Phimosis in men. Reasons why the head does not open in an excited state

Phimosis or narrowing of the foreskin in men occurs for a number of reasons. Pathology is accompanied by acute pain. In the absence of timely and adequate treatment, there is a high risk of developing complications that negatively affect men's health. The appearance of discomfort when exposing the head of the penis is the reason for contacting a medical facility.

Definition and mechanism of development of phimosis in men in adulthood

Phimosis in men (the reasons and methods for their elimination are indicated later in the article) can develop against the background of an injury. Usually, the pathology is acquired in nature - a congenital anomaly, as a physiological feature, usually goes away on its own.

In adulthood, phimosis in men is formed against the background of tissue atrophy. First, for a number of reasons, the skin becomes thinner, there is a decrease in the volume of soft tissues. The foreskin ring becomes narrower. This is due to the hardening and loss of elasticity of the epithelium.

Causes of the disease

The disease occurs not only in children, but also in adult men. At risk are people who lead a hectic lifestyle. Also, the pathology develops in men against the background of the absence of sexual intercourse for a long time.

Phimosis in men, the causes of which are established by a specialist, may be the result of provoking factors:

• diseases of the skin (lichen, psoriasis, lichen scleroatrophic type, eczema);
• anomalies in the formation of an organ during maturation (disproportionate increase in the glans penis);
• hypothermia, which caused degeneration of the foreskin ring;
• overheating, which provoked severe swelling;
• acute allergic reactions to detergents and cosmetics;
• scleroderma of the flesh;
• hereditary factor;
• diabetic angiopathy, diabetes mellitus;
• staphylococci, streptococci, provoking the inflammatory process;
• STDs (ureaplasmosis, chlamydia, papillomavirus, HIV, carcinoma, xerotic balanitis);
• pathology of inflammatory etiology (balanoposthitis, urethritis);
• mechanical damage to the organ and foreskin caused by wearing tight underwear, pinching the penis by a zipper, masturbation in adulthood.

Often, patients suffering from severe forms of erectile dysfunction complain of phimosis.

Why does not the head open in an excited state during phimosis?

With advanced phimosis, the glans penis opens partially or does not open at all. It is caused by the narrowing of the foreskin ring. There can be several reasons for hardening (scleroderma). During an erection, the penis increases in size, the head is filled with blood, but does not open. The man experiences severe pain when trying to pull the foreskin. Phimosis may be accompanied by a shortening of the frenum. In this case, there is a high risk of curvature of the glans penis.

The danger of phimosis in adults

With a narrowing of the foreskin ring, there is a high risk of developing diseases of an infectious etiology. Sperm and smegma accumulate under the head, creating a favorable environment for bacteria to multiply. It is difficult for men suffering from phimosis to observe all hygiene rules, therefore, carcinogens can accumulate under the foreskin. In this case, the risk of developing cancer is high.

In the absence of adequate treatment, phimosis turns into paraphimosis. Pathology is characterized by the formation of a dense ring of skin around the glans penis. It is impossible to cure the disease with medication, the infringement is eliminated through surgical intervention.

Classification

Pathology is classified depending on the mechanisms of development.

The following types of the disease are distinguished:

• Cicatricial. The foreskin is rather dense and long. In shape, it resembles a proboscis. Scars form on the skin. The complication can be caused by mechanical injury or inflammation.
• Atrophic. It occurs against the background of a ruptured foreskin. Usually, deformation occurs when trying to expose the glans of the penis. The skin loses its elasticity, the flesh becomes thin.
• Hypertrophied. It is characterized by a thickening of the foreskin. The head of the penis is practically not exposed, but the man does not experience pain during intercourse. The complication is usually corrected by manual stretching of the skin.

Physiological phimosis in adult men is rare. Pathology is diagnosed in children under 5 years of age.

Stages of development of phimosis and symptoms

Phimosis in men (the reasons for development may be different) is formed gradually. Depending on the stage of the course, the symptom complex may also vary.

First degree

At the first stage of phimosis, a man has difficulty exposing the head during an erection. In a relaxed state, the foreskin completely opens the upper part of the organ. Discomfort in the form of pain appears only during arousal. If left untreated, the disease will progress. Many men do not go to the doctor, preferring to endure the pain.

