The foreskin of a 10 year old child. How does phimosis manifest in boys: symptoms and treatment methods. Foreskin plastic surgery for pathological phimosis

To understand how to prevent the disease, you need to have a clear understanding of the mechanisms of its development and symptoms. A narrowed opening of the foreskin, in which opening the head of the penis is difficult or impossible, is called phimosis.

In 90% of boys, phimosis goes away by the age of seven. Until 13-14 years of age, phimosis can be observed to a slight extent. If there are problems with opening the head and the irregular structure of the penis persists, medical treatment is required.

Types of pathology

Phimosis as a disease manifests itself in two forms:

• cicatricial;
• hypertrophic.

Scar form manifests itself in the form of a reduction in the opening of the foreskin due to the formation of scars during the healing of various minor ulcers and injuries. This form of the disease most often develops after mechanical damage to the penis. In some cases, it develops due to infection.

Hypertrophic form develops against the background of congenital defects of the foreskin. The skin of the penis lengthens and noticeably narrows. Most often, overweight boys are susceptible to this type of disease.

Reasons for the development of phimosis in boys

Phimosis, as a form of the disease, is provoked by several reasons:

These reasons provoke the development of a disease that is fraught with serious complications.

Signs of phimosis in a boy

If the child is older preschool age symptoms of the disease are observed, immediate medical intervention is required.

Signs that require medical attention:

Even one of these signs indicates that phimosis has acquired a pathological form that requires immediate treatment.

Treatment of phimosis in boys

Treatment of pathology is carried out in three ways:

• medicinal;
• non-medicinal;
• surgical.

At drug treatment ointments for topical use based on glucocorticosteroids are prescribed. These drugs increase the elasticity of the epithelium, relieve inflammation and stimulate the healing of microcracks, helping to reduce the manifestations of phimosis.

Non-drug treatment used when there are no scars on the patient’s foreskin. The method consists of regular manual stretching of the above-mentioned epithelium. The foreskin is slowly pulled over the head until a mild pain syndrome appears. Perform 10 to 15 frictions several times a day. The first positive results will be visible within a month and a half.

Please note

It is better to carry out manipulations after taking a bath, when the skin is more elastic.

Surgical intervention prescribed only when other methods have failed, as well as in the presence of scars on the foreskin and severely impaired urination.

Types of surgical interventions:

• Separation of adhesions. In boys, this operation is performed under, using a metal probe and a gauze pad.
• Classic surgical method, in which three longitudinal cuts are made followed by cross stitching.
• Operation according to Schloffer. A zigzag incision is made, after which the flesh is stitched at the transition points. As a result, the hole becomes larger and the flesh is preserved.
• Circumcision- circular circumcision of the flesh. Prescribed for severe cicatricial lesions of the epithelium.

Basic treatment can be supplemented with traditional medicine.

Pediatrician Dr. Komarovsky talks in detail about the treatment of phimosis in boys:

Folk remedies for treating phimosis in a child

Baths for the treatment of phimosis:

Physiological phimosis in boys is a common problem for many male children. The child has a narrowed foreskin on the genital organ, which is why it is impossible to open the head.

In most cases, the pathology does not cause concern and passes with time. However, there is a risk of developing other disorders, so you should know how to behave in certain cases.

Possible complications

If hygiene is poor or for other reasons, there may be a risk of complications due to physiological phimosis:

1. Paraphimosis- excessive narrowing of the foreskin, which leads to compression of blood vessels and impaired circulation in the organ. Tissue necrosis and amputation of the penis without medical assistance are possible.
2. - inflammatory processes on the head of the penis under the foreskin. Develops due to poor personal hygiene or organ injury. In this case, the head swells, pain and itching appear, as well as problems with urination.
3. Fusion of the foreskin with the glans- appears in the absence of any treatment. The tissues grow together and the head will no longer be able to open. The child needs surgery.

If you observe these diseases, you should immediately seek medical help.

Prevention

Physiological phimosis develops from birth, therefore There are no specific measures to prevent the disease.

It is only possible to reduce the likelihood of developing complications in the future. To do this you need to follow the following rules:

• regularly wash the child’s genitals;
• use only children's hygiene products (soap, shampoo, creams and ointments);
• treat any, even minor, injuries of the head and foreskin in a timely manner;
• Periodically visit a urologist or pediatrician for a routine preventive examination.

Physiological phimosis not dangerous for health, if you know how to deal with this pathology.

Over time, the problem should go away on its own, but this does not mean that it should be left to chance. A child with phimosis needs special care, first of all this concerns personal hygiene.

