Causes of phimosis in adult men
Phimosis is a disease in which a narrowing of the foreskin occurs.
Depending on the stage of the disease, the head is barely exposed, which leads to a huge number of problems.
If phimosis is not treated early, it can cause serious complications. For example, balanoposthitis and other diseases may occur.
Let's take a closer look at what are the causes of phimosis in an adult male.
At what age can you get this disease?
The reasons for the development of this disease are not fully understood. In early childhood (up to 3 years), the head of the genitals in boys is not exposed and only by 6-7 years begins to separate.
That's when many boys develop phimosis. But the disease often manifests itself in adult men.
Disease in children
If the disease is formed so early, then the reason is physiological processes. In addition, there is congenital phimosis in children, when the opening of the head does not occur even in a teenager.
Another reason for the development of phimosis in childhood is trauma to the genital organ and connective tissue deficiency in the body.
If hypertrophic phimosis develops, then most often it causes an overweight child.
In the pubic area, excess fat accumulates, which is a favorable environment for various bacteria.
Cicatricial phimosis in a boy occurs due to inflammatory processes of the urinary tract. This form of the disease is dangerous because it provokes the appearance of edema and paraphimosis.
The symptomatology of the disease is practically absent, so it is difficult to diagnose the disease. The only complaint parents can hear from their son during phimosis is urination problems.
This is the main symptom, since the undeveloped foreskin of the genital organ presses on the urethra.
Phimosis: causes in men
If phimosis did not develop in childhood, this does not mean that an adult male is not at risk.
Causes of phimosis in adult men:
- Genetic predisposition. It consists in insufficient elasticity of the foreskin, which eventually leads to its narrowing.
- Genital injuries. If scars form on the foreskin, they will interfere with its normal functioning.
- Inflammatory diseases. Phimosis can develop due to balanoposthitis, thrush or sexually transmitted diseases.
- Inadequate hygiene. Even adult men often neglect simple rules, which leads to inflammatory processes and the development of phimosis.
In practice, phimosis often causes several symptoms at once. And sometimes even an experienced urologist cannot identify the cause of narrowing of the foreskin in a patient.
Nevertheless, it is necessary to devote a lot of time to treatment, otherwise there may be the following complications:
- The development of inflammatory processes.
- Purulent discharge with an unpleasant odor from the urethra.
- Itching and pain in the groin.
- Impaired urination.
- The development of paraphimosis.
- Impotence and amputation of the genital organ.
The main rule of disease prevention is compliance with hygiene rules. Washing of the penis is necessary at least 1 time per day, previously displacing the foreskin.
You can use various antibacterial agents for intimate hygiene.
It is advisable to make various baths based on medicinal herbs. They have antiseptic and anti-inflammatory effects, which is necessary for the prevention of phimosis. Infusions are easy to prepare:
- take 1 tbsp. l dry flowers
- pour them 200-300 ml. boiling water
- insist for an hour,
- then strain and use to rinse the penis.
- 10-15 g. Dry medicinal chamomile pour a glass of hot water,
- boil for 10 minutes over low heat,
- after the broth has cooled, it should be filtered, and only then used.
- 1 tbsp. l sequences also need to be brewed in a glass of boiling water,
- leave for a few hours.
The series perfectly heals wounds and has bactericidal properties.
In addition to these procedures, a man should pay maximum attention to his health. It is important to know that some diseases worsen the development of phimosis.
For example, it is diabetes. In addition, it is necessary from time to time (at least 1 time per year) to take tests for the presence of sexually transmitted diseases.
You also need to be more serious about choosing sexual partners and refuse unprotected sex.
We should also say about a healthy lifestyle, which means giving up bad habits and following a certain regime. Sleep, proper nutrition and good rest are the key to men's health.
In the life of a modern man there should be a place for playing sports. Especially useful for diseases of the genital organs, doctors call swimming.
Workloads should be moderate, and those men whose work is connected with computers and staying in the office should spend more free time outdoors.
Phimosis is not a fatal disease, but, nevertheless, quite dangerous.
For circumcision for religious reasons, as well as for what nationalities it is accepted and what the Bible interprets, read this publication.
The causes of phimosis in men can be different. This ailment does not affect the ability to have children, but it affects the appearance of discomfort during sex.
And if the disease is not treated, sooner or later it will go into a more severe form, in which treatment can only be operative.
Symptoms of phimosis
Phimosis in boys is expressed by the main symptom - the inability to expose and remove the head of the penis. In some cases, this condition does not cause complaints in boys, but often enough children with phimosis have problems with urination. So, in the process of urination, the boy can push hard, show marked anxiety. As a result, the urine of the child falls into preputial cavity. It swells, and urine passes in drops or a thin stream through a narrow hole.
Sometimes an inflammatory process joins phimosis, the symptoms of which are pain in the area of the head of the penis and foreskin, the appearance of purulent discharge from the opening of the foreskin. The patient is increasing The lymph nodes, body temperature rises. If takes place paraphimosis, sharp pains appear in the strangulated head of the penis, the head of the penis becomes larger and becomes bluer. In this case, the patient needs emergency care.
With phimosis in adult men, sometimes there are complaints of problems with potencyarising as psychological discomfort due to pain during intercourse.
Causes of phimosis in men
If in children phimosis is considered a normal physiological state, then in men it is a pathology.
Doctors distinguish its main reasons:
- genetic susceptibility to this disease due to the low level in the male body of the elastic component of the connective tissue,
- various injuries of the male organ, due to which scars appear on the foreskin, which subsequently interfere with the normal functioning of the skin on the penis,
- the appearance on the foreskin of a man of scars from various infectious and inflammatory diseases of the genital area, such as trichomoniasis, syphilis, balanoposthitis, etc.,
- uneven development in adolescents during puberty of the foreskin and penis, etc.
Although the causes of the onset and development of such a condition in men are still not fully understood, one should know that in some cases phimosis can cause physical and psychological suffering to the patient.
If you do not treat it in a timely manner, then the development of unpleasant complications is guaranteed:
- the occurrence of various genital inflammation in men,
- the appearance of purulent discharge and an unpleasant smell from the foreskin,
- soreness, blueness and itching in the penis,
- the appearance in this area of adhesions and scars,
- violation of the normal physiological process of urination,
- fusion of the foreskin, etc.
