Phimosis of the penis: causes, symptoms and treatment methods
DISEASES OF LENGTH
Diseases of the penis itself are mostly caused by the defeat of the foreskin. There are infections, including sexually transmitted diseases, and psychosexual disorders (they are not discussed in this chapter).
Pathology of the glans penis and foreskin
Phimosis is the narrowing of the orifice of the foreskin, in which it is impossible to expose the head of the penis. Normally, in newborns, the inner surface of the foreskin and the head of the penis are not separated. As the child grows, the foreskin becomes mobile, its cavity is finally formed by 6 years. Until this age, the forced release of the glans head is not recommended. If by the age of 7 the foreskin remains stationary and balanitis occurs, its circular excision, circumcision, is shown.
Phimosis is congenital (rare) and acquired.
Acquired phimosis can be temporary (for example, in acute balanoposthitis) and persistent (in chronic balanoposthitis with cicatricial changes).
With phimosis, the cavity of the foreskin during urination is stretched due to the urine entering it, difficulties with sexual intercourse can be observed.
For temporary phimosis caused by acute balanoposthitis, corticosteroid ointments are used. In cicatricial phimosis, the circumcision is shown.
Paraphimosis - is the infringement of the glans penis narrow foreskin. Usually occurs at the age of 6–12 years. Accompanying phimosis, occurs when an erection or after catheterization of the bladder, there is swelling of the glans penis, severe pain, it is not possible to move the foreskin back.
Urgent contraction of the glans head, which is usually performed without anesthesia, is necessary. If the anesthesia is still performed, no adrenaline is added to the local anesthetic solution.
- To reduce the swelling of the head of the penis for a few minutes, gently squeeze. Then, pressing the thumbs on the head, index foreskin with index fingers (Fig. 86.1).
- Head at the penis, wrapped with a gauze napkin or towel, captured into a fist and squeezed (Fig. 86.2). When the head is reduced in size, the foreskin is displaced.
- If the head of the penis can not be adjusted, then the operation is shown. Under local or general anesthesia, the pinching ring is cut through the dorsal surface. After surgery, edema subsides, and the foreskin freely stretches on the head of the penis. After the subsidence of the acute phenomena produce circumcision.
Balanitis is an inflammation of the glans penis. Usually balanitis combined with inflammation of the inner leaflet of the foreskin (balanoposthitis). The most common pathogen is Candida albicans. The first manifestations — reddening and burning in the area of the glans penis and the foreskin — are usually caused by poor hygiene. Further the bacterial infection joins.
In infants, balanoposthitis is caused by an untimely change of diapers, in older ones balanoposthitis is one of the complications of diabetes.
When balanoposthit exclude:
Seeding detachable from the glans penis and the inner leaflet of the foreskin.
Careful toilet of the glans penis and foreskin.
- for fungal infection - topical nystatin, miconazole or clotrimazole ointment,
- with trichomoniasis - metronidazole or tinidazole inside,
- in case of bacterial infection - antibacterial therapy, for example, chloramphenicol or chlorotstracycline.
When recurrent balanoposthitis is a circumcision.
Thickening and pallor of the skin of the foreskin - a sign of kraurosis of the penis. In the early stages, topical corticosteroid ointment is effective.
Under 5 years, toilet foreskin is not carried out. Starting from 6--7 years should at least once a week, carefully expose the head of the penis and wash it with warm water.
When taking a shower or bath, do not forget about the toilet of the foreskin.
Carefully expose the head of the penis (fig. 86.4), thoroughly wash the head and foreskin with soap, wipe dry, then close the head with foreskin.
If there is an unpleasant odor, burning and redness of the head or foreskin, expose the head of the penis at each urination.
Circumcision is carried out with anomalies of the foreskin and for religious reasons (circumcision). Performing an operation for social reasons is not recommended, explaining that it is unnatural, useless, the risk of surgery, the possibility of stenosis of the external opening of the urethra. At the present time, the circumcision is performed less frequently than in the past. Proponents of the operation believe that it reduces the accumulation of bacteria near the urethra, reduces the risk of sepsis, cancer of the penis and sexually transmitted diseases.