A massage and, of course, a visit to a doctor who can give an objective assessment of the boy’s condition and, if necessary, select treatment, will not be superfluous.

Until what age is phimosis normal? Komarovsky about phimosis in boys in this video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Phimosis in children is expressed in the inability to release the head from the foreskin of the penis. This phenomenon can be observed both from birth and when the newborn reaches a certain age.

Parents do not need to be afraid that their child has this disease.

You can fight it, however, in order to start using specific techniques and methods, you must reach a certain age.

Phimosis in boys: treatment without surgery is possible. At the same time, pediatricians strongly advise against opening the glans penis of a child under the age of 5 years on his own.

It is during this period that the boy’s genitourinary system is just beginning to form, which means that your actions may not help the child, but only harm.

However, if by the age of five the situation does not change, the child feels discomfort when urinating, and the head has not begun to emerge from the skin of the foreskin, then this is a signal to begin treatment.

Species

There are various types a disease such as phimosis. Depending on what type of disease it is, the method of getting rid of it, that is, the treatment method, is also chosen.

Scarred

With cicatricial phimosis, a child has an excessive length of the foreskin, which prevents the appearance of the head of the penis. Over time, cracks and scars appear on it. Sometimes the consequence of scars is a violation of hygiene rules that the parents did not initially instill.

It can be removed either medicinally or through surgery (). However, it should be remembered that treatment of cicatricial phimosis must take place in the early stages of the development of the disease, otherwise there is no point in such treatment.

Hypertrophic phimosis in boys

Another type of phimosis is hypertrophic.

This type of phimosis is typical for those young people who have a fairly large amount of excess weight.

This disease is common in very young children, adolescents and adult men.

The cause of the pathology is the accumulation of a large amount of fatty tissue in the foreskin area, which affects a significant increase in the penis.

Such processes contribute to the accumulation excess quantity moisture, which causes various infections and complications of phimosis. The head cannot leave the tight-fitting foreskin, which is why the boy may experience pain and receive microtrauma.

It is possible to eliminate hypertrophied phimosis without surgery, but this can only be done in the early stages of the disease, otherwise there will be no effectiveness in drug treatment.

Of course, a lot of attention should be paid to diet.

Congenital

The next type of phimosis is characterized as congenital. It manifests itself in a narrowing of the opening of the foreskin, which simply does not allow the head of the penis to extend beyond the skin. Such an attack may have no reason, or it may be genetically determined, or it may be a developmental pathology in the womb.

If it is observed in the first years of life, then doctors do not recommend treating it, but if by 3-5 years the foreskin has not opened, then such phimosis is eliminated.

In order to cure this disease, both a surgical operation and a bloodless method are used, which consists of zoning, opening the head by expanding the skin.

We looked at what types of disease exist; below you will learn how phimosis in a child is treated without surgery.

Phimosis in boys: photos of treatment at home

Below you can get acquainted with the disease phimosis in boys in the photo; we will tell you about treatment at home and the speed of its implementation further.

How is phimosis treated in a child?

Very often, parents cannot independently examine all the signs of phimosis in their child. That is why the first who pay attention to this are pediatricians.

At the reception, which is held monthly, or due to the child’s complaints, it is revealed early stage phimosis. Your pediatrician should definitely refer you to a urologist, and also, prescribe various tests and examinations.

The urologist must examine the child, conduct some tests on him, perform palpation and massage.

Based on your general sensations, the sensations of the child, as well as the results of ultrasound, Doppler sonography, blood and urine tests, the urologist can draw up a treatment plan.

If the disease is in the initial stages of development, then medications, adjusted nutrition, and some other methods will help you. If the disease is in a fairly serious, moreover, advanced stage, surgical intervention cannot be avoided.

If we are talking about surgery, you will also need to consult a surgeon. Below we will look at how to treat phimosis in a child at home.

Phimosis in boys: treatment at home without surgery

How to treat phimosis in children at home? Doctors strongly do not recommend treating phimosis at home on your own. however, one can also understand parents who do not want their child to undergo surgery.

Therefore, home treatment for phimosis may be acceptable in some cases.

In order for conservative treatment of phimosis in a child to be successful, it must be approached comprehensively.

First of all, you need to prescribe drug therapy that will constrict the blood vessels, thereby facilitating the exit of the glans penis.

Besides, In addition to drugs, you can use traditional medicine methods, for example:

• steaming;
• taking a bath with medicinal herbs.

It is worth adjusting your diet and making it more dietary and acceptable for treatment.

And, of course, a separate role is given to massage, which affects the opening of the glans penis. The massage consists of slowly stretching the skin of the foreskin until pain occurs.