Symptoms of phimosis can best be considered depending on its severity:
- The initial stage of the disease is characterized by only minor difficulties in exposing the glans penis during an erection. During rest, the liberation of the glans is free.
- The next stage of phimosis is manifested in severe difficulty, and sometimes impossibility in the state of erection, liberation from the foreskin of the head of the penis.
- The next stage of the disease is associated with possible bleeding and severe pain when trying to release the glans penis in an erect state.
- The last stage, the most difficult, is characterized by complete closure of the glans penis with the foreskin, which makes it difficult to painfully urinate, decrease potency, with an erection, sharp pain, an increase in body temperature, and an increase in lymph nodes in the inguinal region.
Causes of phimosis
Most male infants are born with adherent prepuce (foreskin) tight to the head of the penis. This condition is considered normal and does not require treatment. At the age of 3 to 7 years, the head of the penis opens in the boys. If this does not happen, medical attention is required.
Causes of phimosis in adult men:
- inflammatory processes affecting the foreskin,
- trauma to the tissues of the intimate area and the subsequent occurrence of scars,
- insufficient production of collagen in the connective tissue (a tendency to it is inherited)
- immunodeficiency conditions
- systemic lupus erythematosus.
There are other causes of phimosis in adulthood. Among these are heart defects, varicose veins of the spermatic cord (varicocele).
Violations of the physiological process of development of the genital organs during puberty also lead to the appearance of phimosis. So, uneven growth of the penis and prepuce can cause a problem. It is even more aggravated if a young man with a tight-fitting sheet of skin sloppyly masturbates. Tissues are injured and inelastic scars form at the site of tears.
Classification of narrowing of the foreskin in adult men
A guideline for determining the degree of pathology for urologists is how a member's phimosis looks and what problems accompany it.
There are four degrees:
- The head easily opens with a relaxed penis, and in an erect state is exposed with little effort.
- At rest, it is impossible to bare the head of the penis, or for this the man has to make an effort.
- The apex of the penis at rest is not exposed at all or is released with considerable effort. At the time of an erection, there is no way to expose the head. Urination in a man occurs without difficulty.
- There is completely no way to open the glans penis. There are problems with urination - urine comes out in a thin stream or drops.
The hypertrophic form of phimosis is characterized by a significant thickening of the prepuce skin, its drooping outside the penis. Atrophic (cicatricial phimosis) - is accompanied by significant thinning of the prepuce skin. Normal tissue is replaced by cicatricial, the foreskin loses elasticity and squeezes the head excessively.
The listed types of pathology are often found in men. Relative phimosis in adults is a rarer occurrence. This condition is manifested by difficulties with exposing the head of the penis only during an erection. Mostly it is observed in adolescents if congenital phimosis did not end with normal opening of the head and treatment was not performed on time.
Symptoms of pathological phimosis in adults
Signs of phimosis differ in men with varying degrees of severity of pathology. The main symptom of the disease is the inability to open the head of the penis. The first and second stages of the disorder are accompanied by pain during an erection, when the skin of the prepuce is stretched.
Launched (3 and 4) stages in men are often accompanied by painful sensations. The prepuce ring is so narrowed that it is not possible to open the head. But not only this symptom allows you to determine the presence of a problem. Men have serious difficulties with emptying the bladder. During urination, pain occurs. Urine comes out with difficulty - a thin stream or drop by drop.
The listed symptoms are a reason to seek medical help.
What is the danger
Severe consequences of phimosis are possible if the problem is started or a man tries to solve it without the help of a doctor.
Phimosis provokes stagnation of smegma, which is secreted by the glands of the foreskin. In the secret that has accumulated around the head of the penis, bacteria are actively developing. This leads to the inflammatory process in the preputial sac - balanoposthitis. The problem affects the head of the penis, skin. They blush, itch and become painful.
Stagnation of urine provokes the development of bacterial microflora and the inflammatory process in the urethra and other parts of the genitourinary system. One of the most severe consequences of phimosis is inflammation of the testicle, which leads to infertility.
Active reproduction of bacteria causes meatitis - inflammatory processes affecting the external opening of the urethra. Therefore, almost all men feel soreness when the bladder is empty.
Attempts by a man to independently expose the head of a penis sometimes lead to its infringement on the narrowest part of the flesh. The phenomenon is called paraphimosis. This often happens during sex or during masturbation. It is not always possible to straighten the head with paraphimosis. She becomes edematous, very painful, turns blue.
Paraphimosis is a dangerous condition in which a man urgently needs to see a doctor.
Another complication of stages 3 and 4 of phimosis is fusion of the glans penis and prepuce. Rarely, it occurs with less pronounced narrowing. There is a problem in men due to the constant close contact of tissues. Synechiae are formed - gluing, fusion of adjacent surfaces. Without surgery, the lesion area increases, gradually the upper part of the penis and prepuce become almost a single whole. With such a problem, a man loses the opportunity to have sex, he is tormented by pain and urine retention during emptying of the bladder.
Which doctor treats the narrowing of the foreskin
Men who notice signs of a narrowing of the prepuce should see a urologist. If there is no way to get an appointment with this specialist, you should go to the surgeon. The specialist puts the diagnosis of phimosis after examining the problem area and examining the patient's complaints. Tests are usually not required, except in cases of bacterial inflammation.
Surgical treatment of phimosis in men
With phimosis of the penis, surgical intervention is used in men with severe forms of pathology. An operation is prescribed if the previously performed conservative therapy did not give the expected result.
An effective treatment for cicatricial phimosis without surgery does not exist. Therefore, men immediately recommend surgery.Most often, this is the complete removal of tissue with scars.
Bloodless surgical treatment is carried out using elastic rings coated with a polymer material. The Petrov retainer is put on the penis so that the head is between the ends of the device. It must be covered in flesh. The skin of the prepuce is held by hand, and the retainer is advanced towards the base of the organ. Then the foreskin is passed through the hole between the sides of the retainer until the upper part of the penis is fully opened. The skin folds are straightened so that they are not infringed.
The operation to circularly remove the foreskin is also called circumcision, or circumcision. The surgeon separates the penis and foreskin with a trough probe, stretches the edges of the skin in opposite directions and fixes it with clamps. The doctor dissects the tissue, directing the scalpel from the external opening to the coronal groove. After that, completely removes the foreskin in a circle, leaving only a bridle on the penis, sutures the edges of the wound.