For the first degree of phimosis, the following symptoms are characteristic:

• in an excited state, the head is not exposed;
• premature ejaculation appears, which occurs against the background of an increase in the sensitivity of nerve endings;
• scars are formed on the skin due to the formation of microcracks.

If phimosis is not treated in time, it can transform into paraphimosis. In this case, the risk of developing necrosis is high: tissues die off due to circulatory disorders.

Second degree

The second stage of the pathology has a more pronounced symptom complex. It is extremely difficult to expose the glans of the penis in a relaxed and aroused state. The widest area does not pass through the ring. If you push back the foreskin with force, the skin breaks.

The development of the second stage is indicated by severe pain that occurs when the head is exposed during urination or intercourse. Also, men complain of premature ejaculation. It is impossible to follow all the rules of personal hygiene. It is quite difficult to clear the head from urine, smegma and semen.

Third degree

St

adia phimosis is characterized by an almost complete lack of mobility of the foreskin ring. When you try to move the skin away, only the tip of the head is exposed. A man's libido decreases, during intercourse he does not reach orgasm.

The characteristic signs of phimosis of the 3rd degree include the appearance of pain during urination. The canal is partially covered with skin. Cracks occur frequently, especially in this condition: the foreskin is stretched, the skin is torn.

Fourth degree

The fourth stage of phimosis is considered the most severe. The patient experiences pain even during sleep. In addition to narrowing the ring of the foreskin, there is a high risk of joining a sexually transmitted infection. The urethra becomes inflamed, the foreskin completely covers the head of the organ.

A man is deprived of the opportunity to have sexual intercourse with a partner. He is incapable of maintaining hygiene. Urine, sweat, smegma and semen accumulate under the head. Against the background of the addition of the infection, the body temperature rises. In the organ, the process of outflow and flow of blood is disrupted. For phimosis grade 4, urinary problems are also characteristic.

Complications of phimosis

Phimosis in men (the reasons are sometimes hereditary) can provoke the development of complications:

Complication type	Description
Balanoposthitis	Pathology develops against the background of non-observance of basic hygiene rules. Smegma and sperm stagnate under the head and foreskin, provoking active reproduction of pathogens. The head of the penis becomes inflamed, and infection enters the cells. The complication can be eliminated only by surgery.
Flesh fusion	The complication is diagnosed in men suffering from stage 4 or 3 phimosis. The foreskin almost completely stops moving, in some areas it grows together with the glans penis. During an erection, when blood rushes to the organ, the patient experiences acute pain. Bleeding may develop. The complication is also eliminated through surgery.
Paraphimosis	Pathology is characterized by a narrowing of the foreskin ring. Against the background of squeezing the penis, severe edema is observed. With paraphimosis, the skin becomes bluish. In this case, the patient is shown circumcision or longitudinal incision.

The most common complications arising from phimosis include infection.

Diagnostics

If you suspect phimosis, you need to consult a urologist. The doctor should feel the organ and conduct an examination. You may need to consult an oncologist and a dermatovenerologist. Laboratory tests are prescribed to the patient if there is a suspicion of inflammatory and fungal lesions of the flesh.

The doctor should not evaluate the degree of narrowing of the ring by exposing the head - there is a high risk of bleeding, especially if the patient suffers from phimosis of 3, 4 degrees. Additionally, ultrasound of the urinary tract and urethroscopy can be prescribed.

Phimosis treatment

Phimosis in men is treated in several ways. The method is selected by a specialist after identifying the exact cause of the development.

There can be several treatment options, they are selected depending on the degree of the pathology:

• surgical intervention;
• drug treatment;
• physiotherapy;
• laser treatment.

Traditional medicine methods have also worked well. They are most effective at the initial stage of phimosis.

Manual stretching of the foreskin

Stretching the foreskin with your hands must be extremely careful. With two fingers (thumb and forefinger), you need to slowly pull the skin up, trying to cover the glans penis. If the slightest discomfort appears, the exercise should be stopped. If it was possible to pull the skin over the head, then the position is fixed for 25-35 seconds, then the fingers are removed. It is necessary to repeat the above steps 10-12 times.