It is very difficult to understand when to stop, due to the fact that children can cry and scream as soon as you start the procedure, without waiting for the pain, simply because they do not like having such a procedure performed on them.

However, here parents should be as careful as possible if it is not possible to entrust such a procedure to professionals. The success of the glans exposure technique also depends on the regularity of the procedures. To make the session as successful as possible:

1. To begin with, the child should take a bath with medicinal herbs.
2. Pour infusion of chamomile, calendula, or string into the water.
3. After the skin begins to look a little steamed, the child needs to be taken out of the water and the session must be performed for at least 15 minutes.
4. By regularly carrying out such treatment, you can save your child from phimosis within the first month, and sometimes you can achieve a positive result even earlier.

There is another method of massage that relieves phimosis.

It manifests itself in the daily stretching of the foreskin until it covers the head of the penis.

This therapy is carried out during hygiene procedures in the bathroom, therefore, the child may have a positive attitude towards such a procedure, because he will be busy bathing.

The massage must be carried out very carefully, until the first pain occurs. Since this method is not as drastic as the one described above, you can expect the first results only after 3-4 months.

After you have carried out all the manipulations with the child, It is necessary to complete the massage correctly:

• you need to get the child out of the bath;
• blot lightly with a towel;
• anoint the skin with Miramistin solution;
• and then blot with a clean napkin.

After this, it would be good for the child to lie down without underwear or diapers in a horizontal position for several minutes. After this, if the child is in good mood and nothing bothers him, you can dress the baby.

It is good to carry out this procedure before going to bed at night, fatigue will not allow the child to be capricious for a long time, and he will fall asleep, forgetting about the discomfort during the procedure.

Due attention must be paid. The most common names are the following:

• Clobetasol;
• Budesonide;
• Betamethasone;
• Diprosalik;
• Hydrocortisone;
• Triderm.

All these drugs have an antibacterial effect, contain antimicrobial components that are necessary for performing a massage and maintaining the results.

In addition, the substances contained in these ointments help remove scars due to cicatricial phimosis, and also reduce the risk of new microcracks.

It should be remembered that treatment with ointment alone will not be effective, so it must be used in combination, along with massage and medications.

Also, many people prefer to add to the procedures conservative treatment phimosis in children folk remedies and recipes. Barley decoction is very popular in the treatment of phimosis.

1. A quarter of the glass is poured with a glass of boiling water and left to steep for 24 hours.
2. After this, the cooled decoction is used to wash the foreskin, which helps eliminate itching and burning, and in general has a calming effect.

A decoction of dried chamomile and linden flowers, which have a beneficial effect on the skin of the foreskin, is also widely used.

Conclusion

Above we looked at how to treat phimosis in boys at home. Pediatricians urge parents not to worry if phimosis is detected in their child in the first years of life. However, this does not mean that you should relax. Try to observe the condition of your child’s genitourinary system for several years, and if you do not see any changes, then begin to treat this attack yourself.

It is important to use the advice of a urologist or surgeon. If phimosis in boys is not treated, the disease can progress to a serious stage. You can treat phimosis in a child at home, but do not be afraid of surgical intervention if it is required. Everything is in your hands, so start monitoring your child’s health now.

Boys and girls from birth have certain physiological characteristics and differences. Diseases of the genital area always cause parents real confusion. One of these diseases is phimosis.

What is it?

Phimosis in boys is a pathological condition in which it is impossible to slightly open the head of the penis due to the presence of a narrowing of the opening of the foreskin. Typically, this pathology is manifested by an increase in the size of the foreskin and some urination disorders. The incidence of phimosis in boys is quite high.

It is important to note that it decreases with age. Thus, in children 7-9 years old, the incidence of phimosis does not exceed 10%. In adolescents, it is less than 2%.

A newborn boy has his own physiological characteristics that distinguish him from an adult man. Normally, all born babies have a connection between the head of the penis and the inner lining of the foreskin. These structural components are interconnected. It was no coincidence that nature provided this feature. This helps prevent infection from reaching the delicate tissue of the external genitalia, and therefore reduces the risk of developing secondary infection.

As a child grows up, various physiological changes occur in his body. Every second boy by the age of 1 year, the head of the penis opens. By 2-3 years this value is already 90%. In some cases, deviations still develop. They lead to the development of various diseases in children, including phimosis.

Typically, boys' reproductive system is formed before the age of 6. If a child has any deviations in reproductive health, they try to treat them conservatively or use “observational” tactics.