Medical indications for surgery are phimosis, paraphimosis, recurrent balanoposthitis. Circumcision is not recommended for hypospadias, since the skin of the foreskin can be used for plastics.
In contrast to circumcision, the dissection of the foreskin leaves a cosmetic defect, therefore it is used only in emergency cases.
Pathology of the external opening of the urethra
Stenosis of the external opening of the urethra
Stenosis of the external opening of the urethra can be congenital and acquired. In adults, the most common cause of the disease is trauma during bladder catheterization. Stenosis may occur after circumcision as a result of ulceration of the glans penis, the risk of stenosis in this case decreases with the local application of vaseline. Rare causes of stenosis include damage to the external opening of the urethra during circulation.
Characterized by pain when urinating and excretion of blood from the external opening of the urethra.
With a small stenosis in a child, the external opening of the urethra is bougienized. In severe stenosis, a metotomy is performed.
Hypospadias is a malformation in which the external opening of the urethra is located either on the ventral surface of the penis, or in the scrotum, or in the perineum. The prevalence is 1: 300 men. There are head (most frequent), peribenon, stem and perineal forms of hypospadias . In hypospadias, the stream of urine is deflected downwards, sprayed or drips down the penis. In all forms of hypospadias, except the head, plastic surgery is shown. Fibrous strands are excised between the external opening of the urethra and the head of the penis and, using the skin of the foreskin, close the defect, then make plastic of the urethra,
Epispadias is a malformation in which the external opening of the urethra is located on the dorsal surface of the penis. The prevalence is 1:30 000 men. Very often, epispadias is accompanied by urinary incontinence due to dysfunction of the bladder sphincter.
Genital warts are multiple warty growths located along the neck of the glans penis, on the inner leaf of the foreskin, near the external opening of the urethra. The causative agent is human papillomavirus. The disease is sexually transmitted.
The affected area should be dry.
Local 10--25% solution of podophyllin or 0.5% solution of podophyllotoxin (only for warts).
Cryodestruction, electrocoagulation under general anesthesia, administration of interferon a to the affected areas, and topically fluorouracil ointment are used.
Penile skin lesions
The most frequently observed damage to the short frenulum of the foreskin. Trauma occurs during intercourse. Damage heals quite a long time, sometimes plastic bridle is required.
The skin lesion of the penis is observed in sexually transmitted diseases - syphilis (chancre), genital herpes, HIV infection, rarely - in penile cancer (tab. 86.1).
Penile cancer is a rare tumor. The prevalence is 1: 100,000 men. It occurs predominantly in the uncircumcised (apparently, due to the carcinogenicity of smegma).
Initially, the tumor has the appearance of a nodule or ulcer on the head of the penis or its neck, it may resemble a condyloma. The tumor is usually hidden under the foreskin, so the first symptom, especially in non-hygienic, is bloody or offensive discharge . In 50% of cases, when first treated, there is an increase in lymph nodes (due to inflammation or metastases).
Priapism is a persistent, painful erection that is not associated with sexual arousal.
The direct cause of priapism is the difficulty of venous outflow from the cavernous bodies. Cavernous bodies are tense and painful, while the spongy body and the head of the penis remain soft.
Priapism is considered an emergency: it can lead to venous thrombosis of the penis and impotence.
Idiopathic priapism is most often observed, less often it occurs after the administration of prostaglandins in the treatment of impotence, in blood diseases (for example, sickle cell anemia or leukemia), metastases of malignant tumors, damage to the spinal cord, intake of anticoagulants, phenothiazines, some hypotensive drugs, in case of hashism. A common cause is intracavernous administration of certain drugs, especially papaverine.
When prism requires immediate consultation of the urologist. To exclude blood diseases urgently perform a complete blood count. Metaraminol is administered intracavernously, 1 mg as a weak solution, then the penis is massaged. Apply cold, for this ice cubes injected into the rectum (this is especially effective if priapism due to side effects of drugs). If there is no effect, then re-inject metaraminol or perform venous bypass.
What are the symptoms of penile disease?
As a rule, diseases of the penis manifest themselves quite quickly. To delay the visit to the doctor is not recommended: early start of diagnosis and treatment is always a guarantee of successful treatment.