To stretch the foreskin, you need to grab the left side of the flesh with the fingers of the left hand, and the right side with the right, and try to slightly expand the ring. If it turned out to stretch the foreskin, then the position is fixed for 45-60 seconds. The exercise should be done 3-5 times a day.

Before touching the genitals, you must thoroughly wash your hands with any hypoallergenic soap. If painful sensations appear during stretching of the foreskin ring, then the exercise should be stopped immediately. To make the process less painful, you can stretch the flesh while standing in a warm shower. Use shower gel or liquid soap as a lubricant.

Medication

With phimosis, patients are prescribed hormonal preparations in the form of ointments.

The composition of complex therapy may include drugs:

• Betamethasone. The active ingredient in the composition of the drug is the substance of the same name. The medication has a local anti-inflammatory, antiproliferative, vasoconstrictor, antiallergic and antipruritic effect. The ointment is prescribed for patients with phimosis of 1-2 degrees. The drug must be applied to the foreskin 1-2 times a day, in a thin layer, evenly distributing. The use is categorically contraindicated in patients suffering from hypersensitivity, viral, fungal skin lesions.
• Hydrocortisone. The ointment contains hydrocortisone acetate. Synthetic glucocorticosteroid has antipruritic, anti-edematous and anti-inflammatory effects. The use of the ointment is advisable for phimosis of 1 and 2 degrees. It is not recommended to use the product for people suffering from dermatitis, fungal and viral infections of the skin. Do not apply ointment to open wounds. Tuberculosis and diabetes mellitus are considered relative contraindications. With phimosis, ointment is applied to the foreskin 2-3 times a day, in a thin layer. You do not need to rub it in.

When an infection joins, the doctor may prescribe antibiotics (most often in injections).

Physiotherapy

At the initial stage of the development of the disease, the patient may be assigned the following physiotherapeutic procedures:

• Bulbous probe. In the process of carrying out the procedure, dihydrotestosterone is applied to the foreskin in the form of a gel. The probe is gently inserted into the ring, trying to slightly expand it. The procedure can be carried out up to 2 times a week. Before each session, take a bath with decoctions based on medicinal plants.
• Phonophoresis. Medications are injected into the deep layers of the skin by means of ultrasound. The procedure is completely painless. Oily anandrogen-containing agents are applied to the foreskin. The required radiation frequency and intensity are set on the apparatus. The session lasts 5-6 minutes. It should be carried out once every 2 days. The course of treatment is no more than 14 days.

Physiotherapy procedures have an anti-inflammatory effect. Also, patients note a decrease in the severity of pain after 3 sessions.

Surgical treatment for cicatricial phimosis

With phimosis in adult men (mainly of the cicatricial type), a circular excision of the flesh is performed. The operation is considered cosmetic and less traumatic. It lasts no more than 25 minutes. The naked genitals are covered with napkins on all sides and treated with an antiseptic solution. Before excision, the specialist must find the whitened area of ​​the skin. In this place, a belt is formed that squeezes the head.

The markings are applied with a marker, the anesthetic is infiltrated. The foreskin is clamped and excised longitudinally. The skin should split left and right. The free edges of the flesh are sutured with self-absorbable sutures, the head is closed with a sterile bandage.

After the operation, the patient is monitored for the first day in the hospital, then released home. It is advisable that the wound is not under sterile gauze or bandage for a long time. After the operation, no scars are formed, complications after a circular section are rare.

Laser treatment

Laser excision of the foreskin is a painless cosmetic procedure. It is usually prescribed to patients with advanced phimosis. According to reviews, the result after laser correction remains forever, the risk of re-development of pathology is minimal. The procedure is carried out in a hospital setting. Its duration is 20-25 minutes.

The procedure does not require special preparation (you do not need to follow a diet, the abolition of any drugs is not necessary). The operation is performed under local anesthesia. The urologist applies markings to the skin. It is not necessary to cover the organ with sterile napkins during the procedure.