In the postoperative period, a man is prescribed antibiotics, antifungal drugs to avoid inflammation.
In the first week, the operated organ is bandaged daily. In addition, doctors recommend that men make baths based on herbs, antiseptic compresses, and also use powders.
By the method of laser destruction, the scars that caused phimosis are destroyed. Such a bloodless operation is performed for men without incisions, the risk of infection and complications after it is minimal.
Also, a laser is used to remove the skin leaf with phimosis. A beam heated to a temperature of 300 degrees is used instead of a conventional scalpel.
The laser procedure has advantages over the traditional operation:
- It is practically bloodless (a beam seals blood vessels).
- There is no risk of infection and complications.
- The wound on the penis heals much faster than after traditional circumcision.
Plastic surgery of the foreskin
Less traumatic surgical treatment of phimosis is carried out with local anesthesia. Often a man goes home the same day.
The specialist makes a small vertical incision on the skin in its narrowest part. The fabric diverges, begins to fall freely. Then the surgeon makes a cosmetic suture with a catgut (absorbable thread). The head is closed, a sterile napkin is applied.
During the day after the intervention, doctors recommend keeping the penis closed. This is necessary to avoid paraphimosis.
Bandaging a man is done a day after surgery. During the procedure, the head is exposed, a sterile bandage is applied to it. Wound healing should occur with an open penis in order to exclude the possibility of repeated phimosis.
Men with phimosis are recommended to gently (slowly) stretch the skin until a slight pain appears. Stretching is recommended for 10 minutes every day. When the tissue becomes sufficiently elastic, it is recommended to switch to masturbation with a limited range of motion.
To stretch the prepuce, two fingers are carefully inserted between it and the penis, and then stretched to the sides. The width of the tension is gradually increased.
Every day, while taking a warm shower or bath, men need to pull the skin down until minor pain occurs. With the regular use of this method, the penis is exposed after 2 months, and the question of how to get rid of phimosis becomes irrelevant.
All tensile manipulations should be carried out with clean hands. To avoid damage, it is worth using a baby cream or lubricant. In the presence of microcracks on the surface of the skin or head, it is better to abandon the procedure until complete healing.
Drug therapy for phimosis involves the use of ointments, gels based on corticosteroids (Clobetasol, Betamethasone). Hormonal drugs are applied twice a day to the skin of the foreskin and head. As a result of regular use, the tissue becomes elastic, swelling, inflammation is removed, and damaged areas heal quickly. Treatment lasts from 1 to 3 months.
The use of hormonal agents is combined with manual techniques for compressing prepuce tissue.
For the treatment of phimosis, traditional medicine advises making baths with medicinal herbs. Procedures are carried out daily at a water temperature of 36-37 degrees. The duration of the session is 15-20 minutes. Use herbs with bactericidal properties:
- a series of
- blackberry leaf
- Melilotus officinalis.
For bath with phimosis 2 tbsp. dry raw materials pour 250 ml of boiling water, slowly bring to a boil. Insist the broth well wrapped 6-8 hours. The liquid is filtered, poured into a clean vessel and the penis is immersed in it.
If there is no way to make a bath, you can replace it with lotions. The gauze is soaked with the same warm broth, squeezed slightly and applied to the penis. During the procedure, you need to ensure that the lotion does not cool.
Folk remedies must be combined with the prescribed medication for phimosis and sprains.
Pathologies of the genitourinary system in men most often have an infectious origin, pathogens can be viruses, bacteria, fungi. The risk of developing the disease increases with weakened immunity against the background of smoking, alcohol addiction, frequent hypothermia. The ICD-10 code for male genital diseases is N40 – N51.
List of diseases:
- Urethritis - develops against a background of infections after injuries of the urethra. It manifests itself in the form of burning and pain during emptying of the bladder, scanty discharge with an admixture of blood, pus.
- Balanoposthitis - in the acute form of the disease, erosion occurs on the glans penis and in the foreskin, there is swelling, redness of the skin, severe pain, white plaque, fever. If the pathology becomes chronic, the symptoms become muffled, the skin in the affected areas shrink.
- Epididymitis is an inflammation of the appendages of the testicles, develops against the background of urethritis, prostatitis, prostate adenoma, and may be a complication of mumps. Signs - soreness, swelling of the scrotum, frequent urination, discharge with blood.
- Vesiculitis - inflammation is localized in the seminal vesicles, occurs as a complication of urethritis, prostatitis, caries, and diseases of the nasopharynx. STI, irregular or violent sexual activity. Signs - a sharp increase in temperature to 38.5 or more degrees, acute pain in the groin, which radiates to the lower back, intensifies when the bladder and intestines are empty, mucus with streaks of blood is present in the feces.
- Inflammation of the prostate gland (prostatitis) - characterized by rapid urination at night, there is a feeling of an overflowing bladder, pulling pains in the groin, lower abdomen. Loin. Against the background of the disease, erectile dysfunction develops, sexual desire decreases, the process of ejaculation is accompanied by pain.
- Candidiasis - when infected with yeast-like fungi, mycotic prostatitis, urethritis develops. Signs are an accumulation of white cheesy discharge on the glans penis, itching, pain in the perineum, discomfort during ejaculation and urination.
- Cystitis is an inflammation of the bladder. The main symptoms are low-grade fever, severe discomfort during urination, blood, mucus may be present in urine.
With urethritis, pain and burning appear during urination
Non-infectious urological diseases include varicocele - expansion of veins near the spermatic cord and testicles on one or both sides, pathology often occurs in adolescence. The disease is accompanied by slight discomfort in the scrotum, which can cause infertility.
In inflammatory processes of the urogenital system in men, a change in diuresis is always observed - the number of urge to urinate per day increases or decreases, urinary incontinence, pain, burning, discomfort during the process of emptying the bladder.
Sexually transmitted diseases
Sexually transmitted infections are often diagnosed in men with promiscuous sex life. Lack of adequate treatment can cause the spread of pathogens to other systems and organs. The code for ICD-10 is A50 – A64.
The list of sexual diseases:
- Gonorrhea - manifested in the form of discharge of pus from the urethra, frequent urination, pain and burning in the genital area. If you do not start treatment, the inflammation will pass to the testicles, which is fraught with infertility.
