosis is dangerous in boys and what can happen if this pathology is not treated in a timely manner.

Consequences of phimosis in a child

Childhood phimosis is dangerous, primarily due to its complications. If therapy for this disease is not carried out, the child develops the following pathological conditions.

• Paraphimosis. The most dangerous complication of childhood phimosis is associated with pinching of the head of the penis. A dangerous situation is often associated with forced opening of the head of the penis. The narrow foreskin cannot return to its original position, strongly compresses the head and impairs blood circulation in it. The head of the penis acquires a bluish tint and becomes sharply painful. In this case, the boy is indicated for emergency surgical care. Delay is dangerous due to necrosis of the tissues of the head and its amputation.
• Inflammatory diseases, balanoposthitis, balanitis. Inflammation of the foreskin or head of the genital organ is one of the unfavorable consequences of phimosis, which develops with systematic non-compliance with the rules of intimate hygiene. The area under the foreskin is more often infected in boys with reduced immunity or children suffering from any infectious disease. Characteristic signs of inflammation of the foreskin or head of the penis in a child are swelling of this skin fold, redness of the organ, the appearance of purulent discharge from under the prepuce, and severe pain. If the inflammation is not treated in a timely manner, phimosis progresses, and scars form on the skin of the foreskin. Boys with balanitis or balanoposthitis definitely need emergency medical attention. The separation of scar growths on the inner part of the prepuce is carried out by a surgeon. He carefully inserts a probe into the space between the skin fold and the head of the penis and uses it to separate existing scars. The procedure allows you to create the necessary conditions for the outflow of accumulated pus.
• Acute urinary retention. This condition is often a reflex and is observed in young children. The child tries to avoid the pain that occurs with each urination, so he delays the process of urine flow. A boy who cannot empty his bladder for a long time develops anxiety and complains of pain over the groin area and in the tummy. When palpating the area above the pubis, a distended bladder is felt.
• Formation of smegmolites. Pebbles inside the foreskin sac (smegmoliths) are formed due to inflammation caused by stagnation of sperm. The seminal fluid does not completely come out due to the narrowed foreskin, it stagnates and becomes a favorable environment for pathogenic bacteria.
• Fusion of the foreskin and the head of the penis. The fold of skin above the head of the boy's penis moves with difficulty. Constantly being in one position, it fuses with the epithelial tissues of the head. If the genital organ is not touched, such adhesions do not create discomfort. But any attempts to expose the head and move the prepuce upward lead to sharp pain and bleeding from the penis.
• Oncological pathologies. Cancerous tumors in the penis are formed due to stagnation of smegma. Secretory fluid in large quantities becomes a fertile environment for the appearance of carcinogenic substances. It is carcinogens that give impetus to the formation of papillomas and malignant tumors.

So, with phimosis in children, the consequences can be dangerous. Therefore, an experienced urologist should treat this disease. All medical procedures and home therapy must be carried out under his strict supervision.

Does phimosis affect conceiving a child?

The boy's parents must understand that phimosis must be treated on time. The disease, which has reached its highest, category 4, is dangerous due to impaired reproductive functions in adulthood. Men who have had to deal with inflammation of the foreskin often ask their doctor the following question about phimosis: is it possible to have children with this disease? It also worries parents whose children have suffered pathology. Experts say that only the last stages of phimosis (3rd and 4th) pose a danger to full conception. Advanced phimosis provokes impaired ejaculation and leads to infertility.