Narrowing the foreskin

In phimosis, the foreskin narrows, making the penis head not completely exposed.

Causes of phimosis

Almost all healthy boys under the age of 3 have physiological phimosis, but at this age this pathology is not considered. The cause of this condition is the epithelial coalescence of the inner surface of the penis with its head. Physiological phimosis usually disappears by 3-6 years, as the narrow opening of the preputial sac of the boy is stretched, so that the head of the male reproductive organ opens completely. Pathological phimosis has the character of anatomical narrowing of the prepuce, in medicine it is divided into acquired and congenital constriction.

With congenital phimosis, the foreskin becomes like a proboscis. If a child suffers a balanoposthitis before the spontaneous opening of the preputial cavity occurs, then because of inflammation the tissues of the foreskin will scar, becoming less extensible, this leads to the development of pathological phimosis. Acquired phimosis is both temporary and permanent, occurs as a result of diseases of the penis.

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Symptoms of phimosis

This pathology is divided into several degrees, depending on the size of the narrowing of the hole in the foreskin:

  • First degree. The easiest degree of pathology - the head of the genital organ in a calm state is freely exposed, but with an erection, in order to expose the head, some effort will be required.
  • Second degree. The head of the penis at this degree in a calm state is bare without effort or with difficulty, but with an erection does not fully open.
  • Third degree. The head of the reproductive male organ in a calm state is bare with significant efforts, and if they are not applied, the head will not be bare completely, with an erection not exposed. The child does not experience problems with urination.
  • Fourth degree. The penis head is not bare at all, with urination the child experiences difficulties, the foreskin has a pinhole. During urination, the preputial sachet swells, the urine outside comes out dropwise or in a thin trickle. Prepecial stones( smegmolites) can form, acute urinary retention develops. At a phimosis during an erection there can be painful sensations, it is caused by that the head of a penis can not be exposed.

Treatment of phimosis

The foreskin from the head of the penis is divided manually, if the boy has 4 years old physiological phimosis persists. Elasticity of the prepuce in boys makes it possible to expose the head, for this purpose the foreskin is pulled in the proximal direction, after these actions it will be possible to see the line of the head adhesion with the inner side of the foreskin. If the manual separation method is not possible for any reason, the separation is done using a button probe that is made of metal. With this method, the head from the foreskin is separated by circular motions gradually. After the procedure, the head is treated with vaseline oil, and to avoid paraphimosis, the prepuce bag is closed.

After such intervention, parents should disclose the preputial cavity of the boy at least once in 2 days. It is very important to follow all the doctor's instructions, including rinsing the cavity with soapy water or a slightly pink solution of potassium permanganate. This is done in order to remove the smegma.

Slightly expressed phimosis, which does not cause anxiety, makes it possible to carry out hygienic procedures - removing from the preputial cavity of smegma without treatment. It is necessary to remove the smegma, it is not important to eat phimosis or it is absent.

In other cases, when the opening of the head for the hygiene of the preputial cavity by a bloodless way, it is not possible to resort to surgical intervention - circumcision or circular excision.

If acute balanoposthitis occurs along with phimosis and the preputial bag is not flushed, then for the treatment of inflammation a longitudinal dissection of the prepuce is performed. In this case, circumcision is carried out after the elimination of balanoposthitis.