Phimosis - is the inability or difficulty in removing the head of the penis due to the narrowing of the foreskin (skin folds covering the head).
Phimosis is physiological for children up to 7 years, and is considered a pathology for adult men.
Overview
By itself, phimosis, especially in children - not uncommon, and is not a pathology. However, difficulties in deducing the head of the penis can lead to the formation of painful and dangerous complications.
Dividing phimosis to physiological or pathological is conventional, since the influence of some factors (forcible opening head boy parents, excessive zeal in hygiene) can lead to disease and the need for urgent intervention of doctors.
Causes
Exact cause of phimosis is not set, release:
- genetic predisposition to phimosis,
- connective tissue features,
- traumatic nature,
- scar nature,
- inflammatory nature of phimosis.
Phimosis in children is often combined with heart defects, flatfoot, varicocele.
development mechanisms
The occurrence of phimosis associated with uneven growth and development of the foreskin and the glans formation, especially in the period of growth and puberty. The narrowing of the foreskin leads to microtraumas and tear skin folds of the glans and inner folds of skin, which leads to inflammation and scarring, which further narrows down the hole. Very often injuries occur during erection, during the onset of sexual activity.
Phimosis in children is considered a normal variant up to 2-3 years, although permissible incomplete removal of the head up to 6-7 years. Until that time, uncomplicated phimosis is not subjected to the treatment, although it is necessary to actively control and pay great attention to hygiene.
Phimosis in men may persist from childhood, and can be formed during adolescence, due to active penis growth and formation of inconsistencies between the size of the foreskin and glans member.
signs of phimosis
The main symptoms of phimosis are difficult or impossible to complete removal of the head of the penis foreskin. When sexual intercourse or masturbation may occur:
- micro-tears of the foreskin,
- bleeding from minor to heavy,
- soreness
- straining at urination process,
- pain during erection,
- feeling of tension of the skin,
- reduced potency due to psychological stress and expectation of pain.
Depending on the degree of symptoms of phimosis are four degrees of severity:
- the first power head completely free opens in neeregirovannom state. During an erection the head is exposed with little effort
- with second-degree head is exposed erection to the efforts to bring the head is difficult or impossible during erection
- while the third degree of phimosis in the normal state of the penis head is exposed to the considerable efforts during an erection can not be uncovered, thus voiding function is not impaired
- at the fourth degree of phimosis can not be even partially withdraw the head at rest, urination impaired, urine is released drop by drop, with straining or intermittently, in a thin stream. When urination urine fills and expands sharply region between the head skin and the foreskin, forming a bag.
Diagnostics
Phimosis diagnosis performed when viewed from the penis, usually does not cause any difficulties. The diagnosis is made clinically, without additional research methods.
treatment of phimosis
Diagnosis and treatment of phimosis engaged urologists and surgeons. There are two methods of treatment:
- Conservative therapy (rarely used because of the low efficiency)
- surgical treatment.
application attempts were conservative methods:
- stretching the foreskin fingers or special tools.
- hormonal agents long courses to enhance tissue elasticity.
Conservative therapies have shown their low efficiency and are rarely at first, at least the second degree of phimosis.
The basic method of treatment is operative method.
apply:
- elective surgery circumcision with careful preparation,
- emergency surgery for dissection of the foreskin in the presence of complications. The operation of the circumcision is carried out immediately, but only at calming inflammation and eliminate the infection.
In operations foreskin is removed partially or completely, the operation is performed under general anesthesia.
complications
The most dangerous when phimosis is the formation of complications. These include:
- paraphimosis, pinching the penis head sharply constricted scar the foreskin. It may reach the penis necrosis.
- fusion of leaflets of the foreskin to the head, and the head of the stripping is not possible, adhesions are torn - there is pain and bleeding.
- colonization of the space between the head of the penis and the skin of the foreskin, in the preputial prostanstva.
In case of violation of the free removal of the penis in the prepuce smegma accumulates, the remnants of urine and semen. It is a breeding ground for germs. May occur and inflammation of the glans penis.
prevention
One hundred percent efforts to prevent phimosis does not exist, but a careful personal hygiene and lack of violence on the head opening boys are fundamental. At the first sign of phimosis is prohibited to self-medicate, doctors need help.
