Phimosis – causes, types, treatment and care. Treatment for phimosis

Proven content

Phimosis is a narrowing of the foreskin opening, which in turn prevents the exposure of the penis’ glans. It is called an anatomical defect that occurs in boys and men. Disregarded phimosis can cause difficulties in sexual life.

Phimosis – what is it?

Phimosis is a minor anatomical defect that occurs in boys / men. More precisely, it is a narrowing of the foreskin, which makes it impossible to slide it off the glans of the penis. It used to be thought that phimosis was a genetic defect, which turned out to be untrue. This problem affects boys who were poorly cared for in their infancy.

Any doubts related to the care of a newborn baby should be consulted with a pediatrician as soon as possible. You can have a consultation in the form of a faster and convenient home consultation, offered by HomeDoctor.

Phimosis – incidence

Over the years, many medical reports of the occurrence of phimosis have been published. These vary considerably due to the difficulty of distinguishing physiological phimosis (lack of developmental capacity) from pathological phimosis, differences in definition, fixation problems, and numerous additional effects on neonatal circumcision rates in cultures where most male infants are circumcised. A frequently cited statistic for the incidence of pathological phimosis is 1% of uncircumcised men.

When phimosis is simply equated with a lack of retraction of the foreskin after the age of 3, significantly higher incidence rates have been reported. Others have reported up to 50% in adolescents and adults, although many cases of physiological phimosis are likely included.

See also: Male Circumcision – What Is It and How Does It Work? [WE EXPLAIN]

Phimosis – causes

In young children, we are dealing with a long weed foreskin, which is usually removable, but requires compliance with the rules of hygiene, consisting in retracting the foreskin, washing the glans penis and removing the mast from the gastric groove. The condition can also occur if the foreskin is forcibly retracted before it is ready. This can damage the skin and cause scarring, making it difficult to retract the foreskin later.

If the rules of hygiene are not followed, the foreskin becomes inflamed easily, which in turn leads to the shrinkage of the foreskin opening. Under the foreskin, the mastic produced in the gastric groove collects and may also retain urine. One of the infections that can lead to inflammation of the head of the head is lichen sclerosus. This is a skin condition that can be triggered by an abnormal immune response or hormonal imbalance. Symptoms may include white spots or spots on the foreskin. The skin can itch and break easily.

In adult men, phimosis is most often associated with non-compliance with the rules of personal hygiene, which leads to chronic inflammation of the foreskin, which, while healing by scarring, causes problems with the foreskin. This condition significantly hinders sexual intercourse as well as sperm ejaculation, and – if surgical treatment is not undertaken for a long time – can lead to neoplastic changes in the penis.

Phimosis – diagnosis

How do we recognize phimosis? A child has phimosis when the foreskin cannot be removed from the head of the penis (in a three-year-old child). Until the age of three, this adhesion of the foreskin is normal because the foreskin is glued to the glans, the so-called mastka, which is in the form of an oily discharge containing bacterial flora and epithelial cells. When the child is 2 years old, the foreskin should slowly come off (the mastic rinses out). Of course, the foreskin should not be pulled back as it causes pain.

An indication for consultation with a doctor is when the foreskin cannot be removed in a XNUMX-year-old child. In adult males or boys, phimosis can be diagnosed when the foreskin only partially slides off the glans. Same as for children – DO NOT force the foreskin down as this may result in entrapment of the foreskin in the gastric groove and leading to penile necrosis.

Are you looking for a facility where you can undergo surgery to treat phimosis? Check which clinics in your area do it.

How does phimosis develop?

People with phimosis may have difficulty urinating. If the condition persists in adolescence and even into adulthood, pain can also occur with erection and intercourse. In addition, adolescents and adults with phimosis will find it difficult to wash the head of the penis and the area under the foreskin. This makes it easier for bacteria or fungi to settle here, causing the inflammation.

Trying to push your tight foreskin away can cause pain or minor injuries. In rare cases, it can also lead to the so-called paraplegic (Latin. paraphimosis). In this state, people can no longer pull the foreskin forward over the head of the penis, restricting the blood supply. In exceptional circumstances, the head of the penis may die (necrosis). This is an emergency and requires immediate medical attention.

Also check: Pain during intercourse

Phimosis and paraphimosis

A condition called an parapostrum can occur when the foreskin is retracted but cannot be moved back to its normal position. This may require emergency medical attention. One of the complications of the parapostrum is decreased blood flow to the end of the penis.