- Chlamydia infection is diagnosed in 15% of young people who have an active sex life. Pathogenic microorganisms affect the urethra, prostate gland, testicles, but often the disease proceeds without any special signs. The first signs may appear 10–20 days after infection - colorless or yellow discharge with an unpleasant odor, slight pain during urination, urine turbid with impurities of pus, swelling of the testicles, itching in the urethra.
- Genital herpes - a recurring disease, manifests itself in the form of itching, redness of the head of the penis, multiple vesicles with fluid appear.
- HPV - human papillomavirus causes the appearance of warts in the genital area, sometimes there is slight itching. There are no other signs of pathology, but against the background of infection, cancer of the penis and anus can occur.
- Syphilis - one of the most dangerous sexually transmitted diseases, often goes into a chronic, latent form, which leads to damage to the brain, heart, blood vessels. The first signs are a solid chancre of brown-red color with smooth edges on the head of the penis, sores, swollen lymph nodes, low-grade fever, joint and muscle pain.
Gonorrhea is characterized by discharge of pus from the urethra.
The only way to avoid infection is to use condoms for casual sexual intercourse. Carefully approach the issue of choosing a partner. During treatment, it is strictly forbidden to drink alcohol, any sexual intercourse is prohibited before re-testing.
Rashes on the penis can be caused by an allergy to foods, latex, components of gels, lubricants, external signs are similar to herpes.
Reproductive system diseases
Problems with an erection arise against a background of chronic urological diseases, frequent sexually transmitted infections, and an improper lifestyle.
Endocrine disorders, hypertension, diabetes, vascular disorders can provoke the development of the disease.
Impotence is often accompanied by premature ejaculation, decreased libido, priapism, when severe pain in the penis appears against the background of arousal.
Urological problems adversely affect a man’s erection
Male infertility is the result of injuries, developmental pathologies, poor quality seminal fluid, mental and sexual disorders, and prolonged exposure to toxic substances on the body.
Peyronie's disease - curvature of the penis during erection, the causes of the development of pathology are not identified. Against the background of severe pain and deformation of the organ, sexual intercourse is impossible or difficult, which significantly reduces the likelihood of a successful conception.
In approximately 30% of cases, impotence in men of reproductive age is psychological in nature, develops amid stress and overwork.
Congenital genital pathologies most often occur in premature infants, anomalies are recorded in approximately 30% of boys. The code for ICD-10 is Q55.
The main pathologies:
- Cryptorchidism - the testes do not descend into the scrotum, but are located in the inguinal canal or abdominal cavity, the disease can be one-sided or two-sided.
- Hydrocele - accumulation of fluid between the scrotum and the membranes of the testicles, usually the pathology in newborns disappears on its own during the first year of life.
- Hypoplasia - underdevelopment of the testicles.
- Aphalia - absence of the penis, agenesis - absence of the testicles.
- Macrofallus and microphallus are significant deviations of the length of the penis up or down.
Hydrocele causes an increase in testicular size
Phimosis - the inability to remove the head of the penis due to narrowing of the foreskin, in children under 7 years of age, the disease is considered a physiological phenomenon, for adult men - a pathology that occurs against the background of injuries, inflammatory processes. Signs - bleeding of varying degrees of intensity against the background of constant tears of the foreskin, pain during erection, worsening potency.
The testicles must independently descend into the scrotum at 6–9 months, if this did not happen before the year, treatment is required.
How to recognize cancer
|Incontinence, enlargement of the prostate gland, weak stream of urine, frequent urination.||Prostate cancer|
|Swelling of the testicles, compaction, a change in their position, a feeling of heaviness in the perineum.||Testicular cancer, always developing rapidly|
|The presence of blood impurities in urine, feces||Bladder cancer|
Prostate adenoma is a benign tumor, but can degenerate into a malignant neoplasm.
Previously, the disease was rarely diagnosed in men under 54 years old, now the first signs of pathology appear already at the age of 25 years.
The exact causes of the adenoma have not been established, but often a sedentary lifestyle, a hereditary factor, failures in the hormonal background contribute to the development of the tumor. Symptoms - problems with urination, a decrease in the stream of urine, an increase in the volume of the bladder, and kidney failure develops.
Diagnosis of male diseases begins with a medical history, a thorough examination and palpation of the male genital organs. Most diseases have specific signs, so a doctor can make a preliminary diagnosis at an early stage.
- clinical analysis of blood and urine - shows the presence of inflammatory processes in the genitourinary system,
- biochemical, hormonal blood test,
- analysis for HIV, syphilis, other sexually transmitted diseases,
- biopsy - carried out with diseases of the testicles and their appendages, seminal vesicle, prostate gland,
- a smear from the urethra - allows you to identify the type of pathogens, latent infections,
- endoscopy, urethroscopy - the method allows you to see changes in the mucous membrane of the urethra,
- X-ray, MRI, CT, radioisotope methods,
- Pelvic ultrasound,
- test for tumor markers,
- spermogram - what you need to know about this analysis,
- Doppler study of blood vessels,
- sexological test, assessment of the degree of erection - carried out in the presence of complaints of problems with potency.
To assess the condition of the prostate gland, a transrectal digital examination is performed - normally the size of the organ should be 2-3 by 3-4 cm, how it looks and where it is located can be seen in the photo.
Prostate in the body of a man
Male Disease Treatment
After determining the diagnosis, the doctor draws up a treatment regimen, the treatment of mild forms of the disease is carried out with the help of physiotherapy and medications, under the constant supervision of a specialist, you can be treated independently at home. With advanced, congenital forms of genital diseases, surgical intervention is required.
In the treatment of urological diseases in men, drugs are used that fight the causative agents of the disease, eliminate unpleasant symptoms, and strengthen and restore immunity and erectile function.
The main groups of drugs:
- antiseptic solutions - Miramistin, Chlorhexidine, used to wash the head of the penis, remove plaque from the foreskin,
- antibiotics - Amoxicillin, Cefuroxime,
- antifungal drugs - Nystatin, help with candida urethritis, prostatitis,
- antiviral agents - Acyclovir, prescribed for exacerbation of genital herpes,
- drugs to improve potency - Phentolamine, Sildenafil, Tentex Forte, drugs with testosterone, L-arginine - more ways to increase potency,
- alpha-adrenergic blockers - Cardura, Omsulosin, are necessary to improve the condition of prostate adenoma,
- immunomodulators - Pyrogenal, Reaferon.