Signs of penile disease:
- Pain in the penis at rest, as well as pain during erection or sexual intercourse
- Swelling of the penis
- Redness of the skin and / or glans
- Deformation (usually curvature) of the penis
- Any education on the penis
- Urinary Disorders
- Sexual disorders
How is the diagnosis of the disease of the penis?
At the reception, the urologist-andrologist will conduct a detailed examination of the penis with palp
Based on the results of the examination and conversation with the patient, he will prescribe and take all the necessary laboratory tests. Will send to the ultrasound diagnosis of the penis, which will be carried out by the ultrasound doctor here, in the clinic. If necessary, he will give directions to X-ray examinations and MRI.
What are the most common penile diseases?
Balanitis (balanoposthitis) is an inflammatory disease. The foreskin of the penis head is affected. Balanoposthitis can be the result of STDs such as syphilis, chlamydia, trichomoniasis, candidiasis, mycoplasmosis. Symptoms - burning, itching, cracks in the foreskin, yellow or white deposits on the head, red spots may appear on the skin. Depending on the pathogen, antibacterial treatment is carried out.
Ulcers, erosion on the penis - a very serious symptom of a number of diseases (syphilis, genital herpes, balanoposthitis, candidiasis, Fornier's gangrene, scabies, lichen sclerosing, penile cancer).
Condylomas of the penis provoke human papillomavirus 6 and 11, abbreviated HPV 6, 11. In men, genital warts are most often located on the penis and scrotum. Condylomatosis is transmitted sexually. The course of this disease depends on the characteristics of the immune system: the disease may recur. Kondilomatoz is treated radically - removal, with the mandatory correction of immunity.
Urethritis - inflammation of the urethra (urethra). Depending on the cause, urethritis is divided into infectious and non-infectious. Infectious urethritis - the result of the penetration of the pathogen into the urethra. Both specific (eg, gonococcus, gardnerella, etc.) and non-specific pathogens (staphylococcus, streptococcus, E. coli) can become an infectious agent. Most often, the infection occurs through sexual intercourse.
Non-infectious urethritis is most often the result of injury. The urethra is often injured during cystoscopy, catheterization, the passage of stones or sand with urolithiasis.
Phimosis is a narrowing of the foreskin. The head of the penis opens with difficulty. Phimosis can be a physiological phenomenon (in newborn boys), which passes by itself.
Pathological phimosis can be congenital and acquired.
According to the degree of severity, there are four degrees of phimosis. The first degree - the narrowing of the foreskin occurs only during erection. The second - the opening of the head is difficult and without an erection, and in an erection state the head is closed completely. The third degree - the minimum opening of the head. The fourth and most severe degree - the head is not bare at all, the urine is excreted drop by drop.
Phimosis is treated only with a scalpel. Our clinic is advised by an experienced urologist.
Cavernite - with this disease, inflammation of the cavernous (cavernous) bodies of the penis occurs. The reason - damage to the penis or inflammation in the urethra. With cavernitis, the temperature sharply rises to 39-40, chills, weakness, pain in the joints begin. The penis swells, there are seals (infiltrates), touches that cause pain. Treatment to the doctor should be prompt, and in case of acute form, hospitalization will follow.
Peyronie's disease is a curvature of the penis. Such deformation occurs gradually, about two years, as a result of the appearance of seals on the skin (Peyer's patches). This seal consists of dense connective tissue, and calcium salts are gradually deposited in it. The penis deviates towards the growth of such a hearth.
Curvature of the penis may be due to other reasons. For example, when the development of the cavernous bodies of the penis occurs unevenly, the member deviates to the right or left.
Penile cancer is quite rare. There is a theory that the likelihood of oncology of the penis is lower in men who have been circumcised during childhood or early age.
We list some predisposing factors (precancerous diseases):
- phimosis (constriction of the extreme flesh)
- chronic balanoposthitis (inflammation of the head and foreskin)
- xerotic obliterans balanitis (for this disease is characterized by the appearance of white spots, wrinkling of the skin of the penis)
- HPV types 16 and 18, 6 and 11
- cutaneous horn of the penis - compacted, thickened area of skin (usually appears at the site of injury, moles, etc.)
