Phimosis in a child – symptoms and treatment. Treatments for phimosis in a child

Phimosis is a condition that prevents the foreskin from being properly removed from the head of the penis. The condition is completely normal and physiological in most boys whose penis does not have any abnormalities. Over 90% of cases resolve by age seven, although foreskin adhesions still prevent full retraction in more than half of this age. Phimosis usually disappears on its own by age 18. Phimosis can occur naturally or be the result of scarring. Your child may not need treatment for phimosis unless it makes it difficult to urinate or is causing other symptoms. If the child grows up, phimosis will require medical intervention.

What is phimosis?

The penis is covered with a tissue called the foreskin. Normally, the foreskin is loose and slides over the penis, covering and exposing the head of the penis (glans). It can also cover and reveal the opening of the penis. However, if the foreskin is too tight, it cannot move. When this happens, the foreskin can close on the glans, causing a condition called phimosis. As a result, a tight ring of scar tissue forms above the glans penis, preventing the foreskin from retracting from the glans.

Phimosis in a child – causes

Phimosis is when the foreskin cannot be withdrawn from the tip of the penis. In late puberty, the foreskin can usually be completely retracted from the glans and the glans can then return to its place. Phimosis occurs normally in some boys, then we talk about the so-called physiological phimosis. At the beginning of a child’s life, the foreskin is partially attached to the top of the penis. Over time, the foreskin will break free, exposing the glans of the penis. This usually happens between the ages of two and six. During puberty, the vast majority of boys have a fully retractable foreskin.

However, it sometimes happens that phimosis occurs when the foreskin has already been pulled back. This happens when the tissue becomes scarred and fibrous, preventing the foreskin from retracting properly. This can happen as a result of injuries, infections, inflammations, scars and other conditions (skin diseases such as eczema, psoriasis, lichen planus, etc.). This condition is known as pathological phimosis. Also in this case, the foreskin must not be withdrawn by force, as this will damage it. You may need surgery in these cases.

Also read: Penis – structure, size, erectile dysfunction. The most common diseases of the penis [WE EXPLAIN]

Phimosis in a child – occurrence

Phimosis in a child is normal at a young age, however, the foreskin should begin to relax on its own in early childhood. It is estimated that about 10% of boys will still have a tight foreskin by the age of 7, and only 1% will still have a problem with phimosis by the age of 17. If there are no signs of loosening of the foreskin, at the age of 5 or 6, it is recommended to consult a doctor.

Phimosis in a child – symptoms

In most cases, the baby is unable to retract the foreskin, and because of this, a swelling forms at the tip of the foreskin when the glans is retracted. Other symptoms of phimosis in a child are discomfort and pain. Occasionally, a child may retract part of the foreskin, but not all of it. Discoloration may also appear on the glans when the glans is hidden under the foreskin.

The most characteristic symptom of phimosis in a child is the bulging of the foreskin, which occurs when urinating. This is because urine builds up inside the foreskin as it comes out of the penis. However, it is worth realizing that such situations can also occur when the foreskin is not problematic, when the boy is still young and his foreskin has not fully retracted. With heavy phillips, not only can you have problems urinating, but the chance of problems such as inflammation of the glans, which happens when your foreskin becomes inflamed due to irritation or infection, increases.

Usually, phimosis in a child is not a cause for concern as it may resolve on its own. However, you need to respond if phimosis causes pain and other symptoms. If this happens, you should of course not try to withdraw the foreskin yourself, so as not to damage it. You should be aware that the foreskin usually cannot be retracted at a young age. It becomes a little looser in early childhood (ages two to three, sometimes later). If the foreskin is damaged, there may be a problem with retraction in the future, and this may require phimosis surgery to correct the problem.

If we are afraid that our child’s foreskin does not hide for too long, it is worth going to the doctor with the toddler for further consultations. Older boys may also feel uncomfortable or concerned about phimosis, so it’s important to talk to them about their condition and allow them to speak to their doctor if they so wish.

See also: Changes in urination can mean you have health problems

Phimosis in a child – diagnosis

If you have phimosis in children, your doctor will ask about your child’s symptoms and health history. Your baby will also undergo a physical examination including an examination of the penis and foreskin. The test will help rule out cirrhosis of the glans and foreskin, a disease that can prevent the foreskin from receding. The doctor will also check for scars or damage to the foreskin that may be responsible for the symptoms of phimosis.