The tissue is excised along the markings, the adhesions are removed and the penis is treated with an antiseptic solution. After the operation, the doctor explains to the patient how to care for the organ during the rehabilitation period. It is not necessary to stay in the hospital; you can go home immediately after the laser correction.

Traditional methods

Traditional medicine cannot be considered an alternative to surgery or drug therapy. Infusions and decoctions based on medicinal herbs are used as a prophylactic agent against inflammation. They need to be prepared according to the recipe, strictly observing the dosage regimen.

Effective anti-inflammatory agents:

• A decoction based on chamomile. Traditional medicine is used externally for phimosis of 1-2 degrees (baths, lotions). Pharmacy chamomile flowers (2 tbsp. l. ready collection) is poured into a pan of enamel. The raw material is poured with hot water (300 ml, it is advisable not to use boiling water). The pan is put on low heat, after 5 minutes. the container is removed. The broth must be drained several times through the gauze folded several times. Trays with chamomile decoction can be done 2 times a day.
• A decoction based on yarrow. The product can be prepared from fresh and dried plant parts. The stems, together with the leaves and flowers, must be placed in an enamel container. Raw materials are poured with hot water (300 ml). The container must be put on low heat and bring the water to a boil. After 3 min. remove from heat, cool and drain.
• Infusion of woad dye. Dried plant roots (2 tbsp. l) finely chop, place in a thermos. Pour boiling water over the raw materials (500 ml). Cork the thermos tightly and put it in a warm place for 5 hours. decant the ready-made broth.

The shelf life of finished products is no more than 72 hours. every 3 days you need to prepare fresh infusions and decoctions.

Rehabilitation and prognosis

The disease is quite successfully treated. After the operation, during the rehabilitation period, it is important to follow a number of rules to speed up the healing process. It is strictly forbidden to visit baths, saunas and swimming pools for the first 3-6 weeks after surgery. It is not recommended to swim in open water bodies (lakes, rivers).

The foreskin must be treated with antiseptics daily. This will minimize the risk of developing an inflammatory process against the background of an infection. Also, experts recommend refraining from visiting tanning salons. It is necessary to completely exclude sexual contacts for 10-14 days. Physical activity is completely contraindicated. It is advisable to stay in bed. Underwear must be changed daily.

The prognosis after surgery is quite favorable. The result is saved forever. After surgery, phimosis does not form again.

If phimosis does not bother, can it not be treated?

Even if phimosis does not bother a man, it must be treated without fail. The sooner the patient goes to a medical facility, the less likely it is to develop complications. In the absence of adequate treatment, phimosis will progress. It is easier to cure the disease at an early stage, until phimosis has transformed into paraphimosis or balanoposthitis.

Both pathologies are characterized by a strong narrowing of the foreskin ring. A man cannot normally empty his bladder; he experiences acute pain during intercourse. Basic hygiene procedures also become impossible.

Can the foreskin be stretched?

It is possible to eliminate phimosis by stretching the foreskin only at an early stage of the development of pathology. Exercise will also help prevent scleroderma (hardening, narrowing) of the foreskin ring.

There are several main stretching methods:

• The first way. You need to try to pull the skin over the head of the penis. You need to act carefully so as not to damage the foreskin. After stretching, it is necessary to fix the position for 40-45 seconds, then smoothly return the foreskin to its original position. Experts advise using a lubricant.
• Secondway. This method is suitable for the initial stage of phimosis. You need to purchase an expander in advance in a pharmacy or specialty store. A small-diameter silicone ring should be placed under the edges of the foreskin. The expander holds the skin in the desired position for several hours.

Exercises must be performed at least 3 times a day. Before carrying out, you must thoroughly wash your hands with soap, and the genitals with warm water. If a man is allergic to lubricant, then the exercises can be performed while lying in the bathroom or standing under the shower. It is important to control the degree of pressure on the genitals - sudden movements can provoke a rupture of the foreskin. Cracking of the skin is usually accompanied by bleeding.

Phimosis in men is a completely curable disease. It is important to consult a doctor in a timely manner, who will identify the exact cause of the development and select the correct treatment. It is strictly forbidden to independently select medicines. Traditional medicine will not relieve the problem. Various infusions, decoctions and herbal lotions have a supportive effect.

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