Very often, parents of little boys hear from a pediatric surgeon the diagnosis of phimosis. And this causes bewilderment and confusion, since it is completely unclear what to do, how to treat the child, and whether it is necessary to resort to surgical intervention.
Not in all cases should the alarm be sounded, says the authoritative children's doctor Komarovsky. For the most part, the diagnosis given by the surgeon to the baby does not need treatment. But to understand the essence of what is happening is necessary. Evgeny Olegovich talks about phimosis in boys and the correct attitude of his parents towards him in more detail.
About the problem
Medical reference books say that phimosis is a pathological narrowing of the foreskin, as a result of which it becomes difficult to expose the head of the penis. You should not consider this a disease, since almost all newly born boys have this problem.
Only 3-4% of male babies born have a mobile foreskin, for all the rest it is not possible to bare a member. This does not carry any danger, since it is a physiological feature.
Physiological phimosis goes away on its own, as the child grows up, along with the beginning of the production of male sex hormones. They affect the ability of the foreskin to stretch - the more hormones, the more elastic the flesh. Already by six months, according to statistics, the head of the penis opens freely in 20% of children, and by one and a half years - in every third.
About 90% of boys get rid of physiological phimosis by 3 years. In the remaining 10% of children, narrowing of the foreskin can be observed until the end of puberty, and this, according to Evgeny Olegovich, will also be a variant of the norm.
Only 1% of these "belated" boys have true phimosis, which is a pathology. For a correct understanding of this problem, Dr. Komarovsky explains that of this 1% in 98% of young men whose penis has not opened by the age of 16, phimosis can be completely cured with the use of corticosteroid ointments and simple exercises to increase the elasticity of the flesh. In most cases, the doctor says, boys themselves successfully solve this problem, because all adolescents are engaged in masturbation.
Thus, the need for an operation is so insignificant that you should not immediately run to doctors with the requirement to cut, trim and open the head as soon as possible. Moreover, you should not worry, panic and worry! Komarovsky argues that the statements of doctors about the severity of phimosis and insistent recommendations in conducting therapeutic measures are rather commercial in nature and are rather far from medicine.
What to do for parents
First of all, says Evgeny Komarovsky, moms and dads should clearly understand that if a child's surgeon diagnoses a child with phimosis, then this is most often a diagnosis for the sake of a diagnosis: the doctor only states the fact that the boy has a physiological narrowing of the foreskin. We already know that it is quite natural.
If such an unpleasant verdict is passed to a teenager aged 15-16 years, and conservative measures (corticosteroid ointments and stretching) did not help, you should contact the surgeon for simple manipulations - circumcision. This will not worsen a man's life in the least, but in some ways will even improve it.
What not to do
Komarovsky does not advise parents at home to forcefully open the boy's penis. Such advice, as practice shows, can be given not only by "all-knowing" friends and grandmothers, but also by district surgeons in a polyclinic. If the child does not have any pain, he has no difficulty in urinating, there is no redness, inflammation, nothing needs to be touched.
When bathing and washing, you should not try to wash something under a closed foreskin, especially with soap. Between the foreskin and the head of the penis, a sufficient amount of special lubricant - smegma, which has excellent antibacterial properties, is released, and therefore there is no need to rinse. But soap, which can get under the foreskin, can cause a severe chemical burn.
When you need medical attention
There are several situations in which parents should seek qualified medical help as soon as possible:
- Paraphimosis;
- Balanoposthitis;
- Adhesions between the foreskin and the head of the penis.
- Paraphimosis can arise when parents, contrary to common sense, decided to do their own hand stretching of the foreskin with physiological phimosis. At some point, everything went wrong: the head came out, but it turned out to be clamped by the foreskin from below, and it could not be returned back. If this happens, you need to deliver the child to the surgeon as soon as possible, the count goes for minutes. Otherwise, a head pinched by a ring of narrowed flesh, deprived of a normal blood supply, is at risk of developing gangrene, which, in turn, is fraught with amputation of an organ so important for a future man.
The sooner the child is delivered to any nearest medical facility, the better. With timely treatment, the doctor can do by manually repositioning the head of the penis into place. In no case should you try to do it yourself at home! But what you need is to immediately squeeze the head of the penis slightly and apply something cold to it, but avoid frostbite.
In some cases, this is even enough to relieve puffiness and return the foreskin to its place. But you shouldn't count on this and hesitate to see a doctor.
- Balanoposthitis and other inflammatory diseases of the penis also should not be treated at home with folk recipes. A child who, against the background of physiological phimosis, has pain during urination (he cries before peeing), reddened and swollen foreskin, must be shown to the pediatric surgeon. These diseases are more common in children than in adult men, which in itself is dictated by the physiological age-related narrowing.
If pathogens of infection, which the smegma itself cannot cope with, enter the favorable environment, which is smegma, then inflammation may begin. In this situation, you do not need to open or rinse anything, but you should immediately go with the child to a medical institution. This also applies to inflammation in babies who already have the head of the penis opening. Balanoposthitis itself can lead to scarring and secondary phimosis.
- Synechiae (adhesions). Fusion of the foreskin and the head of the penis can be congenital, or it can develop gradually, especially in children who often suffer from inflammatory processes of the foreskin. The doctor should establish the degree and localization of the fusion. He will prescribe treatment, which does not have to be surgical. About 40% of synechiae are successfully treated without the use of surgical instruments and manipulations. Extensive adhesions require surgical intervention.
Doctor Komarovsky's advice
Daily hygiene procedures for boys with physiological phimosis should include flushing with plain water. During bathing, once every 2-3 days, you can wash the child with soapy water (for the solution, use baby soap). In this case, washing should be external, you should not open the head of the penis. It is not necessary to use a disposable syringe, as numerous sites for moms advise, to try to flush the head of the penis without opening the foreskin. Such actions can injure and infect the baby's genitals.
The development of inflammatory processes on the narrowed foreskin is facilitated by factors such as an incorrectly chosen diaper, too tight panties for a boy, as well as aggressive laundry detergents. Parents should make sure that the genitals are free enough so that the underwear and diapers are comfortable, not pinching anything.
Pampers need to be changed more often so that the child has less contact with urine and feces, and panties should be washed with hypoallergenic baby powders.
Physiological phimosis will not be complicated by inflammation if parents remember: smegma infection is most likely if the child sweats a lot, overheats. It is best to maintain optimal microclimate parameters in the house - temperature 18-20 degrees, relative humidity - 50-70%.
You can also learn about what children's phimosis is from the following video just below.