- Kern's erythroplasia - reddening area with clear contours on the head or foreskin
- Bowen's disease, often arises as a comorbid pathology in cancer of internal organs, manifests itself as red plaques on the head of the penis.
Remember that penile diseases are easier to prevent in most cases than to cure!
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Phimosis (Phimosis) is a pathological condition of the penis, in which the foreskin is so narrow and immobile that it does not allow to expose the head during erection or at rest. This causes not only significant discomfort to the man, but also entails the emergence of various diseases of the reproductive and excretory system.
The foreskin, or preputium, is the skin fold that covers the head of the penis. Its structure is very similar to the structure of the eyelid or the labia in women. A preputium consists of two layers, passing into the coronal sulcus. The upper layer is represented by epithelial tissue (skin), and the inner layer is the mucous membrane. The foreskin from the lower side of the penis passes into the bridle, which does not allow the prepucial fold to move to the base of the penis.
At rest, the preputium covers the head of the penis, thus forming a narrow space - the preputial sac. Its main function is protection against drying out and exposure to external factors. Therefore, in the treatment of phimosis, experts try to remove such anatomical formation only in extreme cases.
Frequency of occurrence
Phimosis of the penis is a fairly frequent pathology.which, as a rule, does not cause inconvenience to the man. During the laying of all organs and structures in the womb, the head and the preputium of the penis are formed from the same tissue. The member continues to form until puberty.
Врождённый фимоз характерен для 95% новорождённых мальчиков. To 1 year of life, the head opens in 20−25% of babies, and in 3 years - in 50−55%. Already by the age of 6, the complete elimination of phimosis should occur, and if it does not occur, it is considered pathology. Very rarely, the head of a member opens during puberty. This is facilitated by the production of significant amounts of hormones that make the foreskin more elastic.
For some peoples of Southeast Asia, congenital phimosis continues to maturity, which is considered the norm. This is due to the fact that they have a genetic predisposition. In ancient Greece, a long and narrow preputium was considered a virtue for a man, and a bare head was considered indecent. That is why the male half of the population used special leather ribbons (kindesdes), one end of which was attached to the head of the penis, and the other was tied to a belt.
Classification of pathology
Depending on the type of pathology, treatment will be determined. It is selected individually for each patient based on the degree of the disease.
There are two main types:
- Physiological. It is characteristic of newborn boys and, as a rule, it disengages by the age of six. It is recommended that such children daily carry out hygiene of the genital organs, as well as periodically conduct medical examinations. Such phimosis is not considered a pathological condition.
- Pathological. Formed when non-compliance with preventive measures to eliminate physiological phimosis. The disease requires a certain treatment, and for the latter stages - surgical intervention.
Pathological form is divided into two types. Classified by the mechanism of disease:
- Hypertrophic. Formed due to a significant lengthening of the foreskin. At the same time, phimosis looks like a proboscis, which is why this species is also called proboscis. According to statistics, hypertrophic phimosis is characteristic of men suffering from overweight. Not only the metabolism is disturbed, but also a significant amount of adipose tissue is formed in the pubic region, which becomes the reason for preputium lengthening.
- Atrophic. This form develops due to a decrease in skin fold. In this process, there is a significant narrowing of the preputial ring, which does not allow exposing the head.
Causes of disease
The most common type is congenital. The reasons for its occurrence are still a mystery to doctors. Nevertheless, the fact that phimosis is characteristic of some peoples inclines to the version that the genetic predisposition is the root cause. That is, there are such genes whose products are responsible not only for the formation of a certain form of the foreskin, but also for its elasticity.
It is important to note that, as a rule, such an anomaly is very often combined with some congenital pathologies: disorders in the structure of the connective tissue, the structure and work of the musculoskeletal system (flatfoot, scoliosis).
Very often, the pathological form develops as a result of self-correction by parents without medical consultation of the physiological phimosis in a little boy. This leads to adhesions between the mucous membrane and the skin fold, which significantly reduces the size of the preputial cavity.
But the main cause of most cases of development of the disease of the penis are infectious diseases, which lead to inflammation in the preputial sac. As a result, cicatricial phimosis is formed.
The degree of constriction of the preputial ring
There are four main degrees of constriction of the ring prepucium. Depending on this form, a specific treatment is prescribed.