In many children who have various pathological conditions in childhood, by adolescence they completely disappear without treatment. In any case, you should definitely monitor your baby and monitor any changes in his health.

Causes

The only reason that leads to the development of the disease is present moment No. Many andrologists and pediatric urologists are still arguing about what contributes to the development of phimosis in children. They identify several reasons that can cause this pathological condition in boys. In some cases, the development of the disease can be caused by exposure to several causative factors simultaneously.

This pathological condition is caused by:

• Disorders of intrauterine development. Impact of adverse factors external environment or chronic diseases in a pregnant woman contribute to the formation of various pathologies during pregnancy. The stages of organogenesis in the fetus are disrupted, which contributes to the onset of various diseases in the future. Typically, clinical signs of phimosis in this case appear in a child under one year of age.
• Traumatic effects. The external genitalia in boys are quite easily damaged. Especially for kids early age. A blow to the intimate organs, a fall, or independent attempts to open the head of the penis can cause significant injury to the child. The consequence of this, as a rule, is the formation of persistent phimosis.

• Infectious and inflammatory pathologies in the area of ​​the external genitalia. A child's body, due to the fact that it has reduced immune resources, is easily exposed to any infectious agents. Usually they become a wide variety of viruses and bacteria. Getting into the intimate area through the bloodstream or through contact and household contact, they can cause severe inflammation in the child. The consequence of this, as a rule, is the formation of persistent andrological pathologies.
• Complications of urological operations. An incorrectly chosen surgical procedure in most cases leads to the formation of various long-term complications. One of them is phimosis. Damage to the tissue of the glans penis or foreskin contributes to the formation of pathologies and acquired anatomical defects in this area.
• Insufficient number of connecting structures. This feature is individual and occurs only in children who have a special predisposition to this.

Species

Doctors distinguish several forms of this pathological condition. This classification is necessary in understanding the essence of the disease, as well as for drawing up examination and treatment tactics in the future. Thus, phimosis can be congenital, hypertrophic or cicatricial.

A large number of cases of cicatricial phimosis occur due to violation of personal hygiene rules. This leads to the fact that infection easily penetrates into the area of ​​the external genitalia and an inflammatory process develops.

Much less often, cicatricial stenosis is a congenital pathology. This pathological condition is characterized by a fairly long foreskin, which prevents the glans penis from fully opening. Due to severe inflammation, various cracks appear on the skin and scars form.

In this case, it becomes extremely difficult to carry out hygiene procedures. If inflammation intensifies, then phimosis can even develop into a very dangerous condition - paraphimosis. The treatment strategy for cicatricial phimosis is the prescription of conservative therapy or surgery. The choice of treatment tactics remains with the treating urologist. The prognosis of the disease is favorable. The risk of complications is average.

According to statistics, most often the development of a hypertrophic form of phimosis is caused by the child being overweight. In this case, obesity is most dangerous in the lower abdomen and groin area. The abundance of fat cells in the reproductive area makes it easy for fat folds to appear there. It is important to note that this form of the disease occurs not only in the youngest patients, but also in adult men.

Large accumulations of adipose tissue lead to the head of the penis is slightly compressed. The skin begins to get wet, which causes the formation of various macerations and irritation. Compression of organs located in the reproductive zone by adipose tissue leads to the fact that the foreskin of the penis begins to tightly cover its head. This significantly aggravates the course of the disease. Pronounced moisture in the skin leads to various irritations appearing on the skin, which become an excellent environment for the development of pathogenic bacteria.

In the treatment of hypertrophic obesity, normalizing the daily routine and prescribing a therapeutic hypocaloric diet are very important. For such children, the necessary physical training regime must be selected. Therapy for hypertrophic phimosis in most cases is conservative.

Doctors from several specialties take part in the treatment of the child simultaneously.

Congenital forms of phimosis are quite common. Many doctors agree that the cause of this pathological condition is congenital anomalies of intrauterine development and genetic predisposition. In some cases, specialists cannot identify a specific cause that caused the baby to develop adverse symptoms. Congenital phimosis is characterized by the presence of a pronounced narrowing of the opening of the foreskin, which is manifested by the impossibility of exiting the head of the penis. Quite often, such conditions are accompanied by the presence of multiple synechiae in the baby.

Doctors do not actively treat congenital phimosis in infants. Basically, they choose a wait-and-see approach, which allows them to monitor the course of the disease and predict the outcome of the disease in the future. Pediatric urologists treat congenital forms of phimosis.

If the doctor, during an examination of the child, finds signs of illness, he “puts” the baby on the dispensary register. In this case, you should visit the doctor at least 1-2 times a year.

