Treatment of phimosis in children
Phimosis in children
Phimosis is a narrowing of the foreskin, in which the preputial cavity does not open, and the glans of the penis cannot be exposed (completely or partially).
For children in the first years of life, physiological phimosis is a variant of the norm: the foreskin looks like a proboscis, in which there is a small opening surrounded by folds.
But such phimosis arises not due to the narrowness of the foreskin, but due to the connection of its inner surface with the head. This is due to the fact that by the time the child is born, the preputial cavity of the penis is not fully formed. The head and inner leaf of the foreskin separate independently by about 5–8 years.
The glans opens due to the growth of the penis, the appearance of the first erections and the rejection of epithelial cells of the glans penis. Smegma accumulates between it and the inner layer of the foreskin - a product of fatty degeneration of the rejected epithelial cells. Thus, the preputial sac is gradually released, but smegma accumulates and decomposes in the closed cavity, which can lead to inflammation and other complications of physiological phimosis.
In infants (up to one year old), the cavity between the head and foreskin is still absent, therefore, at this age, the risk of complications is extremely low. But later, with an increase in the gap between them, the likelihood of complications increases. The latter often include purulent balanoposthitis and real acquired phimosis of inflammatory etiology. Along with these diseases, itching and pain in the penile area, urinary incontinence (enuresis), etc. appear.
Complications of phimosis in children
The most common complication of phimosis in children is balanoposthitis. This purulent inflammation of the glans penis and foreskin is extremely dangerous, since its prolonged course and frequent relapses can lead to scarring changes in the foreskin tissue. This makes it less elastic and makes it even more difficult to release the head.
It is possible to recognize purulent balanoposthitis by detecting redness of the foreskin and discharge of pus from the preputial sac. The disease is also characterized by severe pain when urinating. Often, to avoid pain, a child may deliberately delay urination, which leads to serious complications.
Treatment of phimosis in children
Phimosis in children mostly goes away without special treatment, but in case of complications, you need to know about first aid.
To resume urination in case of urinary retention, it is necessary to slightly expose the upper part of the head (in the place where the urethral opening is).
Acute balanoposthitis requires maximum disclosure of the peructal sac. However, you should not be too zealous in this, because you can damage the delicate skin of the foreskin, up to tears and bleeding.
Particular attention should be paid to the hygiene of the penis. After any attempts to stretch the foreskin, warm baths should be done with a solution of potassium permanganate. The procedure takes about 10-15 minutes, after which the head should be lubricated with an ointment or emulsion containing an antibiotic. Such measures have a beneficial effect on the well-being of the child, eliminate itching and pacify pain.
But you should not engage in self-medication, because it can only provide temporary assistance. It is imperative to show the child to the doctor (urologist, pediatrician, dermatologist, surgeon), because the most dangerous complication of phimosis is penile cancer, which occurs due to too long stagnation of smegma in the peripal sac. After the examination, the doctor will prescribe treatment (corticosteroid therapy, foreskin stretching, or surgery to excision of the foreskin).
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