Pyrogenal - an effective immunomodulator
After the end of antibiotic therapy, it is necessary to drink Bifiform, Ribomunil, other probioics, prebiotics, and vitamin complexes will help strengthen the immune system. If incontinence occurs, use special pads that quickly absorb fluid.
Uncontrolled intake of drugs to improve potency can cause serious problems with an erection, malfunctions of the cardiovascular, nervous system, and impaired liver function.
In the absence of a therapeutic effect after drug therapy, with advanced forms of urological problems, congenital anomalies, an operation is performed. In some cases, surgery can be done at the request of a man.
Types of andrological operations:
- circumcision - circumcision of the foreskin during phimosis, in some cases men do it for hygienic reasons,
- restoration of functions in the testicular vein with varicocele,
- falloprosthetics - prosthetics of male dignity are carried out with organic forms of erectile dysfunction, which allows in 95% of cases to achieve a noticeable positive result,
- changing the length and thickness of the penis - lengthening is carried out by reducing the hidden perineal region, special implants are used to thicken,
- removal of malignant and benign tumors.
One of the best tools for the treatment and prevention of adenoma is regular massage of the prostate, it is carried out through the rectum, only a qualified specialist should do the procedure. Contraindication - suspected presence of prostate tumors.
Phimosis in men
Phimosis is a narrowing of the opening of the foreskin of the penis. This pathology leads to the inability to partially or completely expose its head. The problem is both congenital and acquired. It requires mandatory treatment, because against the background of phimosis, infectious diseases often develop. Skin can also be injured. It is strongly not recommended to fight pathology on one's own; a urologist and surgeon are involved in solving the problem.
A characteristic sign of phimosis in men is the lack of the ability to remove the glans penis. Other symptoms include:
- Painful sensations of varying intensity during an erection,
- Violation of the urination process,
- Fever, purulent discharge during the development of a bacterial infection,
- When the head is infringed, its swelling and blueness.
The patient experiences difficulty urinating mainly due to the inflating bag of the foreskin with urine. It stands out in a thin stream.
In adult men, in most cases, pathological phimosis is diagnosed. It can be cicatricial and hypertrophic. The first form develops as a result of severe inflammatory processes, injuries. The second type is detected mainly in patients with overweight.
For phimosis, 4 degrees of severity are characteristic:
- First one. In a calm state, the head of the penis is completely exposed, during an erection it is difficult.
- The second one. In the usual state, excretion occurs with difficulty, with an erection it is impossible.
- The third. At rest, the head does not open or is partially displayed.
- Fourth. Nudity does not occur at all.
The problem of narrowing the foreskin is relevant among men of different ages and requires specialized treatment. Timely access to a doctor will help to avoid the dangerous consequences of phimosis.
If in children the inability to remove the glans penis can usually go away on its own, without the intervention of doctors, then in men phimosis requires treatment without fail. Even if the problem is not acquired, but congenital and not resolved in time, the narrowing of the foreskin in adulthood does not disappear on its own. Phimosis develops as a result of:
- Reduced skin elasticity,
- Scar formation,
- Progression of diseases of the circulatory system,
- Sclerosis of the skin of the foreskin.
A decrease in the elasticity of the integument often occurs after balanoposthitis, various STDs. Usually it is chlamydia and gonorrhea. Infectious diseases lead to inflammation of the urethra.
Scarring is a fairly common cause of phimosis. Rough connective tissue appears after burns and injuries of the penis.
Experts say that phimosis in men is treated quite successfully. Usually, several specialists deal with the problem of phimosis in men. It:
The main thing is to seek help in time. At the initial appointment, the doctor will ask the following questions:
You may also need the help of an infectious disease specialist, a venereologist. Diagnosis of pathology is based mainly on examination of the penis. It is important for the doctor to evaluate the degree of permissible head exposure. In addition, the presence of pus, adhesions and other unhealthy manifestations should be determined. Next, the specialist is determined with the features of therapy.
Today conservative and surgical methods of treating narrowing of the foreskin are distinguished. Drug therapy involves the use of special hormonal ointments.
If the patient has a 1-2 degree of phimosis, then with caution resort to a kind of training. It is necessary for the phased extension of the foreskin ring.
Such a treatment of phimosis in men at home is prescribed exclusively by a doctor based on the results of examination and analysis. It is important to exclude even the slightest tears of the skin.
Exercises are performed over a long period.
Surgical treatment involves circumcision. The doctor makes a circular incision of the foreskin, stitches are applied to the skin.
It is important to treat phimosis correctly and in a timely manner. If there is no competent medical care, then complications often develop:
- Inflammation of the head of the penis and foreskin,
- Paraphimosis, which is dangerous by necrosis of the head,
- Tissue fusion,
- Urethra inflammation.
To avoid phimosis, you should carefully follow the rules of personal hygiene. It is also necessary to exclude injuries of the inguinal region, directly of the penis. Refusal from random sexual relations, the use of condoms also contribute to the prevention of the appearance of pathology.
It is recommended to visit a urologist once a year if there are no complaints about the condition of the genitourinary system. Regular examinations will prevent the development of phimosis, as well as other unpleasant and dangerous pathological processes, including prostatitis, cystitis and urethritis.
To alleviate the condition of the patient with the development of phimosis, after consulting a doctor, you can resort to alternative methods. Usually this:
- Decoctions for taking baths. Chamomile, calendula, blackberry leaves or thyme are steamed. Insist about 30 minutes, filter and add to water.
- Wild strawberries. The leaves are steamed, cooled to body temperature and applied to the penis.
- Lotions. Chamomile is poured with boiling water, let it brew for 5 hours. Then squeeze and make a compress. A warm lotion is applied to the penis.
- Barley. Grains are boiled in clean water for about 1 hour. Insist broth, filter and rinse the penis 2 times a day.
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Phimosis and paraphimosis: causes, symptoms, diagnosis, treatment, recovery from illness and preventive measures
Health June 22, 2018
In the article, we consider the clinic, diagnosis and treatment of phimosis and paraphimosis. Phimosis is a congenital pathology of the foreskin in boys.