Share the following stages of phimosis:
- First degree With this pathology, it is possible to release the head from the skin fold at rest, but with an erection this causes considerable difficulty, which is accompanied by pain.
- Second degree At this stage of the disease, exposure of the head in tranquility is difficult and causes significant discomfort. When excited, the preputium completely hides the penis or opens it slightly.
- Third degree To release the head of the penis, both at rest and during erection, is impossible.
- Fourth degree This pathological condition not only causes pain and discomfort during sexual intercourse, but also during urination. This is due to a significant narrowing of the preputial ring. This stage requires surgery.
It is important to note that the first three degrees of the disease are characteristic of adult men or teenagers. For children, these conditions are considered normal. But if a small child accumulates in a preputial sac during urination or narrows the trickle of urine, this is considered a pathology and requires the advice of a specialist.
Signs in men
Phimosis 4 degrees develops in rare cases. Therefore, as a rule, the main symptoms of the disease occur during intercourse. Signs of a violation of the structure of a prepucium are:
- pain during sex,
- decrease in sensitivity during intercourse,
- premature ejaculation,
- decrease in potency.
Therefore, men may experience psychological problems that are formed due to constant discomfort during sex, as well as the uncharacteristic appearance of the penis. That is why it is recommended to consult not only the urologist, but also a psychologist.
Not always the disease is accompanied by problems in sexual intercourse. However, this condition requires treatment.
Danger of asymptomatic form
There is a perception among people that if the disease is asymptomatic, it is not necessary to treat it. But it is not. This is especially true of pathological conditions associated with the reproductive system.
The mucous membrane of the head produces a large number of various substances:
They are part of a secret called smegma. Its main function is to protect the penis head from drying out. During puberty, a significant amount of smegma is produced, and at a later age, its secretion decreases. These substances accumulate in the prepucial space along with dead epithelial cells. All this forms the ideal medium for the reproduction of pathogenic bacteria. Only constant hygiene of the genital organs prevents the development of infection. But in the case of phimosis, this is a difficult procedure.
Permanent smegma stagnation can cause such complications:
- balanitis - inflammation of the mucous epithelium of the head of the penis,
- Balanoposthitis - inflammation of the mucous membrane of the head and the inner layer of a preputium,
- the accumulation of carcinogenic compounds that can cause not only cancer in men, but also in their partners, causing cervical cancer,
- penile cancer,
- papillomas on the penis.
In young children, the accumulation of smegma does not occur, because at an early age it is produced in small quantities, so the prepucial cavity is self-cleaning. In adolescence and in older age, men need to carry out daily hygiene of the genital organs, which consists in washing the head of the penis and preputium with clean water and soap.
In the case when the disease is asymptomatic and does not cause discomfort, doctors still strongly recommend getting rid of this pathology, because in the future it can cause the development of various inflammatory processes in the genital organ. In addition, it contributes to the occurrence of paraphimosis.
Complications in adults
Paraphimosis - a pathological condition of the penis, in which there is a significant narrowing of the ring of the foreskin, as a result of which the exposed head is pinched. This causes impaired blood circulation, as well as swelling and increased pressure in the penis.
This disease occurs only in the initial stages of phimosis, when it is still possible to expose the head. As a rule, the pinching of the head with a prepucium occurs in men and adolescents during intercourse or during masturbation.
Determining paraphimosis is easy. Its signs are:
- severe pain in the penis,
- swelling of the penis head,
- blue penis.
If you do not take any treatment, then over time the pain decreases, but this is due to a strong circulatory disorder in the penis. With a complex form of paraphimosis, the color of the head may become purple or black. All this indicates the beginning of necrosis.
To prevent such complications, it is recommended to immediately seek the help of a urologist. At the initial stages it is possible to reposition the penis head without surgery. Since this procedure is accompanied by severe pain, analgesics are administered to the patient. At later stages, an operation is required to dissect the preputial ring.
Physiological phimosis characteristic of all newborn boys. This is due to the fact that the inner layer of prepucium remains fused with the mucous head. That is why in no case can you expose the head of the penis to the baby, since this can lead to injury, which later becomes the cause of the following pathologies:
- erosion of the inner epithelium of the prepucial cavity,
- inflammatory process,
- secondary pathological phimosis.
