Phimosis in boys: photo, treatment
- Little anatomy
- What is phimosis?
- Types of phimosis
- Causes of phimosis
- Symptoms of phimosis in boys
- Complications of phimosis in boys
- Diagnosis of phimosis in boys
- Treatment of phimosis in boys
The reproductive system is of great importance for a person, primarily because it is this that ensures the continuation of the genus and the existence of the species for a long time. In humans, this system is combined with urinary organs and, among other things, is necessary for the normal functioning of the body.
Normal in representatives of the stronger sex the head of the penis is covered with foreskin. This anatomical formation is a duplicatory skin and has two sheets - external and internal. The inner part of the foreskin covers most of the time the head of the penis and acquires some features characteristic of the mucous membranes of the body.
The significance of this area of the flesh is still actively debated among scholars from around the world. Some believe that the foreskin is a kind of rudiment, does not bring the patient benefits, and sometimes even harmful, contributing to the accumulation of microorganisms. Also mentioned is the likelihood of oncological pathology of the foreskin, which does not threaten patients after performing circumcision. Their opponents say that in practice, the probability of developing urinary tract infections in circumcised and uncircumcised men is about 1%. Cancer of the foreskin is also extremely rare. At the same time, the surface of the glans penis is protected from the effects of adverse factors, the epithelium on it does not harden, and the sensitivity remains at the same level.
Normally, the foreskin covers the entire surface of the head in an unexcited state. During an erection, it shifts and completely exposes the head in most men. In this case, there is no pain and discomfort. However, this is not found in all men.
What is phimosis?
Phimosis is a condition in which the foreskin has a hole so narrow that the head of the penis cannot be completely exposed. It should not be rash to call phimosis all cases where the head of the penis can not be exposed independently and without the application of additional efforts.
Almost all healthy newborn boys can not completely expose the head of the penis. This is characteristic of only 4% of babies born. At the age of one year, for many boys, the foreskin is still connected to the penis with synechiae and is completely displaced in only a small percentage of children.
By the age of three in every fifth child, the foreskin is so mobile that the head of the penis is completely exposed. That is why until this age about phimosis it is not recommended to perform surgery. The fact is that pathology can retreat independently under the influence of changes occurring in the body of a child and adolescent in the process of growing up.
Not always, this state brings discomfort to the patient. About a quarter of young guys at the age of 18 cannot fully expose the head of the penis, but this does not bother them much. Some even like their condition, and they deliberately do not carry out treatment.
The disease is important for children and adults. In the latter case, the presence of the disease is almost always due to the lack of adequate treatment in childhood. Indeed, in early childhood the head of the penis is in most cases not exposed, which is normal. Gradually, the child matures, and parents no longer often see his genitals (they used to take part in bathing the child). After puberty begins, and the teenager is already shy of his nakedness, unaware of the problem.
Types of phimosis
Doctors allocate several degrees of phimosis, depending on how far the size of the foreskin does not correspond to the diameter of the head of the boy's penis.
- Grade 1 is characterized by the fact that the head of the penis can open, but only in a quiescent state. Exposure of the head during an erection is difficult, and sometimes completely impossible.
- 2 degree - it is difficult to bare the head in an unexcited state. With an erection, the glans penis is not brought out, or only the tip of the penis is exposed. In this case, the foreskin strongly squeezes the tissue, which complicates the outflow of venous blood from the body. As a result, the extended tip of the penis swells like a ball.
- 3 degree - during an erection the head of the penis cannot be bare even partially. In a calm state, it is only partially exposed, and is never fully displayed.
- 4 degree - the most pronounced, since the head of the penis is never exposed. When this happens, urination is impaired due to difficulty urinating the urethra. It accumulates under the foreskin (externally, it looks like swelling) and is trickled out or completely drops out. Also in such patients ejaculation is difficult.
In addition, some scientists identify relative phimosis, a condition in which the narrowing of the foreskin becomes somewhat noticeable only during erection (this can be attributed to the 1 degree of development of the disease).
Causes of phimosis
There are several reasons that can trigger phimosis in boys.
- Congenital phimosis occurs most frequently and develops due to a slight violation of the formation of genital organs. This may be due to a genetically predisposed lack of an elastic component in the tissues of the child's foreskin.
- Injuries to the penis cause the development of a narrowing of the foreskin in cases where a large scar of connective tissue is formed during the healing of the injury. It flesh and forms the so-called cicatricial stenosis.
- Balanopostitis - inflammation of the foreskin of the penis, which develops as a result of exposure to pathogenic microorganisms. If appropriate measures are not taken in a timely manner, then a large amount of penile tissue may be damaged and later phimosis may develop.
Symptoms of phimosis in boys
- The most important symptom of the disease is the inability to open the head of the penis or the difficulties that arise when trying to do this.
- In severe phimosis, when the head is completely covered with the foreskin, urination is impaired. At the same time, small children tense up, worry, and often cry. Urine droplets exudes from the hole in the foreskin, and the preputial cavity swells like a sack.
- Older children may complain of pain that occurs during an erection. It is important to have a relationship of trust with the child, and then he will not hesitate to tell parents about this problem. Interestingly, painful sensations are more typical for stages 1 and 2 of the disease. This is explained by the fact that during an erection the head may still be exposed, but the preputial ring squeezes either part of it or the shaft of the penis. At 3 and 4 degrees, the foreskin covers the head even during erection and nothing is compressed by the preputial ring.