In some cases, such an anomaly can occur independently during puberty, as well as as a result of various injuries and inflammatory processes in the genitals.
This disease is characterized by improper narrowing of the foreskin, due to which the head of the penis cannot pass through a narrow hole.
As a result, its exposure is impossible, very painful or difficult. Physiological phimosis is a fairly common occurrence.
In almost all boys, in the first months of life, the head of the penis does not completely open from the preputial sac. By the age of six months, phimosis is observed in 83% of infants.
In most boys (90%), this pathology resolves by 3 years on its own. However, in cases where this did not happen by the age of 7, phimosis is classified as pathological.
What is phimosis and paraphimosis? This question interests many.
Paraphimosis in men is a rather dangerous disease associated with infringement of the glans penis.
An adverse process develops due to the fact that the foreskin is significantly narrowed and begins to squeeze the delicate scalp.
The development of paraphimosis begins after the complete removal of the flesh behind the coronary sulcus, which changes the blood circulation in the penis and leads to the rapid development of swelling of the penis and tissue necrosis.
Wounds and ulcers appear on the affected areas, and the strangulated area with paraphimosis acquires a bluish tint and becomes edematous. In this case, the foreskin has the form of a dense swollen roller, the patient has problems with urination.
Pathology is diagnosed taking into account information from the anamnesis and the results of a visual examination. The course of therapy can be based on manually adjusting the head or applying surgical techniques, which is most important if paraphimosis is at an advanced stage.
Surgical procedures include puncture from edematous areas and circular excision of the flesh.
Consider the main differences between phimosis and paraphimosis.
What is the difference between these pathologies?
Paraphimosis is a more acute condition when compared with phimosis.
It develops, as a rule, after phimosis, but in some cases it can also occur as an independent phenomenon, acting as an adverse consequence of improper masturbation.
If the essence of phimosis is the narrowing of the flesh, then paraphimosis is a more dangerous and complex condition in which a narrow prepuce squeezes the head of the penis.
What is the difference between phimosis and paraphimosis? The main difference is the inability to expose the head of the penis. A man with the appearance of the first signs of this pathology should consult a doctor. You can provide first aid yourself by lubricating the head with greasy cream and try to push it under the flesh. If this is not possible, the patient should go to a medical facility.
Paraphimosis and phimosis, which develop in childhood, pose a serious threat to the health of the boy. The shifted flesh exposes the head of the penis and squeezes it.
As a result, there is a rapid development of edema and a serious complication in the form of tissue necrosis. Often eliminating such complications is obtained exclusively by surgery, through resection of the foreskin.
Phimosis and paraphimosis in children are very common.
If phimosis in children can be cured independently and without radical therapy, then paraphimosis in boys requires urgent treatment by a surgeon or urologist. Outwardly, it is manifested by a blue head of the organ and its pronounced swelling.
Parents by such signs can immediately recognize this disease in their child.
In such a situation, they should immediately call an ambulance and take the child to a hospital where surgical treatment of an acute condition will be carried out.
It is imperative that with paraphimosis in a child, help should be provided to him very quickly. If appropriate measures are not taken in a timely manner, head tissue will die, irreversible necrotic processes will appear.
The consequence of the pathology in this case will be deplorable - the surgeon will have to remove the child's part of the genital organ. In addition, ulcers, inflammations and wounds appear on the penis, which are provoked by pathogenic microorganisms that fall on the mucous membrane of the prepuce and head.
The outcome of phimosis and paraphimosis in children can be favorable provided that the foreskin is rapidly reduced.
Diagnosis is based on patient complaints. To make a diagnosis, the examination should be carried out by a surgeon or urologist.
The specialist determines whether the main symptom of the disease is the inability to open the head of the penis during phimosis or, on the contrary, to adjust it during paraphimosis.
As an auxiliary technique, a patient is interviewed to determine the characteristics of the pathology, if we are talking about such a disease in an adult. If the pathology has developed in the child, such data can provide his parents. Treatment of phimosis and paraphimosis should be timely.
Phimosis can be treated in various ways. Non-drug treatment involves slow manual stretching of the flesh. Tension it on the head for ten minutes, experts recommend daily.
The use of stretching methods, according to experts, has an efficiency of about 80%. Carrying out such procedures is most effective during bathing, when the skin becomes elastic.
It should be borne in mind that stretching the foreskin is necessary before the onset of pain, without continuing this procedure with the development of pain.
If the flesh is elastic and no cicatricial changes are observed on it, the method of its stretching is applied, which is carried out using local anesthesia. In addition, plastic surgery of the flesh is sometimes performed as a surgical technique to increase the size of the prepuce ring, without resorting to excision.
Drug treatment of this disease involves applying to the foreskin and head corticosteroid ointments. Such procedures should be carried out regularly for a long time. Under the influence of such ointments, the elasticity of the skin becomes higher, and it stretches better.
Thus, a disease such as phimosis is completely cured. The use of glucocorticoids helps relieve inflammation and swelling, activates wound healing.
Surgical therapy of phimosis is used at the third or fourth degree of the development of the disease, when conservative treatment did not give positive results.
Paraphimosis as a complicated form of phimosis involves surgical methods of therapy, since it is an extremely acute condition that requires urgent measures to eliminate it. The only treatment in this case is surgery to remove the foreskin.
In the process of surgical procedures, adhesions are separated in the prepuce bag using a metal probe. If there are scars on the foreskin, then during the operation they are excised.
Such operations are usually carried out under local anesthesia, and general anesthesia is possible only in childhood.
Recovery period and prevention methods
The duration of the recovery period is quite individual: the rehabilitation period is from 2 weeks to 2 months. In children and young patients, the recovery period is approximately one month, due to regenerative processes: the younger the patient, the faster the wound heals. On the tenth day, it partially heals and dressings can be carried out once a day.
Pain after an operative solution to this problem can be very intense, and this is considered the norm. To stop such discomfort, you can take painkillers.
Prevention of phimosis and paraphimosis is quite simple - it is enough to observe the hygiene of the genital organ and prevent its trauma. In childhood, preventive measures include regular postponement of the foreskin and exposure of the head of the penis.
Reviews about these pathologies
Phimosis and paraphimosis are quite common in men. Reviews confirm this. Patients report that by following preventive measures, surgery can be avoided. In any case, it is better not to delay the visit to the doctor.
