Phimosis ( narrowing of the foreskin ) - Causes, Symptoms and Treatment .MF .
phimosis - narrowing of the opening of the foreskin (skin at the tip of the penis), does not fully expose the glans penis.
Causes of phimosis
In virtually all healthy boys until three years have seen physiological phimosis, which is not a pathology.The cause of this condition is the so-called inner bonding surface epithelial foreskin of the penis head.At about 3-6 years in normal narrow opening preputial baby bag expands and creates an opportunity to fully open the head of the penis, that is, the physiological phimosis disappears.
pathological phimosis is caused by anatomical narrowing of the foreskin, which is divided into innate and the obtaining.
Foreskin phimosis congenital acquiring a sort of "proboscis".If, before the onset of spontaneous opening of preputial cavity child suffers balanoposthitis (eg, due to the accumulation of smegma in it), the inflammation leads to scarring of the tissues of the foreskin, they become less extensible and appears pathological phim
Congenital phimosis in the child
Acquired phimosis occurs as a consequence of the penis diseases, and may be temporary (edema, infiltration of the head of the penis or foreskin during inflammation or injury) or permanent (in the development of scarring, for example,in chronic balanoposthitis).
symptoms of phimosis
Depending on the size of the restriction opening in the foreskin is isolated degree of phimosis:
At first, the easiest level in the quiescent state of the penis head exposed easily, but during erection, this requires a little effort.
At 2 degrees glans penis in repose opens with difficulty or without effort, and with the erection does not open fully.When
3 degree of phimosis head does not open fully or open only in the quiet state of the penis and a considerable effort, there is no problem with urination.
Phimosis 4 degrees leads to difficulty urinating, it is impossible to expose the glans penis, the hole in the foreskin point.When urination preputial sac swells, urine excreted trickle or dropwise.Possible acute urinary retention, or formation of preputial stones (smegmolitov).
pathological phimosis 4 degrees
usually phimosis drew the patient's attention when it causes problems with urination or complicated by inflammation (balanitis, balanoposthitis), tumor formation.When phimosis penile hygiene difficult, smegma accumulates preputial cavity, and because it is a good breeding ground for microorganisms, hence the inflammation.This is common in preschool children when preputial sac has not yet opened, and smegma has already begun to form, there is its stagnation, the penis looks swollen that alarming parents.
Besides phimosis can cause pain during erection due to the inability to uncover the glans penis.
complications of phimosis With phimosis
difficult holding hygiene measures, there is a stagnation of smegma, on this basis can develop inflammation (balanoposthitis), the accumulation of a large number of smegma provokes the formation of preputial stones (smegmolitov).Inflammation in difficult to treat phimosis, thus there is scarring of the foreskin and phimosis exacerbated moves to the next level.
Zatrudeniya urination can lead to disruption of emptying of the bladder and upper urinary tract with a reduction in their tone, the appearance of residual urine, which favors the development of urine-genital infections.
Children phimosis in conjunction with balanoposthitis may be the cause of enuresis (bedwetting), as well as cause spontaneous erections, and that causes trauma to the child.
When 3, 4 degree of phimosis may occur partial or total increment of the foreskin to the glans penis mucosa.At the same time attempts to open the head cause pain and bleeding.In this case, resort to surgery.
a long-term phimosis can be complicated by tumors of the penis due to the constant exposure to carcinogenic smegma.
Samostoyatelnye attempts to open the head with phimosis can cause paraphimosis - infringement of the glans penis foreskin, and delayed medical care - to necrosis of the glans penis.The head can not close the foreskin, it swells, it turns blue.First aid in this case - to call the doctor, make cold, 5 minutes to try to straighten the head.On failure, you need to cut infringes ring.
The diagnosis usually is not difficult and is performed after the external examination of the penis.To determine the cause of inflammation (if any) taken swab for analysis.
Treatment of phimosis
If for 3-4 years boy saved physiological phimosis, usually resort to manual separation of the foreskin and the glans penis.Since childhood foreskin is very elastic, which allows it to expose the pulling head in the proximal direction, while the line head spayaniya noticeable with the inner surface of the foreskin.At impossibility of manual separation resorted to using a metal probe bellied which circular motion gradually separated the head from the foreskin.After the head is treated with liquid paraffin treatments, and preputial sac is closed for preventing paraphimosis.After medical intervention, parents should at least 1 time in 2-3 days to disclose the preputial cavity of the child by the doctor and to wash her little pink solution of potassium permanganate or soap and water to remove smegma.
If phimosis is weak, does not cause anxiety, enables hygienic procedures - removal of preputial smegma cavity (and to do so it is necessary, regardless of the presence or absence of phimosis, phimosis and in - particular care), treatment is needed.
In all other cases where the exposure of the head by a bloodless for hygiene preputial cavity is not possible, there is only surgery - circular circumcision (excision of a circular or tsirkumizatsiya).
When combined with acute balanoposthitis phimosis and no possibility preputial wash bag, you must longitudinal incision of the foreskin for the treatment of inflammation.After elimination of balanoposthitis is performed circumcision.
Prevention of phimosis
no specific prevention of phimosis.Secondary prevention is careful hygiene of the penis and timely visit to the doctor at the first signs of pathological phimosis, inflammation or injury.
doctor-therapeutic Naumenko ON