Difficulty or inability to open the glans penis in the background of scarring and narrowing of the foreskin, which is called "cicatricial phimosis". In men the disease is usually secondary, or is the result of untreated phimosis in childhood. The pathology of suffering from 2 – 3% of men. Cicatricial phimosis brings a lot of inconvenience to the men, in addition to the impossibility of normal hygiene, such failure adversely affects the quality of sexual life, and in severe cases – to violate the act of urination.
In addition, because of the accumulation of smegma in the foreskin SAC and breeding of bacteria can develop following diseases:
- the urethra;
Smegma is a product of the secretion of glands, has carcinogenic properties that could lead to cancer of the penis. Therefore, an adult man, even as a preventive measure, you need to get rid of phimosis.
The lack of skills of proper hygiene at a young age – before disposing factor in the formation of adhesions of the glans penis with the skin.
What is phimosis
In young children, the lengthening and narrowing of the foreskin is a physiological nature. As a rule, the growth of the penis, the head open independently. With some boys this happens in 3-4 years, the other 6 – 7, medical procedures, running closer to the youth. Exception – pronounced phimosis, which is to prevent the flow of urine and recurrent balanitis or balanoposthitis.
In adults, most are diagnosed with cicatricial phimosis. It leads to inflammation of the inner layer of the foreskin and the glans of the penis in the background of various diseases, among which are the leaders of sexually transmitted diseases, recurrent urinary and genital candidiasis, diabetes, genetically determined change in the connective tissue, burns and injuries of the genital organs, obesity. Reason – the decline in the elasticity of the tissue and formation of adhesions (scarring).
What are the symptoms of cicatricial phimosis
There are several symptoms, cicatricial phimosis, which a urologist, after a medical examination makes the diagnosis. Typical signs:
- the inability to use head;
- cicatricial changes of the skin;
- pain when trying to move the foreskin;
- discomfort during intercourse caused by blood filling the corpora cavernosa, to increase the diameter of the member and the increased compression of the phimosis ring;
- the occurrence of the opening of the foreskin as a result of trauma and reversibility;
- painful night erections.
When you join a secondary bacterial microflora appear purulent discharge.
Cicatricial phimosis in men is not resolved on its own, medical attention is necessary, 100% of the cases.
This condition develops when trying to reveal the head, with a little effort, or after sudden movements during intercourse. The foreskin moves, but tight phimosis ring compresses the head of the penis, which leads to swelling and poor circulation in the body. Pain syndrome is expressed significantly in paraphimosis, the glans penis becomes bluish tint.
The state is considered to be a urological emergency and requires immediate hospitalization for urgent operative treatment.
Procrastination leads to tissue death, in extreme cases amputation of the penis.
Stage cicatricial phimosis
There are 4 steps:
Step 1: the glans penis is exposed as a "calm" state, during erection, problems can arise;
Step 2: difficulties with exposure of the head erectus and calm state, the pain.
Step 3: the head is not open, the foreskin moves with difficulty, the appearance of the areas of trauma rupture of the adhesions, the separation of droplets of blood. The progression of adhesions leads to the next step.
Step 4: inability to lift the head, a significant narrowing of the phimosis ring problems with the flow of urine, filling his foreskin pouch during the act of urination, to change the quality of the urinary stream.
What tests are needed cicatricial phimosis
Laboratory examination includes the following tests, which they need before hospitalization for the treatment of:
- The general analysis of blood and urine;
- blood for syphilis, hepatitis b and C, HIV infection;
- >the blood sugar;
- screening for sexually transmitted diseases confirm the possible cause;
- blood group and RH factor;
- determination of the coagulation values the blood (coagulation);
- the study of urethral discharge microscopy;
- copious purulent discharge – tank.seeding flora and sensitivity to antibiotics.
Instrumental studies of cicatricial phimosis uninformative and suspected inflammatory diseases of the male genital tract.
If the exposure head is fused to any tumor, it is possible to perform biopsies for later histological examination.
Sometimes in cases of suspected lymph nodes lymphadenitis prescribe ultrasound examination of regional lymph nodes.
Treatment of cicatricial phimosis in men
In the early stages of the disease and without pain, perhaps the use of conservative treatment. Note that the future positive resolution of the issue, these patients should be the risk of recurrence. Because there is already a tendency to adhesion, a radical solution is surgery.
Drugs conservative treatment:
- Corticosteroid cream. Relieves inflammation, increases the elasticity of the foreskin, to relieve the swelling. Application of hormonal creams to artificially perform the stretching of the foreskin.
- Antibacterial drugs. Inhibit the growth and reproduction of bacteria, is a potent anti-inflammatory effect. When a severe inflammation of antibiotics with a broad spectrum of activity prescribed inside the mouth, local treatment more suitable products in the form of creams.
- Antiseptic solutions. Spread baths or lotions with a solution of potassium permanganate (potassium permanganate), sodium bicarbonate (baking soda), herbal plants, which have anti-inflammatory, wound-healing properties: chamomile, calendula, sage, st. john's wort, oak bark.
In any case, before the planned surgical treatment is justified to cut short the phenomenon of inflammation.
Surgical treatment of cicatricial phimosis
Laser treatment used in the early stages of the disease. In these cases, the use of lasers, such as photo-degradation is an effective and less traumatic way to solve a delicate problem.
The benefits are the following:
- the rapid recovery of the patient after intervention;
- the ability to save the foreskin and the normal sensitivity of the penis head;
- no bleeding, scar deformity;
- a small risk of getting the infection;
- security surrounding tissues;
- the ability to perform procedures on an outpatient basis.
Treatment of cicatricial phimosis is performed under general anesthesia and lasts 30-40 minutes. Outpatient treatment involves applying anti-inflammatory creams, antiseptic baths.
The classic radical method to get rid of phimosis are functioning of the Circumcisio (circumcision).
It is carried out in stationary conditions or in an outpatient surgery. The nature of the operation, the dissection and removal (in whole or in part) of the foreskin, cosmetic seams set himself resorboituvia threads. Recovery time is 3-4 weeks. If the operation was successful, and postoperative periods without any complications, sex after circumcision can be practiced for about a month.
The main disadvantages are the increased sensitivity of the exposed head during sex, and its consequences, early ejaculation or a change in sensation during intercourse. As a rule, these States do not require treatment.