Narrowing the foreskin is the classic definition of phimosis. But in fact, under the mask of phimosis, much more serious violations may be hiding than just preputial stenosis (narrowing). Phimosis will not be exactly called disease, as it means more anatomical features of male sexual morphology, which can create the prerequisites for possible complications or diseases.
With phimosis, preputial stenosis prevents the actual opening of the penis balanus, which makes not only painful intercourse (dyspareunia), but also just an erection. In severe phimosis, a progressive narrowing of the external opening of the urethra and the man complains of discomfort or pain during urination.
Classification of phimosis
There are several types of phimosis. Congenital phimosis: : preputial stenosis is present from birth. In such circumstances, surgery is recommended only when the patient complains of serious difficulty urinating or when the form of the foreskin does not allow for proper hygiene. In therapy, recommendations for correcting phimosis are contradictory. Some doctors recommend the exercise «scroll» for people with phimosis, in order to increase skin elasticity. And other experts speak out against preputial gymnastics, especially for children, since it is considered the cause of acquired phimosis.
Acquired phimosis: : sometimes occurs as a result of inflammatory processes in the penis balanus and foreskin (balanoposthitis, balanitis), bacterial infections and preputial gymnastics. In this case, the patient complains of a progressive narrowing of the foreskin. In this case, surgical treatment is recommended.
Complications of phimosis
As mentioned above, phimosis is not a disease, however, if present, the patient is at risk of balanoposthitis, postitis or balanitis in acute form due to accumulation of smegma and urine. The foreskin becomes painful, itching, redness occurs. When phimosis is accompanied by a short bridle, the patient is usually circumcised. Phimosis can be complicated by the so-called » strangulation of the head or paraphimosis. Paraphimosis leads to edema and necrosis of preputial tissues. In this case, surgery is necessary to increase the preputial opening.
Diagnosis of phimosis
Diagnosis is based on the clinical observation of a specialist. Typically, a biopsy or other invasive test is not required, except when the patient complains of difficulty and burning during urination.
Typically, congenital phimosis is not a serious condition, and if there are no complications, then it’s not worth doing an operation or applying any other types of treatment. The doctor may prescribe ointments to the patient, based on steroidal substances, which are rubbed with careful movements aimed at opening the head. However, this is often not necessary, as the condition can be aggravated.
In patients who, in addition to preputial stenosis, show a clear picture of urination disorders, circumcision can be an effective solution to the problem. You must understand that inability to urinate easily and simply leads to serious complications at the kidney level. There is another option for the treatment of phimosis, in addition to circumcision, is the expansion of the preputial opening and / or stretching (lengthening) of the frenum.
