Phimosis is a pathological phenomenon that is characterized by a narrowed external opening of the foreskin of the penis. According to statistics, this anomaly is observed in every fourth male, and is diagnosed most often before the age of seven. Sometimes it occurs without any symptoms, but most often it is accompanied by a number of potentially dangerous complications, for example, paraphimosis. Paraphimosis may appear after masturbation or sexual intercourse.
It should be noted that the pathological situation of the occurrence of an anomaly may occur due to diseases such as: balanoposthitis, syphilis, cardiovascular pathology, diabetes mellitus, obesity. Narrowing of the foreskin ring can be facilitated by: cystoscopy, penis piercing, promiscuity, lack of sufficient personal hygiene, narrowing of the tissues and veins of the penis, trauma to the penis with further scarring, a consequence after surgery for circumcision of the foreskin, congenital anomalies.
With a complication, there is an infringement of the head of the genital organ by the ring of the foreskin in the region of the furrow of the head. The danger is that a strong swelling of the foreskin and head develops, which is accompanied by severe pain. If paraphimosis is not treated, it is possible to provoke the development of necrosis of the foreskin and gangrene of the head.
Clinical paraphimosis is very painful, there is swelling of the penis, starting from the head, and its turning blue. In the absence of timely medical action, pain is suppressed, and the head becomes dark purple or even black.
Preparing for the procedure
Indications include the presence of infringement of the glans penis, pain syndrome and complicated urination. There are no contraindications to this procedure, since inaction can provoke serious and dangerous complications. There are no special preparations. Reduction is performed as quickly as possible after the diagnosis is established. If there are complaints, you should contact a urologist or surgeon. Actions are carried out on the basis of an external examination.
Procedure Algorithm
In the case when there is no swelling or it is insignificant, all actions can be performed without anesthesia. The head is poured with cold clean water to eliminate minimal swelling.
If the swelling is severe, then all actions are performed after local anesthesia (local anesthetic is injected using a syringe with a thin needle directly into the base of the penis).
To reduce the appearance of puffiness, the doctor may first perform the following procedures:
- applying an elastic bandage to the penis;
- surrounding the penis with ice packs;
- the use of special decongestants, such as hypertonic saline.
The head is carefully treated with an antiseptic, then lubricated with petroleum jelly. The doctor covers the penis in the center with one hand, the second hand performs manipulations to push the head through the pinching ring. Moderate pressure on the head provokes a decrease in edema, and the head becomes easier to place.
If it is not possible to set the head, they resort to surgical intervention – a dissection of the foreskin is performed on the back of the penis, as a result of which the compression decreases, and the head returns under the foreskin with simple movements of the doctor.
After the procedure with surgical intervention, the doctor necessarily puts several stitches on the dissected place, which will be removed after 7-10 days.
If signs of necrosis have already appeared, another surgical intervention is performed, most often it is a complete or partial amputation.
After the operation, it is important to perform the following manipulations: treatment with antiseptics, taking antibiotics, taking multivitamins, proper and regular personal hygiene, and refraining from intimacy.
The genital organ is tied to the stomach for 10-15 days in order to ensure the outflow of fluid, due to which swelling has formed. Underwear is selected comfortable and compression.
After removing all the stitches, it is recommended to visit the doctor regularly to observe the healing process and notice the development of side effects in a timely manner (they are extremely rare).
Prevention of paraphimosis
It is much easier to prevent the manifestation of such serious consequences than to eliminate and treat them in the future. In childhood, the prevention of paraphimosis consists in regular examination of the genital organ by parents, a urologist or a pediatrician. A preventive examination by a urologist allows you to determine the presence of phimosis, which is a precursor to paraphimosis. It is important to cure phimosis in a timely manner, this may require surgical intervention – circumcision. It is important to understand that phimosis in childhood rarely causes such a disease as paraphimosis, unless, of course, the parents or the doctor try to forcefully expose the head of the child’s genitals.
Phimosis in adults can be cured without surgery if you gently and daily try to stretch the foreskin yourself with your hands or devices (specially designed for this). Manipulation will increase the size of the foreskin ring, as a result, avoiding the possibility of infringement of the head in the future.
You can also use special ointments that will help improve the elasticity of the foreskin and soften it.
Do not forget about the regular hygiene of the glans penis through the use of a hygienic shower. Proper hygiene will not allow the development of infectious processes that can provoke a narrowing of the foreskin of the penis.
In any case, it is recommended, regardless of age, to regularly visit a urologist, since the timely determination of the pathology will allow it to be eliminated without serious consequences.