Additional tests for phimosis may include:

1. urine tests to check for urinary tract infections.
2. taking a swab to check the foreskin for bacteria.
3. blood and / or urine tests to measure blood sugar in the body. Phimosis is a risk factor for type 2 diabetes.

Also read: Penis diseases – priapism, phimosis, inflammation of the glans

Phimosis in a child – treatment

In most cases of phimosis in children, no treatment will be needed. If there are no signs of damage to the foreskin, and it has never been able to regress, it is advisable to wait and see if this is natural, as long as the baby is still small enough and experiencing no symptoms of phimosis.

For older children, you may need to undergo phimosis or other surgery if it is unlikely that the foreskin will retract itself. Phimosis surgery is also recommended when the child feels pain or has problems, for example, urinating.

For the treatment of phimosis in children, if there is no significant scarring or any evidence of cirrhosis of the glans and foreskin, hydrocortisone is administered. Treatment consists of applying a steroid cream to the foreskin to encourage it to relax. It is estimated that as much as 85% of mild to moderate phimosis responders well to this treatment. However, the use of creams may be temporary. Occasionally, phimosis may reappear several months after treatment ends.

Surgery will be required for some children. This procedure is only used when the phimosis is unlikely to correct itself, the symptoms are severe or associated with scarring or damage.

Phimosis in a child – surgery

Basically, in the case of phimosis surgery, there are two different procedures. The first is to make a small incision to release the fibrous scar, and the second is to circumcise. The latter option is often recommended as the incision may look unsightly and may eventually require circumcision later in life to improve the appearance.

Circumcision is a procedure performed under general anesthesia to remove the foreskin by surgery while the patient is asleep and unaware of what is happening. During circumcision, an incision is made and the foreskin is sutured after the foreskin is removed and will heal for the next week or two. Proper care after surgery is essential in circumcision. The idea is to keep the surgical wound clean and dry while it is healing to reduce the risk of infection. The child may also need painkillers to relieve any discomfort.

The risk of serious complications is low in children with phimosis, although there is still a risk of problems such as infection, bleeding, or an allergic reaction to the anesthetic used during the procedure.

Once the foreskin is removed, nothing will be covering the glans. Circumcision not only solves the problem of non-sliding of the foreskin, but also all other problems with phimosis such as urination problems. As circumcision removes the foreskin, it should be understood that this changes the appearance of the penis and affects its sensitivity. It is helpful to discuss the risks and benefits of circumcision in treating phimosis with your doctor before surgery. The parent should also remember to talk to the child calmly (in a way appropriate to his age) to ensure that the boy has understood everything and is aware of what is going to happen.

Also check: Treatment of phimosis. How much does phimosis surgery cost?

Phimosis in a child – complications

Complications resulting from not treating phimosis in children, apart from pain, also include problems with urinating. Phimosis can also increase your risk of developing a glans infection or inflammation.

The psychological aspect cannot be forgotten either. This is because boys may feel uncomfortable with this condition as they age, which can affect their confidence or cause problems such as anxiety. Even if there are no physical symptoms of phimosis, it may still be important to consider the psychological effects of the condition on your baby.

Phimosis in a child – prevention

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

However, this does not change the fact that you should take care of proper penis hygiene. Parents or guardians should receive guidance on the best way to clean their child’s penis from their doctor.

In the first years of life, the gentle retraction of the foreskin and regular cleaning, such as bathing or changing diapers, significantly affect the condition of the foreskin, making it easier to clean, and it relaxes over time. For this reason, parents must educate their children to always wash and dry their penis regularly. While bathing, you should wash your penis with water every day. This should also be done with babies who have been circumcised. Take care to use soap that does not contain any irritants, and avoid using agents such as perfume on the penis.

It is also very important for parents to be aware that the foreskin does not move for the first few years of a child’s life. When children are old enough to take care of themselves, they should be taught proper penis hygiene.

Also read: How should the penis be washed? Lack of hygiene can lead to serious diseases

What is the difference between phimosis and paraphimosis?

Like phimosis, the paraphimosis also affects the foreskin, but it is always an emergency, while phimosis is not. Shampoo occurs in men who are partially or completely uncircumcised. In the case of the parapostrum, the foreskin remains in place behind the glans after retraction and cannot be slid back over it. This can happen, for example, when performing an exercise stretching phimosis, when the foreskin is pulled back, but it cannot be pulled over the glans again. In such cases, treatment is necessary so that the tip of the penis is not damaged and gangrene does not develop.