If the baby does not experience discomfort, then take any action is not required. Enough to hold a daily toilet of the genitals. Soap at this age is recommended to use no more often than once every 3-4 days, but it must be ensured that soapy water does not fall into the preputial bag.
The separation of the foreskin is due to the death of epithelial cells. This is a natural, but very long process. When this occurs, the formation of children's smegma. Unlike an adult, its main component is the dead cells of the epithelium, which go outside with the urine.
Complications in children
Complications of physiological phimosis in children are extremely rare. Their causes are not only poor hygiene, but also inflammatory processes, frequent overheating and allergic reactions. In children, the following complications can occur: paraphimosis, urinary retention and balanoposthitis. If such pathologies occur, it is required to seek help from a specialist.
Post, balanitis and balanoposthitis
Balanitis, fasting and balanoposthitis are diseases that occur in children much more often than in men. This is due to the structure of the genitals of a little boy. The development of such diseases contributes to a number of factors:
- diabetes mellitus - a high content of glucose in the urine acts as a breeding ground for the reproduction of bacteria,
- overweight - a violation of metabolism occurs,
- hypo-or avitaminosis - helps to reduce immunity, so the body can not fight infection,
- injuries due to improper opening of the head,
- allergies - medicines and allergens affect the immune system,
- overheating or overcooling
- wearing tight clothes.
Most often, children develop balanoposthitis - inflammation of the penis and prepucium. For the resolution of such a diagnosis, the patient should have the following symptoms:
- post - redness and swelling of the prepuce penis,
- balanitis - inflammation in the head of the penis,
- pain not only when urinating, but also in a state of rest,
- discharge from the penis.
For the treatment of the disease, antibiotics are prescribed, as well as anti-inflammatory drugs. Also of particular importance should be given to the hygiene of the penis. In the absence of treatment, adhesions may form with the subsequent development of cicatricial phimosis (by mistake it is also called a phimotic scar).
Development of paraphimosis
Paraphimosis in small boys develops only when parents forcibly open the head of the penis. Symptoms, possible complications and treatment for this disease are the same as for men.
Doctors do not recommend self-resort to any first aid. The correct decision in identifying paraphimosis in a child will be an immediate appeal to a specialist for medical help. To transport a boy with paraphimosis, you need to lie on his back, and his legs should be wide apart. To eliminate the pathology, an operation is performed to cut the preputial ring. During this procedure, general anesthesia is used. When this drug is injected into a vein.
Surgical intervention is resorted to only in cases where conservative treatment does not give the desired result. Nevertheless, some doctors still believe that surgery is the only correct solution for getting rid of phimosis.
But in practice, the following methods of treatment are most often used:
- drug therapy - the use of hormonal ointments that contribute to stretching the skin of the penis,
- special tools that stretch the skin fold of the penis,
- daily stretching of the hands of a prepucium.
But if the patient has cicatricial phimosis, conventional conservative treatment will not solve this problem.
Before you begin this type of therapy, you need to seek advice from your doctor. It will help determine the correct treatment tactics. During the procedure it is necessary to remember the following rules:
- It is necessary to carry out the stretching of the skin fold gradually, avoiding any pain,
- The procedure should be performed every day.
There are several methods for stretching a prepucium. The effectiveness of each of them is different and depends on the severity of phimosis.
There are three main ways:
- Exposure of the head. To achieve the desired result, you need to pay at least 10−15 minutes a day. In the initial stages of the disease, it is possible to eliminate the pathology using such an exercise in 1 month.
- Stretch prepucium. The essence of this method is to regularly stretch the skin fold during bathing and after each urination until pain arises. This method is effective for eliminating phimosis in boys. The duration of treatment can be from 3 to 4 months.
- Finger stretching. With this method of treatment, it is necessary to insert the fingers under the prepuce of the penis, then gently push them apart.
In order to achieve a positive effect as soon as possible, hormonal ointments are used in combination with the methods of stretching. They are based on corticosteroids that help soften and increase skin elasticity. In addition, these drugs can eliminate the inflammatory process that most often accompanies phimosis.
But there are a number of contraindications for which such treatment is prohibited:
- bacterial or fungal infection,
- increased levels of corticosteroids in the body,
- hypersensitivity or intolerance of the drug.