Complications of phimosis in boys
In addition to the above clinical manifestations of the disease, the development of certain pathologies provoked by phimosis is possible.
Balanoposthitis is an inflammation of the inner leaflet of the foreskin and the head of the penis. Special glands continuously secrete a specific secret (smegma) that falls on the head of the penis and, in the presence of foreskin, accumulates during the day. Gradually, it mixes with the dying epithelium (this is the normal process of renewing the integument of the body) and a small amount of urine (in any case, part of it remains on the head). The result is a substance having a white color and a specific smell.
Most of the boys, who follow the rules of personal hygiene, regularly wash their genitals and do not face problems. In the presence of phimosis, especially pronounced, it is difficult to carry out a careful toilet of the penis head and foreskin. As a result, a large amount of smegma accumulates in the preputial sac, which is a good nutrient medium for microorganisms. As a result, patients at times increases the risk of developing balanoposthitis.
The disease is characterized by the following symptoms:
- redness of the head;
- excretion of pus from the preputial sac.
Frequent state developing in boys with phimosis. It is important to always remember: under no circumstances you can make great efforts when trying to expose the head of the penis. The fact is that it smoothly expands in the direction from the opening of the urethra, and the trunk of the penis itself is considerably narrower. As a result of the forced opening of the head, the foreskin is somewhat stretched (this can cause a momentary feeling of pain), and then tightly wraps the ring behind the head.
The collapsed blood vessels no longer perform their function, and the tissues of the head begin to experience a lack of oxygen and nutrients. If measures are not taken promptly, necrosis or gangrene of the member may develop, which forces the medical staff to remove the affected area - the patient becomes disabled.
Manifestations of paraphimosis:
- the head is enlarged and swollen;
- the boy feels a strong pain (the kids cry and do not allow to touch the penis).
The fusion of the head and foreskin
With prolonged contact, the epithelial tissues gradually more and more firmly adhere to each other and form synechiae - adhesions. This condition only aggravates the situation, making the opening of the head impossible.
Diagnosis of phimosis in boys
The disease is easily detected with a simple external examination. There is no need to resort to additional research methods and subject the patient to various diagnostic procedures.
The fact that the boy's foreskin cannot expose the head is able to be determined even by a person without special education, but the doctor’s function is different here. Based on their experience and knowledge, health workers can determine the degree of phimosis and choose the right treatment strategy.
Treatment of phimosis in boys
Doctors are always trying to avoid surgery, because even the simplest operation involves certain risks. At the first stages, they resort to conservative methods, which in some cases eliminate the problem.
Since the foreskin is elastic enough, you can achieve its stretching with the help of some exercises, which can be taught to any teenager or toddler's parent (young children cannot perform on their own).
- The gradual stretching of the foreskin by partially stretching it on the head of the penis. It is necessary to bare the head until a slight unpleasant sensation appears. If the child is small, then you need to be extremely careful and not make great efforts. Exercise should be daily for 10 minutes. Sometimes when the head is fully exposed, teenage boys start to masturbate. In this case, it only benefits, because masturbation contributes to stretching the tissues of the foreskin and eliminating the disease.
- You can also stretch the preputial ring with two fingers that are inserted between the head and the flesh. They must be diluted to the sides, causing tension, each time more and more strong. In 75% of cases with good faith, you can get rid of the disease.
- During bathing or bathing under the action of warm water, the fabrics become more elastic. As a result, doing the exercises at this time is more productive. It is important not to make a lot of effort in order not to provoke paraphimosis. According to researchers, after 2 months, you can achieve full opening of the head, even with pronounced phimosis.
- For fixing the foreskin in the desired position can be used special rings, put on the penis.
When performing any exercise, you need to remember the golden rule: never try to sharply expose the head of the penis.
This treatment is not widely spread, but do not forget about it. The technique consists in the use of ointments with glucocorticoids. If you daily rub it into the area of the head of the penis and massage it, then you can with a high degree of probability achieve a success.
Not all doctors want to use hormonal ointment in boys, even though the use of side effects has not been described.
These methods are resorted to only in cases where previous techniques have not brought the expected effect. In most cases, doctors perform longitudinal cuts of the foreskin, followed by its stitching. This increases the diameter of the preputial ring, and the head may be exposed.
A number of patients are assisted by a Shklofer surgery. Under local anesthesia, the surgeon performs a zigzag incision, after which the edges of the wound are stitched in such a way that the area of the flesh increases while all its tissues are preserved.
The problem can be circumcision - an operation in which the foreskin is completely excised and the head of the penis remains naked. The disadvantage can be considered the fact that over time the open surface will somewhat harden and change the sensitivity.
Surgical treatment is most effective and helps the patient in 99-100% of cases.
If suddenly it happened that the foreskin is shifted behind the head of the penis and squeezes the tissues located below, then you should immediately contact the experts, without waiting for the deterioration. Otherwise, serious complications are possible.
If the compression of the penis is not strong, then it is sometimes possible to eliminate the problem conservatively: the organ is lubricated with petroleum jelly or other similar substance and the foreskin moves neatly (without application of great efforts). Otherwise, it is necessary to perform surgery: the foreskin is dissected and the pressure is removed. Often, the operation continues and completely remove the flesh.