Phimosis - This is an inborn or acquired constriction of the foreskin, that is, the petal covering the glans penis. Phimosis is the most common malformation of the male genital organ. The head of the penis sometimes opens with great difficulty, in a neglected form - it may not be exposed at all.
Phimosis - causes
In newborn boys, phimosis is a physiological phenomenon, passing, as a rule, by 3-4 years.
In men, the disease persists from childhood or develops during puberty. In most cases, phimosis has hereditary roots - pathology can go from father to son.
The development of the disease during puberty is due to the fact that in the stage of excitation the head of the penis increases several times, the skin of the foreskin, while having low elasticity, cannot stretch to the desired parameters, therefore, there is a constant microtrauma of its skin. When healing, the cracks form a dense scar that cannot stretch, since the scar tissue is not elastic. The more microcracks, the more scars. Accordingly, the skin tightens, coarsens, and the foreskin narrows.
Penis injuries can cause scar tissue. Syphilis, diabetes, genital herpes and balanoposthitis (inflammation of the foreskin lobe) can also contribute to the appearance of phimosis in men.
Phimosis - symptoms
In medicine, 4 degrees of pathology are distinguished:
1 degree - the head of the penis is exposed easily in a calm state, with an erection there are minor difficulties.
2 degree - the head is barely bare in a calm state, during an erection - practically does not open.
Grade 3 - the head is not exposed at all, even in a calm state, the urinary passage remains open, there are no problems with urination.
Grade 4 - the process of urination is difficult; first, the prepuce bag swells, then urine flows out in a thin stream; the head is completely closed.
Patients with phimosis complain of pain when trying to expose the head of the penis, especially in a state of erection. Phimosis partially or completely eliminates the implementation of hygiene measures in the area of the head of the penis, this inevitably leads to stagnation in the prepuce cavity. The accumulation of smegma (fat-like secretion) in it creates a favorable breeding ground for the growth of pathogenic bacteria. Swelling and inflammation develop.
At 3 and 4 degrees of the disease, due to the fact that the head of the penis practically does not open, its full or partial fusion with the petal of the foreskin can occur. Any attempts to separate them are accompanied by not heavy bleeding and sharp pain. This condition requires immediate treatment.
When trying to expose the head, for example, during masturbation or at the time of sexual intercourse, a formidable complication may develop - paraphimosis (pinching of the head with the foreskin ring). Swelling of the tissues develops, the head turns blue. You need to try to straighten the foreskin, if you can’t do this, immediately call an ambulance, and in the place of the edema, apply cold.
Phimosis - diagnosis
Usually not a problem. Inspection and diagnosis are usually carried out by a urologist or surgeon.
Phimosis - treatment and prevention
There are three main methods for eliminating the pathology: corticosteroid therapy, foreskin stretching, and surgical treatment (by far the most effective and effective).
The essence of corticosteroid therapy is the continuous and continuous application of special ointments on the skin of the penis. It is believed that steroid ointments make the skin more elastic, relieve swelling and accelerate the healing process of microtraumas. It may take a long time before a shift in the positive direction occurs.
The method of stretching the foreskin - based on the systematic and gradual expansion of the skin with your fingers or special tools. The procedure must be carried out for 30-60 minutes a day for several months. Perhaps a complex combination with corticosteroid therapy. Not every man has the patience for such a long manipulation. In addition, the above methods are effective in the first two stages of phimosis. With 3 and 4, surgical intervention is indispensable.
Circumcision (circumcision) is the fastest way to eliminate phimosis. The essence of the operation is the partial or complete removal of the foreskin, as a result of which the problem is completely eliminated. However, if severe inflammation has developed, circumcision cannot be performed.
In urgent cases, with severe edema or paraphimosis, a longitudinal dissection of the constricting ring of the foreskin is done to prevent necrosis of the genital organ.
With severe inflammation, the doctor can prescribe antibacterial therapy in the form of ointments and tablets, and only after treatment, circumcision is used.
Prevention of phimosis: actually not developed, since the disease is due to genetic factors. The only thing necessary is to monitor the condition of the penis of newborn boys: treat the head and foreskin, periodically clean to prevent inflammation. If by 6 years old the boy’s phimosis does not go away, you need to contact a surgeon or urologist to prescribe the appropriate treatment.