From the article we learned how the diagnosis and treatment of phimosis and paraphimosis are carried out.
What is phimosis and classification of pathology
Phimosis is a narrowing of the foreskin of the penis, as a result of underdevelopment of connective tissue, when it is impossible to bare the head.
Phimosis occurs in newborn boys, but by the age of 5-6, the foreskin moves freely and allows you to fully open the head of the penis.
In adulthood, this is a pathological condition of the penis, and provides methods for eliminating phimosis, since during penile excitation it makes it difficult to expose the head and comfortable insertion into the vagina.
The disease can be a congenital defect in the supporting tissue in the body, its weak elasticity. Also, phimosis can develop against the background of crease deformation with injuries, inflammations. At this time, damage, swelling and scarring of the coronary sulcus occurs. The inner part of the foreskin is glued to the head, the head may be injured.
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Stages depending on the degree of exposure of the penis head
The disease is determined during an external examination of the penis.
Depending on the degree of exposure of the head of the penis, phimosis is classified into several stages:
|Stage 1||The head opens freely in the absence of an erection, during an excited penis moving the foreskin is not easy sometimes painful|
|2 stage||Withdrawal of the head in a relaxed state of the penis occurs with effort, during an erection the head is closed and it is impossible to release it|
|3 stage||In the absence of an erection, the head of the penis is completely or partially closed by the foreskin. Only the urethra remains open|
|4th stage||The glans penis is completely closed. Urine excretion is difficult, painful. Symptoms of the pathological process in the penis are observed: redness, swelling, fever, inflammation of the lymph nodes|
At any stage of the disease, it is necessary to apply measures to stretch the foreskin and eliminate the defective state of the organ. In some cases, conservative treatment is used to avoid negative consequences for men.
Narrowing the foreskin, or phimosis in men: home treatment
The skin covering the glans penis forms a fold. This fold, called the "foreskin", descends onto the head and partially or completely covers it, but easily moves up.
- It is worth noting that many newborn boys are born with existing physiological phimosis, but it is not a pathology, because it is caused by age-related anatomical features.
- If the baby does not bother anything, treatment is not required - as the penis grows, the removal of the head becomes free.
- Phimosis can have several degrees:
- 1 degree. The most light, in which exposure of the head of the penis in a calm state occurs without discomfort and pain. During an erection, when the organ increases in size, the release of the head from the foreskin is carried out with some difficulty. This stage of phimosis does not cause serious discomfort in men, and treatment is required only when complications occur. Phimosis of this stage is called relative,
- 2 degree. It is characterized by head release problems even in a calm state. During an erection, the foreskin allows you to expose only a small part of the head, which can cause a man pain of varying degrees. This stage of the disease requires treatment,
- 3 degree. It is accompanied by the inability to free the head from the foreskin either at rest or during an erection. Incorrect treatment of phimosis at this stage can lead to inflammatory complications and even sexual dysfunction,
- 4 degree. This is the most severe form of phimosis, in which the foreskin closes the head so much that both urination and ejaculation become painful for a man. Residual urine and seminal fluid are collected in a prepuncial sac, which contributes to the multiplication of pathogens and the development of inflammatory processes.
The reasons for the appearance of acquired phimosis in adult men can be such factors:
- non-observance of personal hygiene. Due to the accumulation of smegma under the foreskin, pathogenic bacteria give rise to inflammation, which leads to a narrowing of the flesh,
- traumatic injuries of the penis
- inflammatory diseases of the penis,
- a decrease in the elasticity of the connective tissue, as a result of which microcracks form on the organ,
- obesity, the appearance of excess weight (in this case we are talking about hypertrophic phimosis).
The method of treatment of this disease depends, first of all, on the stage of its development. At the third and fourth stages of the disease, surgical treatment is necessary - circumcisio, that is, circumcision of the foreskin. An operation is performed under local anesthesia, the patient does not experience pain in the process.
After the operation, the patient is still in the hospital for some time, and with a positive dynamics of recovery, he is discharged home. In the first two weeks after surgery, the patient should not have sex and generally prevent the appearance of an erection, since an enlarged penis causes severe pain.
It is impossible to get rid of the problem in another way, and self-medication or neglect of therapy can lead to a worsening of the patient's condition.
In parallel with the use of these funds, doctors recommend using the traditional method of treatment - stretching the foreskin.
This method, of course, will not bring instant results, visible improvements can be noticed after at least two months and only if used correctly.
The method consists in gradually stretching the skin during water procedures in the bath - gently and slowly stretch the flesh while in warm or hot water. This procedure should be carried out twice a week.
Sharp, inaccurate movements can lead to rupture of the flesh tissue, which will further aggravate the position of the patient. If pain occurs, the process must be interrupted and make sure that the skin is not damaged. If there are gaps, the procedure must be postponed until everything heals.
Many men prefer to use alternative treatment at home with the help of baths of herbs - chamomile, string and calendula. To do this, use dry packaged herbs sold in pharmacies.
A glass of each type of grass should be poured with a liter of warm water and put in a water bath to warm up for 17 -20 minutes, then strain through gauze or a sieve.
The resulting broth is poured into a large basin or bath with warm water (approximately 20 liters). Such baths should be taken no longer than 20 minutes three times a week for a month. During the procedure, it is also recommended to periodically gently pull the foreskin - this will enhance the effectiveness of the treatment.
It must be remembered that home treatment is possible only if all the nuances are agreed with the attending physician.
During the period of drug therapy, personal hygiene must be carefully observed - thoroughly wash the penis twice a day. For this purpose, you can use ordinary baby soap or special means for intimate hygiene.
To prevent the appearance of such an unpleasant disease as phimosis, it is necessary to observe simple, but very important rules:
- observe personal hygiene. The penis should be washed with soap every day, thoroughly cleansing the foreskin of smegma,
- do not allow the appearance of excess weight,
- avoid damage to the penis, and if it happened, immediately seek medical help,
- treat infectious and bacterial diseases in time to avoid possible complications,
- do not allow unprotected sex (unless you have a regular partner) or use a condom.
At the slightest suspicion of phimosis, immediately contact a professional urologist and take the recommended course of treatment. Remember that this disease can lead to serious consequences - cancer or sexual dysfunction.
