Phimosis

March 9, 2012

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Phimosis - It is characteristic for men state in which it is impossible to expose the glans penis. This condition can be a normal, that is, physiological , And that abnormal - pathological . Also phimosis in boys are divided into congenital   and acquired .

The most commonly in men diagnosed congenital phimosis. At birth, boys physiological phimosis, that is, the inability to offset the foreskin completely and expose the glans penis, occurs in 96% of cases. Only four per cent of boys are born with a foreskin, mobile to such an extent that the head of the penis is opened fully. Gradually, the situation is equalized, and by six months in twenty percent of the boys head of the penis can be opened. At the age of three have 90% of phimosis disappears, and by about the age of six, this condition resolves on its own in almost all children.

Somewhat different is the situation with acquired phimosis, or a situation where the foreskin has lost elasticity due to illness and injury.

Symptoms of phimosis

Phimosis in boys expressed the main symptom - the inability to expose and bring the head of the penis. In some cases, this condition does not cause complaints from the boys, but often children with phimosis have problems with urination. So, in the process of urinating boy can greatly push to exercise a significant concern. As a result, the child falls into the urine preputial cavity . It swells, and passes urine drops or a thin stream through the narrow opening.

Sometimes phimosis joins inflammation, whose symptoms are pain in the glans and foreskin, purulent discharge from the opening of the foreskin. The patient increases The lymph nodes Growing body temperature. If there is a paraphimosis In disadvantaged head of the penis appear sharp pain, head of the penis to become more and expressed turn blue. In this case, the patient must provide emergency care.

If phimosis in adult males sometimes have problems with complaints potency Arising as a psychological discomfort due to pain during sexual intercourse.

Reasons for phimosis

Phimosis may occur as a result of injuries of the penis and the subsequent formation of scar tissue. As a result, the foreskin is narrowed, and the man manifests cicatricial phimosis . The cause of acquired phimosis may also be inflammation of the foreskin of the penis ( balanoposthitis ). As a result of this disease are also formed scars, and the patient is shown phimosis. Sometimes the cause of phimosis is a genetic disposition to the emergence of phimosis as a consequence of the insufficient number of the elastic component of the connective tissue in the human body

Classification of phimosis

Currently, it decided to allocate four degrees of phimosis. With first-degree   open the head of the penis can be extremely quiescent. If you try to strip the head of the penis during erection, the person will feel pain, also make it difficult.

With second degree   disease head resting display is difficult, and during erection head member does not open. To third degree the disease is characterized by the inability to open the head of the penis, or it is only partially open in the quiescent state. The fourth degree   phimosis - the most severe: in this case the head of the penis do not open, which greatly complicates the process of urination. Urine is a person stands or drops very thin stream.

In addition to the steps described also stands Relative phimosis . In this state, a marked narrowing of the foreskin becomes exclusively during erection.

For phimosis first and second degree is characterized by the manifestation of pain, which mostly occur in the process of erection when pulling the foreskin on the glans penis. When phimosis third and fourth degree of pain, there is usually no, because the size of the preputial ring negligible and, therefore, not possible to expose the penis.

In patients with phimosis even with a relatively small constriction foreskin after the start of active sexual life condition can worsen and after some time lead to the fact that the head of the penis can not be opened at all. The fact is that in the process of sexual intercourse or masturbation injured mucosa, and formed mikronadryvy. In place of tears eventually formed small scars, which ultimately makes the fabric resistant to stretching, and phimosis is enhanced.

Complications phimosis

If the patient has a place marked phimosis, he can stagnate smegma - Fat-like secret that distinguish cancer foreskin. This becomes liquid nutrient medium in which various bacteria breed. As a result, as a result of such a situation develops inflammation. Even unspoken phimosis is a prerequisite for the accumulation of smegma and as a result, the problems of hygienic nature of manifestation.

Patients fourth degree of phimosis the foreskin is narrowed as much as possible, and there are obstacles to the normal flow of urine. As there is a narrowing of the external manifestations of swelling of the foreskin and the penetration of urine drop by drop. In this case, it generates a residual major disruptions in urinary outflow mechanism, and as a consequence, the patient may develop complications infectious nature of the urethra.