During examination, doctors diagnose some children with “proboscis phimosis.” This pathological condition is hypertrophic. It is characterized by excess skin formation in the area of ​​the glans penis, which creates a “proboscis”. The tactics in this case are the same as for other forms of the disease. If conservative treatment is ineffective, surgery is performed.

Symptoms

The clinical signs of this pathological condition are associated primarily with impaired dilation of the glans penis due to pronounced narrowing of the opening. This symptom is the most characteristic. As a rule, parents notice it during regular hygiene procedures.

Some dads and moms make an extremely unacceptable mistake. They try to “open” the head of the penis on their own through overcoming effort. This should absolutely not be done! Such self-medication can contribute to injury to the baby. This pathological condition should only be treated by a pediatric urologist. Self-reduction is unacceptable!

In addition to the main symptom of the disease, there are other clinical signs of the disease. These include:

• Painful urination. This symptom does not always occur, however, it significantly aggravates the baby’s well-being when it appears. The mild course of the disease is not accompanied by urination problems. More severe and complicated forms of the disease contribute to the appearance of disturbances in urinary diversion. The baby may feel pain when urinating or even severe pain.
• Urinary disorders. In some babies, especially with quite severe phimosis, urine may be released with some “interruptions” or flow in a thin stream. If this symptom is accompanied by pain, the child’s well-being is sharply disrupted. The youngest patients usually show this by crying. Older children begin to be capricious and run to the toilet more often to urinate.
• Soreness in the groin area. Typically, this symptom appears when the inflammatory process spreads throughout the intimate area. If phimosis is complicated by a secondary bacterial infection, then the child develops additional adverse symptoms. These include: suppuration from the opening of the glans penis, swelling and swelling of the foreskin, marked increase in body temperature and swelling of the testicles.

The severity of symptoms may vary. Milder variants of the disease, as a rule, are practically asymptomatic.

The main clinical sign in this case is a narrowing of the opening of the head of the penis and the inability to fully open it.

The severe course of the disease is accompanied by the appearance of numerous symptoms that require conservative treatment. When the first signs of phimosis appear, your child should immediately consult a pediatric urologist.

What does it look like in newborns?

In all boys born, the glans penis and foreskin are fused. As the child grows older, this situation changes. There is no need to rush into surgical treatment. Physiological phimosis completely disappears in almost 90% of children by the age of three. Doctors only recommend carefully monitoring the youngest patients, as well as providing proper regular hygienic care.

Often, parents of boys independently discover certain physiological characteristics in their child. The skin of the foreskin of newborn babies is very delicate and easily vulnerable. It is tightly fused with the head of the penis. When trying to expose the head on their own, the child feels pain, begins to be capricious and even cry.

The skin of the foreskin secretes a special substance - smegma. It has a white color and a specific smell. With age, its quantity and composition changes somewhat. The formation of smegma is a completely physiological process. It is necessary for the inner layer of the foreskin to “peel off” from the head of the penis. This physiological situation helps improve the opening of the head.

If too much smegma is formed or its composition changes significantly due to chronic diseases, then the process of normal development of intimate organs is disrupted. Also, this situation can lead to the baby developing clinical signs of a variety of infectious diseases. Smegma is an excellent nutrient medium for microorganisms. Carrying out thorough hygienic care for a newborn baby is necessary as a prevention of diseases of the intimate area.

Diagnostics

The appearance of the first unfavorable signs of the disease should motivate parents to consult a doctor. The doctor will conduct the necessary clinical examination, as a result of which he will be able to establish the correct diagnosis. In some cases, phimosis is accompanied by other pathological conditions that require careful monitoring or adequate treatment.

Diagnosing phimosis is usually not a significant difficulty for doctors. To establish a diagnosis it is quite A clinical examination is sufficient. Additional diagnostics may be required only in complex cases or with a complicated course of the disease. For this purpose, the following are prescribed: general blood and urine tests, biochemical examination (if there are complications), ultrasound examination, Doppler sonography and other methods as indicated.

Complications

The prognosis for phimosis is conditionally favorable. Usually the disease proceeds without the development of long-term negative consequences. However, phimosis can also be dangerous. Especially in weakened children or children with immunodeficiency conditions or concomitant chronic diseases. Treatment of all complications is carried out only in a hospital. For this, the baby is hospitalized in the urology department.

A fairly common complication of phimosis is paraphimosis. This pathological condition is characterized by the appearance of infringement of the glans penis by the foreskin. Most often it occurs during attempts to forcefully open it. Quite often recorded in children aged 7-10 years.

