What is phimosis
At birth, boys are often due to the narrowhole free excretion foreskin of the penis head is not possible. Urination is not broken. No complaints. This physiological phimosis. You can live in peace. From the first months of life, parents report an erection of the penis. This occurs when you urinate, or spontaneously, at any time of the day. The penis is enough to gently but firmly, and gradually expands the narrowed foreskin. Thus, it occurs within 2-3 years itself solve this problem. Recommendations are extremely simple and delicate. Observe the child's genitals clean and observed the surgeon or urologist.
From the anatomy known that the foreskinmember consists of two layers: the outer and inner. Quite often, the inner layer is soldered embryonic spikes (senehiyami) with the head of the penis. During the growth of the penis foreskin reduced adhesions are separated and the head, pushing the preputial sac, freely goes out. Often, however, the problem remains. In children after 3 years it is necessary to resort to small surgical procedure: Dilution of restricted openings foreskin separation senehy using surgical instruments. With careful and properly conducted treatment, the problems usually does not happen. Then, within a few days is recommended baths with slightly pink solution of potassium permanganate, and the daily processing of the glans penis with sterile petroleum jelly or water-soluble ointments (levomekol etc.).
It should be noted that a certain group of patientsthere are no senehii foreskin phimosis. In that case not have to wait up to 3 years. It is necessary to carry out this manipulation at an earlier age. In the prepuce from the coronal sulcus of the penis during the first year of life accumulates secret. It is called smegma. This secret is derived from the discharge of sebum and horny epithelium. It is a "tvorozhestoobraznuyu" mass of yellowish or whitish color. Along with the breeding of the glans penis and the elimination senehy, and be sure to remove smegma.
There is a category of patients with congenital phimosis,which may only be cured quickly. This hypertrophy (excessive development of the leaves of the foreskin) and atrophic phimosis (sharp narrowing of the opening of the foreskin from the underdevelopment of the latter). Treatment options include: in hypertrophic form in most cases it is possible to avoid the circular excision of the prepuce sheets or "cutoff".
have a great operation on arms Surgeons,entitled "preputsiotomiya". It allows you to create a normal external opening of the foreskin without "cutting". After the operation the foreskin completely covers the glans penis and removal of the head free. When atrophic form of phimosis "circumcision", unfortunately, can not be avoided. However, this inherent problem. Much more annoying issues purchased. About them in detail.
The main and most difficult category of patientsare patients with cicatricial phimosis. This is when part of the foreskin of the penis is reborn with the appearance of the scar. The reasons for this are well known. In some cases, when infected and prepuce smegma, there is an inflammation of the foreskin - balanoposthitis. Child Complaints painful urination, penile redness and purulent discharge from the opening of the foreskin cause parents with little patient to the doctor. Consultation with a specialist is required, and as quickly as possible. Treatment of this disease probably conservative. We believe that in the acute period of starting treatment should be extremely cautious. Repeated baths with slightly pink solution of potassium permanganate and the processing of the penis with water-soluble ointments, in most cases, make it possible to stop the inflammatory process. Then, after the inflammation subsided, we conduct removal of the head of the penis with the division senehy. There comes a full recovery.
Sometimes in severe and advanced formsbalanoposthitis have to perform this manipulation in the acute period. If swelling of the penis and the presence of inflammation, "toilet" head comes with breaks in the opening of the foreskin. These breaks sometimes heal with scarring. The outcome of such treatment is often cicatricial phimosis. Later "circumcision" is inevitable.
There is a small contingent of patients inearly elimination of a one-time head of the penis and instrumental division senehy. With a very narrow opening of the foreskin, a one-time removal of the head of the penis, can be accompanied by micro- breaks sheets foreskin and its significant edema. Later in place breaks sometimes forms a scar. In addition, early removal of the glans penis is fraught with the danger of another. The fact is that after the surgical procedure is necessary every day for a week to carry out removal of the head of the penis and its treatment with sterile petroleum jelly or water-based ointments. If you do not, senehii may occur again, will again head removal is impossible. Parents tend to spend these manipulations at home. Someone from the home keeps screaming with fright and pain of the child, and someone is trying to bring the head of the penis for its processing. Finally managed to do it, all worked up ... and do not reduce a head. The foreskin of the penis had infringed on the level of "crown" furrow head and does not allow it right. So far, so complicated. It paraphimosis. Dear parents, if you are within the first minute could not straighten infringement of the glans penis - urgently to a surgeon. Eliminating paraphymosis possible, but if the time spent, trying to do it is under anesthesia. In rare cases, saving only the operation to emergency indications. That's harmless manipulation can lead to emergency surgery.
In conclusion, a few recommendations. The necessary hygiene, attentive and sensitive attitude to the genitals of the child. Be sure to periodically visit the surgeon. And not only when need help in school or kindergarten. The main problems can be revealed and eliminated before the occurrence of complications. In general, to the need of the planned consultations with specialists for young parents often attitude, to put it mildly, cool. Dear parents, the child's health - the most important thing for you. It is better to prevent than to cure. Do not forget about it.