Phimosis is a deformation of the skin surrounding the penis that makes it difficult or impossible to retract the skin. Phimosis is caused by the closing or narrowing of the foreskin hole and prevents the foreskin from being comfortably retracted so that the glans can be exposed. It can occur with both flaccid and erect penis.
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It is ideal that the glans can be uncovered because it significantly influences the correct maintenance of hygiene in the area. Also, having the glans uncovered or being able to retract it easily will cause sexual intercourse without any pain or discomfort.
Phimosis is said to exist when it is not possible to completely retract the skin of the foreskin to expose the glans completely. Sometimes the foreskin does not retract by itself when there is an erection, however, if it can be done manually it will not be considered phimosis.
It’s a very common problem, usually in young children, but when you reach adolescence the problem is only one in two teenagers. Most newborns do not manage to retract the foreskin, but as the child’s age progresses, the problem is solved on its own.
By six months of age, two out of ten children can retract the foreskin. At one year of age they are five out of ten, and at three years of age nine out of ten children have no problem at all. We can make a classification in several levels, from a lower or less serious level that is usually a narrowing that causes pain when having an erection but leaves the glans uncovered, to a higher level that can be a pointy stenosis that can produce difficulties even when urinating normally.
Can I live phimosis without surgery?
The answer is that you can, but you shouldn’t, because phimosis can cause complications like the ones below:
- Pain when having sex.
- Since the penis is not hygienically safe, it can become infected when filled with esmegma, known as Balanitis.
- Balanitis can cause the infection to go up the urethra and cause a urinary tract infection.
- Problems with urination: From a small difficulty to almost complete obstruction that would require a catheterization.
- Cancer: Although it is very rare, there can be one case in a hundred thousand that ends up with penile cancer for not having corrected the problem of phimosis in adulthood.
- Paraphimosis: When the foreskin is forced to leave the glans uncovered, the glans may become inflamed and swollen, so it could not return to its original position. This inflammation would progressively increase due to increasing pressure and could only be surgically resolved if it were not possible to do so manually.
Children with phimosis over the age of 3 can be treated with steroids applied directly to the skin. The pediatrician will advise you to perform foreskin retraction exercises for about 3 months to solve the problem.
Phimosis operation: Also known as circumcision, is the operation performed by the urologist where the cut of the remaining foreskin and then sews the skin retracted leaving the glans free.
Prepucioplasty: This is the operation that allows the foreskin to remain intact, and may be recommended on some occasions.
The area is anesthetized by performing several needle punctures, it can be around the penis and even in other areas such as the glans. Puncture punctures are relatively painful but only at the time of the puncture. Getting some air, squeezing your hands really hard and blowing the air like a breath test is good advice to avoid thinking about the puncture and passing the bad drink as fast as possible. Afterwards you will have the whole area asleep, you will only occasionally notice some pressure but without pain. In less than half an hour the operation will be finished.
The recovery, although there is no pain, is usually the part that brings more problems since it is very uncomfortable the first few days. You should get used to the rubbing caused by gauze that is usually worn for at least two weeks. It is also necessary to sleep lying on your back to avoid unwanted pressure in the area that could cause a point to jump.
Initially, you will be given an appointment at your usual medical centre so that the health staff can give you a treatment consisting of changing gauze, cleaning the area, checking the condition of the points, and applying betadine or substitute. You can keep coming to the center or you can do the healing yourself at home. To make a good hygiene of the cures you must use medicinal soap pharmacy, to clean the area, then apply physiological serum throughout the area and finally apply betadine and let it aerate. It is common that involuntary erections occur in the days following the phimosis operation, in those cases it is necessary to be very careful because you can skip some point that would have to be re-stitched.