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Phimosis – congenital or acquired

Phimosis is a condition associated with wrong hygiene or improper care. Once it was considered a genetic defect , but long-term observations proved it is the effect of improper body washing. Tiny children – up to the age of 2–3 years, they have a physiological foreskin “glued” to the penis’ glans. It is the fatty discharge in which specific bacterial flora develops and accumulate exfoliated epithelial cells.

Symptoms

At about 2 years of age, the foreskin gradually begins to peel off and the mastic rinses out during bathing.

It should be remembered that you must not force the foreskin down as this will cause severe pain. At 3-year-old, a boy’s foreskin should now slide off the penis’ glans – so it is possible to maintain accurate hygiene, consisting in washing the glans and removing the mastics from the gastric groove. Otherwise, bacteria accumulating there can lead to inflammation, and as a result the opening of the foreskin may shrink. This will further aggravate the problem, urine retention and bacteria under the foreskin.

If it is impossible to remove the foreskin from the head of the penis in a child of about 3 years of age, consult this situation with your doctor. It must not be pulled by force!

Treatment

Phimosis is a condition in which the main form of treatment is the so-called conservative treatment consisting of reducing inflammation and strict compliance with hygiene. It happens however, that the child does not improve anyway, and then it is necessary to carry out the surgery under general anesthesia, which takes place after prior consultation at the surgery clinic and pediatric urology of our clinic.

Pre-procedure consultation

During the consultation, the doctor informs the parents about the course of the operation, contraindications and effects, postoperative care and how to look after your baby after surgery. He interviewes parents about other diseases of the toddler, medications taken on a regular basis, allergies and general health condition. He also orders laboratory tests (such as blood count and blood type) to be performed. Next consultations with an anesthesiologist takes place and the date of the procedure is set.

The course of the operation

Phimosis surgery is considered a simple surgical procedure. It consists in widening the mouth of the foreskin (thanks to which it is possible to slide it off) or complete removal of the foreskin. During the widening, it happens that postoperative scars cause its narrowing again and the need to repeat the surgery. Therefore, the second method is safer, and additionally results in a 100% accuracy.

Post-treatment recommendations

After the procedure, the child must wear a dressing for 2 weeks and the penis must be kept in the top position, which accelerates and facilitates healing and accelerates the disappearance of the swelling. You can stick it with a plaster onto the baby’s belly. During this period, antibiotics and soothing ointments such as alantan is suggested to use, because the glans will be highly sensitive. It is important that parents follow the instructions of the doctor and put on follow-up visits.

It is worth emphasizing that phimosis is a condition that can also appear in adults, as the result of inadequate hygiene. In our clinic, pediatric and adult urology and
surgical procedures are performed by the experienced specialist – Phd. Michał Wolnicki.