Phimosis in boys: photos, causes and treatment

Phimosis in boys Phimosis is the narrowing of the foreskin. With such an ailment, the penis of the penis in boys either does not open at all, or opens, but with difficulty, causing painful sensations.

In 96% of newborn boys, the penis head opens not completely because of insufficient mobility of the prepuce. In boys at the age of 6 months, physiological phimosis is detected in 80% of cases. In boys aged 3 years, the glans penis is freely exposed in 90% of cases. Sometimes physiological phimosis disappears only at the age of 6-7 years.

However, it happens that the foreskin is losing its elasticity due to injury or illness. In this case, the acquired phimosis may form. Such phimosis in children and adults is manifested as a consequence of any disease of the penis and can be a permanent or temporary phenomenon.

Classification

Depending on the severity of clinical manifestations, urologists distinguish four degrees of phimosis in boys:

The head is freely exposed in a calm stateand with a little effort - during an erection.

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The head in a relaxed state is exposed with some effort. Exposure of the head during an erection is impossible.
The head in a calm state is not exposed or exposed with a significant force. Exposure of the head during an erection is impossible. Urination is not difficult.
It is not possible even to partially expose the head. Urination is difficult. Urine is excreted by a drip or a thin trickle.

Suspected of the baby phimosis, you can talk with the pediatrician, he will see the baby and say if there is any reason to worry. Independently to move the foreskin is strictly impossible, gross interference can cause harm.

Attempting to "speed up" the process can lead to such undesirable consequences as a rupture of the foreskin (subsequently at the site of the rupture a scar is formed, which can lead to aggravation of phimosis in children) or paraphimosis - pinching of the glans penis with the foreskin.

Causes of phimosis in boys

What it is? Among the causes of phimosis are those that are still unexplained science. As already mentioned, this pathology is normal until a certain age. Phimosis is inherently divided into a disease of pathological and physiological origin.

Causes of pathological phimosisare:

trauma to the penis;
balanoposthitis (inflammation of the head or foreskin);
The lack of an elastic component in the connective tissue (is the result of a genetic disorder).

At birth, narrowing of the prepuce is observed in the vast majority of newborn boys. This kind of phimosis in children is called physiological and is not pathology. Physiological phimosis in boys is temporary. It flows painlessly.

If cryptorchidism or hypospadias are noted simultaneously with phimosis, anomalies in the development of paramezonephalic The duct, which developed during the intrauterine period under the influence of toxic or infectious causes.

Cicatricial phimosis

Cicatricial phimosis is a narrowing of the prepuce to a critical state. This type of phimosis is formed due to the appearance of a scar scar, which hinders the withdrawal of the head of the penis or makes the removal procedure, in principle impossible.

One of the complications, which entails neglected cicatricial phimosis - is paraphimosis. This condition is characterized by the infringement of the head of the penis with an extremely tight flesh. The head turns blue, swelling of varying degrees is observed. There is a pain syndrome.

Symptoms

Phimosis in boys can be determined by the following signs:

difficulty urinating (a trickle of urine is interrupted);
inflammation of the foreskin and severe itching;
hanging of the foreskin above the head or its infringement;
incomplete closure of the head;
the head can turn blue and cause painful sensations in the child.

Such symptomatic indicators can be manifested individually, and can act together. In any case, when the first suspicious signs appear, a doctor's consultation is necessary.

Dangerous complication of phimosis: paraphimosis

Serious complication of phimosis is paraphimosis. In children, pathology is usually formed due to a violent attempt to open the head of the penis. It is a disease in which the head of the penis that comes out of the foreskin is infringed. Being in a tight ring, the head swells, so the pressure of the ring increases.

Symptoms of paraphimosis are cyanotic shade and swelling of the penis, severe pain. After a while, the pain syndrome becomes less intense due to serious circulatory disorders. Without specialized care, the strangled head becomes black or purple.

Also to the complications that need specialist help, include:

postit;
balanitis;
balanoposthitis;
retention of urine.

Phimosis in boys: before and after photos

Find out what phimosis looks like in the photos below.

How to treat phimosis in boys

Treatment is carried out only if the phimosis in the child has passed into a pathological form or with a physiological form - certain problems with urination appeared. Intervention involves the complete or partial elimination of the prepuce.

At 1 degree of narrowing, a child under 13 years of age is not treated.
At 2 degrees also it is possible to do without operation if to apply a technique of gradual extension of a prepuce. Only the urologist shows the method of implementation.
The third degree can be treated with the help of conservative treatment, along with the dissection of adhesions between the foreskin and the sexual organ enveloped by it.
With 4 degrees, only surgery will help.

Methods of treatment of phimosis in boys:

Non-pharmacological. Regularly pull the foreskin manually.
Medicated. Most often prescribed ointment based on glucocorticoids. Ointment increases the elasticity of the skin folds, heals microcracks, eliminates inflammation. The most popular ointment is Clobetasol, Betamethasone.
Operational. Assign in the absence of a positive effect for any type of conservative treatment.

It should be noted that homeopathy and traditional medicine are absolutely ineffective in the treatment of phimosis. But they are actively used as an additional bactericidal, anti-inflammatory and softening effect, if the patient does not have allergy or intolerance to broths, chamomile and marigold.

Treatment of phimosis in boys at home

In the treatment of phimosis at home, gradual opening of the head 1-2 mm may be recommended. The procedure is carried out after a warm bath, preferably with the addition of antiseptic agents: a weak solution of potassium permanganate, decoction of chamomile, calendula, sage. Take it should be 2 times a week for 10-15 minutes.

Previously, the technique of one-stage opening of an extremely flesh with a sharp jerky movement was widely practiced. This procedure is extremely painful for the boy and can cause psychological trauma.

After the water treatment, the foreskin is treated with a healing ointment (beponen, solcoseryl) or baby cream to increase its elasticity and prevent a rupture. The skin is moved no more than 2 mm in one procedure.

Before starting such treatment, be sure to ask permission from the treating doctor, especially when it comes to young children!

Video: Dr. Komarovsky

Also we offer to watch a video in which the famous pediatrician Komarovsky will tell you what to do with phimosis in boys.

Operation

In case of phimosis in boys, the operation is performed only when it is impossible to achieve the necessary effect from other methods of therapy. Surgical treatment consists in the production of three longitudinal incisions with cross-linking. In boys, the operation consists in disconnecting the adhesions of the preputial sac by using a gauze stump and a metal probe.

A number of patients are helpingSchloffer operation. Under local anesthesia, the surgeon performs a zigzag incision, after which the edges of the wound formed are sewn in such a way that the flesh area increases while maintaining all of its tissues.
Disconnection of adhesions. In children, most often this procedure is carried out with a metal probe and gauze tuppure. An operation of this kind is not highly traumatic, and local anesthesia is used.
Circumcision. Ordinary circumcision of the prepuce. Most often it is prescribed for severe scar lesions of the epithelium.
Classical surgical method, used in modern clinics - the creation of three longitudinal dimensions with their subsequent cross-linking.
The solution to the problem can be circumcision- an operation in which the foreskin is completely excised and the glans penis remains nude all the time. The disadvantage can be considered the fact that over time, the open surface is somewhat coarsened and will change the sensitivity.

Operation is not to be feared, it lasts 15-20 minutes, the boy will be able to walk after several hours. The risk of complications, provided that the operation is performed in a hospital - no more than 0.1-0.2%. In addition, surgical treatment is most effective and helps the patient in 99-100% of cases.