The phimosis occurs when the foreskin (the fold of skin covering the glans penis) can retract to expose the glans. This condition can sometimes increase the risk of inflammation between the glans and the foreskin .
Phimosis exists only in men whose penis is only partially circumcised or uncircumcised. Phimosis is naturally present in infants and young children. Then he usually disappears on his own and becomes rare after adolescence.
Causes of phimosis
Phimosis almost always occurs because of coughing maneuvers performed in a newborn or young child. These forced decals cause adhesions and retractions of the foreskin tissues, which can cause phimosis.
In adulthood, phimosis can be a consequence:
- From a local infection (balanitis). This inflammation can result in retraction of the foreskin tissue, making it narrower. Diabetes increases the risk of infections of all kinds, including balanitis. Lack of local hygiene can also cause infections.
- Sclerous lichen or sclerotropic lichen. This skin condition makes the foreskin fibrous that can cause phimosis.
- Local trauma, for example, prepuce trauma. C ome men have a narrow trend foreskin that can shrink at a healing and cause phimosis.
Disorders associated with phimosis
Paraphimosis is an accident that occurs when the foreskin, once decanted, cannot return to its normal initial position, constituting a strangulation of the glans. This accident is painful because it blocks the blood circulation in the penis. A consultation with a doctor is necessary. Most often, the doctor manages to reduce paraphimosis by restoring the foreskin in place with a maneuver.
Paraphimosis may be due to phimosis, in a man who attempted to decode by forcing. It can also occur in a man who has had a urinary catheter placed, without having his foreskin back in place.
Adult men suffering from tight phimosis, who do not seek treatment, and in whom it results in an impossibility of hygiene between the glans and the foreskin, are more at risk of developing penile cancer. However, it is a rare cancer.
Prevalence
In young children, phimosis is normal. About 96% of newborn boys have phimosis. At the age of 3, 50% still have phimosis and in adolescence, at 17, only 1% is affected.
Symptoms of phimosis
Symptoms of phimosis
- Difficulty decanting the foreskin behind the glans penis.
- Phimosis often causes no pain.
- Redness, preputial edema or exacerbated tenderness of the glans.
- Difficulty in urination (when the foreskin is extremely tight).
- Sexual difficulty at the time of penetration. As the foreskin is stretched backwards, there is a risk of paraphimosis. Some men with phimosis, however, work without a problem with a condom.
- Difficulty maintaining good penile hygiene if phimosis is very tight, which can lead to infections.
Symptoms of paraphimosis
- Difficulty recalotating the glans once the foreskin retracted (often revealed during first sexual intercourse).
- Swelling and pain in the foreskin and the end of the penis.
- A purple coloration at the end of the penis, sign of the decrease in blood circulation.
People at risk for Phimosis
- The little boys that the parents put off before 5 or 6 years.
- Men suffering from a skin condition reaching the connective tissue in the foreskin, for example lichen sclerosus.
- Men with diabetes.
Risk factors
- The most often attempted capping by parents in a newborn or child before adolescence.
- The sclerous lichen (or sclero-atrophic) foreskin.
Prevention of phimosis
Why prevent? |
In infancy, the opening of the foreskin (the foreskin ring) is relatively narrow and rigid. Then, over the years, it expands and becomes more flexible, allowing the final capping. It is necessary to respect this process without trying to force it, otherwise, the tissues of the foreskin, attacked by the stretching, stiffen and one obtains a phimosis, instead of preventing it . |
Can we prevent? |
We should never try to decant a child before 5 or 6 years old and at this age, it is recommended to ask him to try to do it alone. If this is not done naturally, you must leave your penis alone! Only 1% of phimosis remains after 16 years. |
Basic preventive measures |
|
Measures to prevent recurrence |
Paraphimosis is mostly a direct consequence of phimosis. It is therefore necessary to treat phimosis to avoid paraphimosis. |
Medical treatments of phimosis
The first treatment of phimosis consists of stretching exercises of the foreskin, from puberty. In a few weeks, teenagers with a not too tight phimosis can overcome this problem.
When phimosis has not improved with exercise, some creams formulated with corticosteroid (cortisone), can be effective because they soften the foreskin.
If this is not effective, surgery is used either for a foreskin plasty (surgical enlargement of the foreskin) or circumcision (complete removal of the foreskin).
Medical treatments of paraphimosis
Paraphimosis, the glans strangled by the foreskin, is a benign problem. Manual compression is usually sufficient to reduce swelling, allowing the foreskin to be repositioned.
If that is not possible, which is rare, you must consult a doctor who will carry out this maneuver himself.
Rarely, it may be necessary to perform local anesthesia, to make an incision to replace the foreskin. Then, it is necessary to treat the phimosis if it is at the origin of the paraphimosis.