Paraphimosis is accompanied by the appearance of severe pain, which brings significant discomfort to the child. This pathological condition requires emergency treatment in a hospital setting.

Organs in the intimate area are very sensitive to any infections. The spread of the inflammatory process leads to the inflammation spreading to neighboring anatomical formations. A fairly common complication in this case is urethritis. This pathological condition occurs due to the fact that bacteria enter the mucous membrane of the urinary tract. Urethritis is accompanied by the appearance of various unfavorable symptoms: difficulty urinating, pain when going to the toilet, pain in the groin area and lower third of the abdomen.

It's important to note that physiological phimosis does not affect conception. This pathological condition goes away on its own by school age.

Only complicated variants of phimosis can cause difficulties in conceiving a child in the future. However, this happens extremely rarely. Treated phimosis does not pose problems in the future for planning children.

Treatment at home

Self-therapy should be carried out only under the close supervision of specialists. Typically, such home treatment comes down to following all medical recommendations, as well as proper hygiene procedures. All manipulations must be carried out in a fairly gentle manner. Daily hygiene should be monitored from the very first days of a child’s birth. It is also worth gradually accustoming your baby to this.

Some doctors practice a method of gradually opening the head of the penis. This is done gradually, no more than 0.5 -1 mm per day. All movements should be smooth and of low intensity. They are usually performed after a warm bath, when the pelvic floor muscles are as relaxed as possible. As an auxiliary therapy, various ointments are used that were prescribed by a doctor.

You can add various ready-made antiseptic solutions and decoctions of medicinal herbs to the bath that is carried out before the procedure. The following are ideal remedies: chamomile, calendula, a weak solution of potassium permanganate, sage and others. Such baths are prescribed 2-3 times a week for 10-15 minutes. The water temperature should be pleasant and not cause discomfort to the child.

After the procedure, the foreskin should be lubricated with a special medicinal ointment, which will be prescribed by the doctor. These drugs have good wound healing and regenerative properties. Such home treatment should be carried out only with the mandatory supervision of the treating pediatric urologist.

Drug therapy

To eliminate adverse symptoms, doctors prescribe various medications. According to their mechanism of action, they can be different: anti-inflammatory, wound healing and regenerating, improving blood circulation, analgesic. The choice of treatment regimen depends on the pediatric urologist. In children under 6-7 years of age, active therapy is not carried out. Preference is given to conservative methods performed in gentle ways.

Doctors prescribe various ointments and creams as local treatment. They are usually applied to the skin in the foreskin area after a hygienic bath. “Diprosalik”, “Miramistin”, “Levomekol”, “Akriderm” help prevent secondary infection and promote rapid tissue healing. These agents have an excellent antiseptic effect, which is necessary to prevent complications of phimosis. Hormonal ointments and products containing antibiotics must be prescribed by a doctor according to strict indications. Independent use of such drugs without consulting a doctor will help significantly aggravate the course of the disease, since these drugs have a number of side effects with long-term use.

Typically, tetracycline ointment is used to treat pathological conditions. The dosage, frequency and duration of use of this drug is determined by the attending physician. All antibacterial drugs are prescribed as a course of treatment. During treatment, strict monitoring of the effectiveness of the prescribed therapy is mandatory.

Hormonal drugs are prescribed for cicatricial phimosis, as well as in cases where previous therapy is ineffective.

Hydrocortisone ointment and Fluorocort have a pronounced anti-inflammatory effect, heal small wounds and cracks in the skin, and also help improve the exposure of the glans penis. Hormone therapy is also used in a course. With long-term use of medications, adverse systemic and local side effects may occur.

In children under 6-7 years of age, in most cases, only conservative therapy is performed. As a rule, it helps to improve the condition and reduce adverse symptoms. This treatment leads to cure in more than 90% of cases. In situations where conservative therapy is unsuccessful, various invasive techniques and even surgeries are used.

Surgical treatment

Today, there are several methods of surgical treatment of phimosis. These include both very common methods and those used only in some countries. In some states, a number of operations are not carried out for ethnic and spiritual reasons. In any case, the choice of treatment tactics remains with the attending physician and must be agreed upon with the baby’s parents.

Operations can be carried out in the traditional way. In this case, the surgeon incises the foreskin and makes axial cuts on it. All excess skin is removed. The doctor then stitches the foreskin sections together. This contributes to a pronounced expansion of the opening of the glans penis. It is easily exposed without pain. This operation is performed under anesthesia.