Another complication that occurs in patients with phimosis - paraphimosis . For such a condition characterized by impairment of the glans constricted foreskin. Paraphimosis may occur if a person tries to expose the head of the penis during sexual intercourse or masturbation. Because of this infringement begins swelling of the glans penis, leading to the fact that after some time to straighten her back is impossible. There is a blue head, it becomes very painful. Therefore, when paraphimosis must be an emergency intervention specialists. In some cases, using a simple, manually reposition the head. However, if the swelling is strongly expressed, the patient should carry out the operation, during which the foreskin is cut or excised her sheets.

Also, due to injuries foreskin phimosis patients may develop inflammatory complications. Injuries and accumulation of smegma in prepuce lead to the manifestation balanoposthitis   (inflammation of the glans and foreskin of the penis). This state is characterized by the manifestation of pain and itching around the penis head. In patients with phimosis third or fourth stage of the foreskin may adhere to the head of the penis. As a result of close contact occurs epithelial bonding head and the inner layer of the foreskin. Thus, manifested seam ( adhesions ). Depending on how long the seam there, strengthens the bond head and foreskin. To treat such a state can only be surgically.

Among the complications of phimosis most severe consequence is penile cancer . The reason for this phenomenon is considered a long stagnation of smegma in the prepuce. It is proved that the majority of people suffering from cancer of the penis, had a congenital phimosis.

Diagnosis of phimosis

Diagnosis is based on patient complaints. To establish a diagnosis, examination of the patient has to spend a surgeon or urologist. First patient survey carried out, during which the specialist determines whether there is a primary symptom - lack of opportunity to withdraw the head of the penis. As an auxiliary method of conducting interviews with the patient to determine the characteristics of the disease.

Treatment of phimosis

To treat phimosis can be different methods. Nemedikmentoznaya therapy involves gradually stretching the foreskin manually. Pulls the foreskin on the penis for five to ten minutes, doctors recommend every day. Application of stretching the foreskin, according to experts, gives an efficiency of about 75%. To conduct such procedures are best while taking a bath, because then the skin becomes more elastic. Note that the delay foreskin is necessary before the first pain, in any case, not continuing to do this procedure with the pain.

If the foreskin is sufficiently elastic and there is no scarring, sometimes the method of stretching the foreskin. This procedure is performed using local anesthesia. Also, as the surgical technique is sometimes used plastic surgery of the foreskin in order to increase the diameter preputial rings without applying the circumcision.

Drug therapy involves the treatment of disease by applying to the head of the penis and foreskin corticosteroid ointments . Such procedures should be done regularly and for a long time. Under the influence of ointments tissue elasticity of the foreskin becomes higher, so it is better to stretch. Thus, phimosis can be cured. Also, the use of glucocorticoids helps relieve inflammation and swelling, stimulates healing of microcracks.

Surgical treatment of phimosis apply now for the treatment of phimosis third or fourth degree. This method is appropriate only if all the above methods do not produce the desired result. Phimosis in boys surgically treated, making the separation of adhesions prepuce using a metal probe and gauze cotton swab.

If the foreskin there are scars in the process of producing their excision surgery. The use of surgical methods are effective at 99-100% Referring rule, surgery is performed with local anesthesia, general anesthesia is possible only at the request of the patient. Surgeons are two types of phimosis: hypertrophic With elongated and hypertrophied foreskin and atrophic When the foreskin has a very thin skin covering the head of the penis much. Both forms of phimosis can be cured with the help of different types of operations. Thus, surgery is possible, in which three longitudinal incision is made and the cross-linking. Another type of operation - a circular circumcision. In this case, the foreskin is removed, and the appearance of phimosis becomes impossible. Note, however, that in such surgical interventions are possible complications, as with any other operations.

Prevention of phimosis

As a precaution phimosis is necessary to adhere to the rules of hygiene of the penis. In this case, it is important to not less than two times a day to displace the skin of the foreskin and wash the head of the penis clean water. Not less important hygiene for prevention of phimosis in newborn boys. In order to prevent inflammation of the glans penis, it is recommended to bathe the child in herbal teas using herbs with antibacterial and anti-inflammatory properties. For this purpose, suitable broth chamomile, calendula, series. As a folk remedy for adult men who have some problems with pulling back the foreskin, recommended local bath, dropping twenty minutes the penis in a decoction of herbs and at the same time pulling the foreskin.