Treatment options for the paraphimosis are similar to those for phimosis. Lubricating the glans and foreskin can help push the foreskin back into place. Be sure to discuss this with your doctor before trying this home treatment. Your doctor will recommend safe brands and types of ointments or lotions. If the paraple persists for several hours, or if you notice any changes in color, or if you feel pain, see your doctor immediately.

Circumcision or partial circumcision can eliminate the fears of retracting the foreskin. Be sure to discuss the risks and benefits of this procedure with your doctor. Being uncircumcised puts a man at greater risk of contracting HIV and other infections.

Phimosis – types

There are two types of phimosis in the basic classification.

Physiological (congenital) phimosis

This type of phimosis is congenital. Congenital phimosis means that a male infant is born with a tight foreskin. This is because of adhesions between the inner layer of the foreskin and the glans penis, making it difficult to retract the foreskin completely. Physiological phimosis is very common in boys. About 96 percent of boys have this condition, according to experts.

Over time, these adhesions weaken and the foreskin begins to relax. When this happens, a gradual withdrawal is possible, and in most cases the problem appears at the age of 5-7. According to research, only in 2% of cases phimosis does not go away on its own. This indicates that only a small fraction of adolescents and adult boys suffer from physiological phimosis.

Pathological (acquired) phimosis

Pathological phimosis is a type of phimosis that develops as a result of trauma, infection, inflammation, scarring, and other underlying medical conditions. It can also occur from skin diseases such as eczema, psoriasis, lichen planus, etc. These conditions make the skin of the penis uneven, itchy and irritated. Pathological phimosis can appear at any age. It develops mainly due to poor hygiene around the penis. If we are unable to properly maintain hygiene, pathogens, dirt, sweat and dead tissue can accumulate under the foreskin. They can lead to infection and thus cause pathological phimosis.

Unlike physiological phimosis, pathological phimosis does not go away on its own and requires appropriate and timely treatment. So if we were able to withdraw the foreskin earlier and the problem of the impossibility of withdrawal appeared only now, we may suffer from pathological phimosis.

In the case of phimosis, we can also talk about its degree of advancement. This classification includes full and incomplete phimosis. Full phimosis is when the mouth of the foreskin is narrowed enough to prevent the glans from being exposed.

When it comes to partial phimosis, we are talking about it when the retraction of the foreskin with the retraction of the glans is possible in some cases:

1. when it is possible to partially expose the glans.
2. when the retraction of the foreskin is possible in a situation where the penis is in a resting state, but it is not possible during an erection.
3. when the retraction of the foreskin into the compulsive groove is possible also when erect, however, the opening of the foreskin clamps in the compulsive groove, causing great discomfort and often also pain.

Interestingly, in women, a similar condition is known as “female phimosis,” in which the clitoral foreskin cannot be retracted, limiting the exposure of the clitoral glans.

See also: Intimate and fungal and bacterial infections. How to deal with recurring intimate infections? [WE EXPLAIN]

Phimosis – treatment

A physical examination and review of a child’s symptoms are usually sufficient to diagnose phimosis or an underlying disease such as glans inflammation. Treatment of balanitis or any other type of infection usually starts with a foreskin swab taken in a laboratory. A bacterial infection will require antibiotics, and a fungal infection may require antifungal ointments.

Treatment of phimosis in children comes down to treating inflammation and observing hygiene. Inflammation can be lubricated with creams containing calcineurin inhibitors, they cause the foreskin to peel off and fulfill its function. In children, in some cases an operation is necessary, which is performed under general anesthesia. The opening of the foreskin is widened so that it can be freely slid off the glans. In more serious cases, circumcision or similar surgery may be necessary. While circumcision is usually performed during infancy, surgery can be performed on men of any age. Circumcision may also be necessary if your child suffers from recurrent inflammation of the glans, urinary tract infections, or other infections.

In adult men, CO2 laser treatments are used to treat phimosis. All necessary referrals for examinations and treatments will be issued by a urologist. You can make an appointment via the halodoctor.pl portal.

Phimosis – treatment

Surgical treatment of phimosis is necessary in older children and adults, usually by removing the narrowed part of the foreskin and creating a wide, well drainable foreskin so that the glans of the penis is exposed. Sometimes the widening of the foreskin is ineffective or the scars cause it to narrow again, in such a situation another procedure is recommended. The dressing put on by the doctor should be changed after about a day.