Another fairly popular method of surgical treatment is considered Shkloffer operation. In this case, the foreskin is excised in a zigzag manner. Then the edges of the wound are sutured. This technique also allows you to excise excess areas of skin that significantly interfere with the movements of the glans penis. Conducted this operation usually under local anesthesia.

Circumcision is a fairly common procedure around the world. The prerequisites for its implementation are usually not only medical. Circumcision of young boys is also carried out for spiritual and ethnic reasons. This procedure is painless if performed on very young patients. In older children, it must be carried out with mandatory preliminary anesthesia.

One of the most minimally invasive procedures today is excision of excess skin using a laser. This technique is quite safe and can be used even in pediatric urological practice. During this procedure, the child experiences virtually no complications.

The laser allows you to minimize blood loss, reduce the risk of developing postoperative scars and long-term adverse effects.

In outpatient settings, pediatric urologists resort to excision of various adhesions using probes. This technique will have a positive result only when carried out in children with mild forms of uncomplicated phimosis. No type of anesthesia is usually used for this procedure. The doctor inserts a special medical metal instrument - a probe - into the space between the foreskin and the glans. By making movements of small amplitude, the probe “opens” the anatomical zone.

In the first month after surgery, all active physical activity is limited. Special restrictions are imposed on sports where there may be injuries. Walking in the fresh air is a good option for physical activity in the first month after surgery. Active games can also be present in the baby's daily routine. The expansion of the physical regime is carried out systematically, under the supervision of the attending physician.

To quickly heal damaged tissues, doctors prescribe various anti-inflammatory ointments. They are usually used topically 2-3 times a day. They are applied to the skin of the foreskin, and in some cases to the head of the penis, after daily hygiene procedures.

To improve the absorption of medications, leave the medications on the skin for a few minutes until completely absorbed.

Prevention

The main task with phimosis is to prevent various infections from getting under the skin of the foreskin and on the head of the penis.

Prevention of secondary infection is an important goal in this pathological condition.

To do this, you should use the following tips:

• Carry out regular hygiene procedures. For this purpose, special children's cosmetics are suitable that do not contain alcohol or aggressive perfumes that can cause severe allergic reactions in a child. A child should be taught to use the toilet every day from a very early age. To preserve reproductive health for many years, such hygiene procedures should be carried out 2 times a day: in the morning and before bed.
• Avoid complications of chronic diseases. Concomitant diseases internal organs can significantly aggravate the course of pathological conditions in the intimate area. Compliance with the recommended regimen, optimal healthy nutrition and active physical activity contribute to the baby’s well-being and strengthen his immunity.

To learn what phimosis is in a boy, see the following video.

Phimosis is a narrowing of the opening of the foreskin. With this disease, the head of the penis in boys either does not open at all, or opens, but with difficulty, causing pain.

In 96% of newborn boys, the head of the penis does not open completely due to insufficient mobility of the foreskin. In boys aged 6 months, physiological phimosis is detected in 80% of cases. In boys aged 3 years, the head of the 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 loses its elasticity due to injury or illness. In this case, acquired phimosis may form. Such phimosis in children and adults manifests itself 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:

1. The head is freely exposed in a calm state and with little effort - during an erection.
2. The head in a calm state is exposed with some effort. Exposure of the head during an erection is impossible.
3. The head is not exposed at rest or is exposed with significant force. Exposure of the head during an erection is impossible. Urination is not difficult.
4. Even partial exposure of the head is impossible. Urination is difficult. Urine is released dropwise or in a thin stream.

If you suspect your baby has phimosis, you can talk to the pediatrician, he will examine the baby and tell you if there is any reason to worry. It is strictly forbidden to retract the foreskin on your own; rough intervention can cause harm.

An attempt to “speed up” the process can lead to such undesirable consequences as rupture of the foreskin (subsequently a scar forms at the site of the rupture, which can lead to worsening phimosis in children) or paraphimosis - pinching of the head of the penis by the foreskin.

Causes of phimosis in boys

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

Causes of pathological phimosis are:

• penile injuries;
• (inflammation of the head or foreskin);
• lack of elastic component in connective tissue(results from a genetic disorder).

At birth, narrowing of the foreskin is observed in the vast majority of newborn boys. This type of phimosis in children is called physiological and is not a pathology. Physiological phimosis in boys is temporary. It is painless.

If cryptorchidism or hypospadias is observed simultaneously with phimosis, they speak of an anomaly in the development of the paramesonephric duct, which developed in the prenatal period under the influence of toxic or infectious causes.

Cicatricial phimosis

Cicatricial phimosis is a narrowing of the foreskin to a critical state. This type of phimosis is formed due to the appearance of a scar ring, which makes it difficult to remove the head of the penis or makes the removal procedure, in principle, impossible.