With the physiological form, the skin of the foreskin is healthy, has no cicatricial changes and is easily stretched with light tension. With pathological phimosis, soft tension leads to the formation of a conical structure with a narrowed dense white end. Such differences make it possible to differentiate between physiological and painful conditions.
- There are 4 degrees of phimosis severity:
• I - may release the head at rest, with an erection is difficult,
• II - release in any condition is difficult,
• III - release is possible occasionally,
- • IV - the head is never released.
- Major patient complaints include:
• the actual impossibility of removing the head,
• painful manifestations during erection, sexual intercourse,
• pain when urinating,
• the appearance of blood in the urine,
• formation of cracks in the foreskin, bleeding,
• urination disorders (weak, intermittent stream, swelling of the skin of the penis, etc.),
- • recurrent balanitis, balanoposthitis due to infection of accumulating smegma.
- Pain, infection, urination disorders are not typical for the physiological form. A long-existing given condition of any form can lead to:
• paraphimosis - a pathology in which the foreskin “gets stuck” behind the head and cannot close the last (requires emergency medical attention because of the risk of circulatory disorders and necrosis),
• chronic balanoposthitis,
• difficulty urinating up to a delay,
• cystitis - an inflammatory disease of the bladder,
• the formation of kidney stones,
- • pyelonephritis - inflammatory renal pathology, etc.
- According to some reports, pronounced phimosis during a prolonged course may be a risk factor for penile cancer.
The diagnosis is established on the basis of complaints made to patients and the results of the examination. If urinary tract infections and / or skin infections are detected, laboratory testing may be required.
The main problem of patients with phimosis is pain when trying to expose the head in the erectile state of the penis. In some cases, it is completely impossible to open it, regardless of whether an erection is present or not. In addition, there may be problems with urination, as well as the accumulation of sperm in the subpouch, and the classic hygiene inconvenience associated with limiting the ability to clean the head. With a neglected state, doctors also identify inflammation of the extreme epithelium and urethra. The above symptoms are characteristic of both adolescents and men.
Types and Types
Doctors distinguish 4 degrees of severity of the phimotic state:
- 1st degree. Problematic and painful exposure of the head of the penis in an excited state.
- 2nd degree. With an erection, the head does not open at all, there are difficulties in removing it in the normal state.
- 3rd degree. The head can only partially be exposed in the non-erect state of the penis.
- 4th degree. The head is not exposed at all, during urination, the stream does not flow freely, but inflates the prepuce sac, and then with rare drops or a very thin stream flows from the scarlet cut of the end of the penis. As a rule, in this case there is chronic inflammation due to the inability to remove secretions from the head, and in some cases smegmolites are formed - solid formations from stagnant smegma. Sometimes an infection of the urethra develops.
The main subspecies of phimosis include:
- Physiological phimosis. One of the most common types of problems, overwhelmingly found in children under three years old. In fact, this phenomenon represents the underdevelopment of the foreskin after a period of infancy: in the first year of life in all male babies, the epithelium is almost closed and fits tightly to the head of the penis. After some time, it “opens”, therefore, up to the age of three to four years, physiological phimosis can be considered a variation of the age norm, naturally, if it does not cause severe inflammation, as well as pain during urination. By five or six years, this type of phimosis passes on its own, and the head of the penis can open freely. If this event does not occur, then you need to contact a specialist.
- Hypertrophic. This type of phimosis is identified by the thickening of the epithelium of the foreskin, its protrusion beyond the head in the form of a "trunk". If there is no proper treatment, this phimosis flows into hypogonadism.
- Atrophic. In this case, the foreskin significantly thins and even completely atrophies.
- Cicatricial. Here, along with classical phimosis, the formation of scars of various sizes on the edges of the foreskin is observed.
Thus, physiological phimosis is NOT a pathology in children under 5-6 years old and there is NO NECESSITY to treat it.
Phimoses can cause a number of negative consequences, some of which require urgent surgical intervention.
The consequence of the problem is regular inflammation under the foreskin, caused by stagnation of the secret. In addition, the above condition often leads to infection of the urethra due to improper excretion of urine and its return to the urinary canal.
The most dangerous consequence of phimosis is paraphimosis - a sharp infringement of the head of the penis, the flesh. Paraphimosis usually occurs due to attempts to expose the head during intercourse or masturbation.The foreskin at the same time blocks the bloodstream of the end of the penis, which in turn leads to edema of the organ, its blueness and other negative state. If it is impossible to return the epithelium to its original state on its own, then emergency surgical intervention in the form of a longitudinal section of the epithelium or excision of its “leaves” will be required.
The main and rather good method of non-operative disposal of phimosis. It consists in a periodic phased extension of the foreskin. The easiest way is masturbation with the most powerful retraction of the epithelium and the corresponding exposure of the penis head.
Stage-by-stage stretching must be performed before the onset of moderate pain and repeated in several approaches two to three times a day (10-15 minutes). In the process of expanding the passage, you can increase the amplitude of the translational movements, up to the complete exposure of the head. For greater efficiency, you can take a hot bath before the procedure and when the skin becomes more elastic, perform the act of masturbation with maximum amplitude.
An alternative way to stretch is to insert two little fingers into the prepuce bag and periodically spread them apart to stretch. This procedure is less traumatic than classical masturbation, but it is less effective.
The basis of drug therapy for phimosis is the application of corticosteroids to the head of a member in the form of ointments - this type of drug gives elasticity to the epithelium, and also relieves inflammation and swelling.
The most effective ointments-drugs for this task are considered to be clobetasol and betamethasone. They must be applied daily and once to the head of the penis, for two months. In this case, the method can be combined with the above-described stretching of the epithelium.
Despite the high effectiveness of surgical intervention, some doctors note a regular appearance in the operated patients of various complications. Most often these are small bleeding caused by not too careful suturing, as well as meatitis and meatostenosis - the former are inflammations of the external part of the urethra, the latter are due to narrowing of the channel of this component of the genitourinary system.
In order to avoid such problems in the first ten days, you must regularly take baths with potassium permanganate, use antibacterial creams that are allowed by your doctor. In some cases, a second surgical intervention may be necessary, most often to eliminate defects in the appearance of the foreskin (plastic) or to restore the meatus - the correct contours of the urethra.