After the procedure, for the first weeks you should wear the dressing and the penis in an upward position (you can stick it with a plaster to the abdomen), this form of dressing makes the penis heal better and the swelling goes down faster. During convalescence, pain-relieving ointments, such as alanthan and antibiotics should be used. The glans can be quite oversensitive as it has never been touched, so handle the penis very gently for the first 10 days after the procedure. After removing the stitches, the rehabilitation of the penis is most often suggested, when the operation consisted of widening the mouth of the foreskin.

See also: Treatment of phimosis. How much does phimosis surgery cost?

Stretching phimosis

Before trying to stretch your foreskin, keep the following points in mind.

1. Be gentle. Don’t pull back the foreskin too hard and stop pulling when it starts to hurt.
2. Use a topical steroid cream to help massage and soften the foreskin to make it easier to hide. A prescription ointment or cream with 0,05% Clobetasol Propionate is usually recommended for this.
3. Don’t wait too long for medical attention. If the cream doesn’t help within four to eight weeks, see your doctor for treatment. Seek immediate medical attention if you have painful swelling or difficulty urinating.

Here’s how to safely stretch the foreskin back into place:

1. Apply a thin layer of steroid cream to the entire foreskin. It should cover the entire area from the tip of the penis to where the foreskin meets the skin below the shaft of the penis.
2. Then you need to gently massage the cream into the foreskin, slowly rubbing it into the foreskin tissue until the cream is completely absorbed into the skin.
3. Finally, carefully try to pull back the foreskin, stopping when you feel any discomfort or pain. You should also try applying cream to the tip of the penis when it is sufficiently exposed.

These steps are recommended to be repeated two to four times a day until we can completely retract the foreskin without pain or discomfort. This can take four to eight weeks, so don’t worry if your foreskin doesn’t twitch after a few days.

You can also massage the foreskin with a hot bath or shower. The high temperature of the water helps to loosen the skin and makes it easier to stretch. It is worth combining stretching in the bath with the steroid cream method to completely hide the foreskin faster.

The same steps apply to retracting the foreskin when the penis is erect. However, then you have to be a little more delicate and careful, because the foreskin can be tighter and therefore offer more resistance.

See also: A hot bath burns calories like a workout

How to pull back the foreskin without pain?

If you experience painful erections with phimosis, see a doctor as soon as possible. Painful erections, especially with symptoms such as swelling and discharge, can be signs of an infection or a sexually transmitted disease (STD).

Keep the following in mind when trying to pull back your foreskin:

1. Do not pull too hard or too fast as this can damage the foreskin or cause injury.
2. Do not pull if you begin to feel pain, even if you do it gently.
3. Stop pulling if your foreskin begins to break or bleed as this could leave you vulnerable to infections and further complications.

Don’t have sex if phimosis is causing pain or you can’t pull back your foreskin enough to expose the head of your penis.

Phimosis – complications

Paraphimosis is the most severe complication. In this condition, the glans is swollen and painful, and the foreskin is held in place by the swelling in a partially retracted position.

Some studies have also found that phimosis is a risk factor for urinary retention and penile cancer.

How can phimosis be prevented?

Physiological phimosis cannot be prevented. This condition is present in almost all newborns.

However, it is important to keep your penis clean. Parents or guardians should receive guidance on the best way to clean their child’s penis. They should also be told not to worry so much about the fact that the foreskin does not move for the first few years of life. When children are old enough to take care of themselves, they should be taught proper intimate hygiene.

How to take care of yourself if you have phimosis?

With or without phimosis, you should take care of the hygiene of intimate parts. This starts early with keeping your genitals clean. Men with an uncircumcised penis are advised to retract the foreskin and wash it under warm water. Using mild or non-perfumed soap will reduce the risk of irritation, as will avoiding using talcum powder or deodorant on the area. You should also make sure your hands are clean before you touch your penis, and the underwear you put on is clean as well.

Most uncircumcised boys have a foreskin that does not move away as it is still attached to the penis. It will start to detach naturally between ages 2 and 6, although it may take longer. Parents should not try to move the foreskin back before it is ready as this can be painful and damage the foreskin.

If a man is sexually active, he should wear a condom during sex and use plenty of lubricant. Rubbing against a penis with and without a condom can tear the foreskin.