One of the complications that results from advanced cicatricial phimosis is paraphimosis. This condition is characterized by pinching of the glans penis by the foreskin. The head turns blue, swelling of varying severity is observed. Pain syndrome appears.

Symptoms

Phimosis in boys can be determined by the following signs:

• difficulty urinating (the stream of urine is interrupted);
• inflammation of the foreskin and severe itching;
• hanging over the head of the foreskin or pinching it;
• incomplete closure of the head;
• the head may turn blue and cause pain in the child.

Such symptomatic indicators can manifest themselves individually, or they can appear together. In any case, when the first suspicious signs appear, you should consult a doctor.

A dangerous complication of phimosis: paraphimosis

A serious complication of phimosis is paraphimosis. In children, the pathology is usually formed as a result of a violent attempt to open the head of the penis. This is a disease in which the head of the penis, which extends beyond the foreskin, is pinched. Being in a tight ring, the head swells, and accordingly the pressure of the ring increases.

Symptoms of paraphimosis are a bluish tint and swelling of the penis, severe pain. After some time, the pain becomes less intense due to a serious circulatory disorder. Without specialized help, the pinched head becomes black or purple.

Complications that require specialist help also include:

• posts;
• balanitis;
• balanoposthitis;
• urinary retention.

Phimosis in boys: before and after photos

You can find out what phimosis looks like in the photos below.

How to treat phimosis in boys

Treatment is carried out only if the child’s phimosis has turned into a pathological form or in a physiological form - certain problems with urination have appeared. The intervention involves complete or partial removal of the foreskin.

• With 1 degree of narrowing in a child under 13 years of age, treatment is not carried out.
• With grade 2, you can also do without surgery if you use the technique of gradually stretching the foreskin. Only a urologist shows the method of implementation.
• The third degree can be treated with conservative treatment along with dissection of the adhesions between the foreskin and the genital organ enveloping it.
• For grade 4, only surgery will help.

Methods for treating phimosis in boys:

• Non-drug. Regularly retract the foreskin by hand.
• Medication. Most often, an ointment based on glucocorticoids is prescribed. The ointment helps increase the elasticity of the skin fold, heals microcracks, and eliminates inflammation. The most popular ointment is Clobetasol, Betamethasone.
• Operational. Prescribed in the absence of a positive effect with any type of conservative treatment.

It should be noted that homeopathy and traditional medicine completely ineffective in treating phimosis. But they are actively used as an additional bactericidal, anti-inflammatory and softening effect, if the patient is not allergic or intolerant to decoctions of string, chamomile and calendula.

Treatment of phimosis in boys at home

When treating phimosis at home, a gradual opening of the head by 1-2 mm may be recommended. The procedure is carried out after a warm bath, preferably with the addition of antiseptics: a weak solution of potassium permanganate, a decoction of chamomile, calendula, sage. It should be taken 2 times a week for 10-15 minutes.

Previously, the technique of instantly opening the foreskin with a sharp jerking movement was widely practiced. This procedure is extremely painful for the boy and can cause psychological trauma.

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

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

Video: Dr. Komarovsky

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

Operation

For phimosis in boys, surgery is performed only when it is impossible to achieve the desired effect from other methods of therapy. Surgical treatment consists of making three longitudinal incisions with transverse stitching. In boys, the essence of the operation is to separate the adhesions of the preputial sac using a gauze pad and a metal probe.

1. Helps a number of patients Shkloffer operation. Under local anesthesia, the surgeon makes a zigzag incision, after which the edges of the resulting wound are sutured in such a way that the area of ​​​​the flesh increases while preserving all its tissues.
2. Separation of adhesions. In children, this procedure is most often performed with a metal probe and a gauze pad. This type of operation is minimally traumatic and local anesthesia is used.
3. Circumcision. Conventional circumcision of the foreskin. Most often it is prescribed for severe scarring of the epithelium.
4. Classic surgical method, used in modern clinics, is the creation of three longitudinal dimensions with their subsequent cross-linking.
5. Circumcision may be the solution to the problem.- an operation in which the foreskin is completely excised and the head of the penis remains exposed permanently. The disadvantage can be considered the fact that over time the open surface will become somewhat rougher and change sensitivity.

There is no need to be afraid of the operation, it lasts 15-20 minutes, the boy will be able to walk after a few hours. The risk of complications if the operation is performed in a hospital is no more than 0.1-0.2%. In addition, surgical treatment is the most effective and helps the patient in 99-100% of cases.