Post Date December, 03 2023
A phimosis is a narrow opening of the foreskin that prevents the foreskin from turning over, thereby preventing exposure of the penis head. The etiology can be divided into congenital and acquired, and congenital phimosis can be seen in every normal male newborn. "When a child is born, there is adhesion between the foreskin and the glans (glans). At the age of 3 to 4 years, due to the growth of the penis and glans, the penis becomes erect. Most children's foreskin can shrink upward by itself, and the glans can be exposed by turning the foreskin outward.". However, some children have very small foreskin openings, and even during puberty, the foreskin cannot shrink, hindering the development of the glans or even the entire penis. The foreskin opening is similar to the size of a pinhole, and some even have difficulty urinating.
Acquired phimosis is often secondary to foreskin inflammation caused by excessive prepuce length, as well as damage to the prepuce and penis head. There is scar contracture at the prepuce opening, causing the skin to lose elasticity and expand tension, preventing the prepuce from retracting upward. In children with phimosis, due to the accumulation of urine between the foreskin and glans, as well as the secretion and peeling off of the epidermis, excessive foreskin scaling is formed, which often stimulates the inner plate of the foreskin and glans, and can cause foreskin inflammation and urethrostomitis. In severe cases, it can cause ulcers or stones in the foreskin and glans. Some children can see soybean residue like substances excreted or have difficulty urinating.
Therefore, children with congenital phimosis must undergo circumcision if there is no significant change at the age of 3 to 4 years, especially if they are often inflamed and inflamed, in order to avoid recurrent infection and redness of the foreskin, resulting in retrograde infection, causing urethritis or cystitis. In addition, long-term foreskin inflammation is an important factor in inducing penile cancer. Regarding the treatment of phimosis, Dr. Lei said that for congenital phimosis in infants and young children, parents can conduct cleaning and nursing at home. First, turn the foreskin up repeatedly to expand the opening of the foreskin. This process should be gentle and gentle, and each time should be moderate to avoid causing pain in the child. "When the penis is exposed, clean the foreskin dirt, and then restore the foreskin, otherwise it may cause incarceration of the penis.". "If the foreskin is tight, cannot be turned upside down, or has acquired phimosis, circumcision should be performed.". Surgery should be performed between the ages of 5 and 6, as it can be seen if the foreskin can shrink by itself. In addition, there is a problem with attending school. After attending school, surgery can only be performed during the holidays, and time constraints can sometimes delay the illness.
Generally, it is not recommended to perform surgery too early because the child is too young to cooperate, and there is also the possibility of spontaneous withdrawal. However, if it is a recurrent infection, or has scar formation, or has incarcerated phimosis, it is not limited to age. Circumcision surgery is relatively simple and generally not very dangerous, and can be performed under local anesthesia in outpatient clinics. Because this part is relatively sensitive, there will be some pain 1 to 2 days after the operation, and there will also be a small amount of bleeding and oozing blood. Younger children should be hospitalized because they cannot cooperate well and must be treated with systemic medication before undergoing surgery after they fall asleep. Dr. Lei reminded parents that this operation should be performed in pediatric surgery in a regular large hospital to ensure the success of the operation. If the surgical treatment is not appropriate, complications such as downward curvature of the penis and painful penile erection can occur, increasing the physical and psychological pain of the child. Dr. Lei also emphasized that children with complete phimosis who do not receive treatment will have an impact on their sexual life as adults in the future. Moreover, due to the stimulation of inflammation and dirt within the foreskin, the risk of developing penile cancer will also be greatly increased. "If you perform this operation again in adulthood, the pain will be much greater than when you perform it in infancy.".