It should be remembered that the use of hormonal drugs is possible only after their appointment by a doctor. They have not only local, but also systemic action.
The following side effects may occur during treatment:
- skin pigmentation,
- violation of the structure of blood vessels,
- thinning of the skin.
It is important to note that folk remedies do not treat phimosis, but only help reduce pain and discomfort, as well as relieve inflammation. But they cannot stretch the preputium.
To facilitate the overall condition, in a pharmacy, it is recommended to purchase chamomile, calendula and a series. They exhibit the following action:
Decoction is prepared according to the instructions, which are presented on the package. To steam out the penis in such an infusion of herbs should be at least 15−20 minutes, after which you need to perform the procedure of stretching a prepucium. Contraindications to the use of baths can only be individual intolerance or an allergic reaction to any of the components of the decoction. Use infusions recommended for the treatment of phimosis in children and adolescents.
To surgery resorted to in extreme cases. There are different types of surgical interventions, which are used to eliminate various complications arising from phimosis.
There are three main ways:
- Bloodless method. It is recommended for children, because this type of operation allows you to save all the functions that the preputium performs. The essence of the method lies in the fact that a probe is inserted under the skin fold, separating all the adhesions. To do this, make a circular motion, and then carefully expand the hole using a special clamp. After this procedure, it is recommended that you manually open the head of the penis every day for one month.
- Surgical intervention. For men, local anesthesia is used during the procedure, and for children - general. The elimination of phimosis occurs at once. After the procedure, the patient is sutured, which must be removed after 8−10 days. You can have sex on day 14.
- Circular excision (circumcision), or circumcision. This is the most common surgical removal of phimosis. The main advantage of the procedure is speed and the absence of any recurrence. In addition, the likelihood of complications is much less than in previous methods.The main disadvantage is the complete removal of prepucium. With the fourth degree of phimosis, as well as with the scar, the only way to eliminate the pathology is precisely a circular excision.
- Plastic surgery. This is an alternative to circumcision, only while preserving part of the prepucium. It can be carried out using both a straight cut and a zigzag. The end of this intervention is stitching the edges of the fold, which makes it much wider. It is worth noting that the disadvantage of this method of eliminating pathology is a significant recovery period. Also, plastic surgery cannot be applied in cicatricial phimosis.
- Use a laser. If in the previous four methods of surgical intervention a scalpel is to be used, then in this case the laser is the instrument. The main advantage is accuracy, safety and a short rehabilitation period (3-4 days). Nevertheless, sex is recommended after 2 weeks.
Phimosis is one of the most common diseases of the reproductive system that can develop in both early and late age. It is very important to diagnose such a pathological condition in time and to begin the correct treatment. With timely measures taken, serious consequences can be avoided.
Causes and symptoms
The development of penis diseases is caused by congenital abnormalities, injuries, hygiene, unprotected sex, infectious exacerbations, the harmful effects of various types of radiation, and decreased immunity.
The list of adverse factors also includes circulatory disorders, contact with allergens, oncological processes, and drug abuse.
Diseases of the penis occur:
- Discharges with an unpleasant smell and color.
- Hemospermia (the appearance of blood impurities in semen).
- Discomfort, pain, burning, pain (with erection, sexual contact, at rest).
- Peeling of the skin, the appearance of cracks, ulcers, vesicles.
- Redness of the whole body or part thereof.
- The appearance of a raid under the foreskin.
- Swelling, swelling of varying intensity.
- Bulk neoplasms.
- Violation of urination, erection, sexual disorders.
- A change in the shape of the body.
Anatomical, post-traumatic disorders
Epispadias - a defect in which the front wall of the urethra is not fully or partially overgrown. The illness is often accompanied by urinary incontinence.
In hypospadias, an external opening of the urethra is observed. During urination a stream of urine is deflected, sprayed, or drains along the penis.
The insufficient length of the frenum of the foreskin causes pain during erection, sexual intercourse. High risk of breaking the bridle during sex.
The small length of the penis (less than 9 cm in an erection state) is the cause of psychological disorders and, as a result, sexual disorders.
The list of congenital anomalies includes a special arrangement of the veins, which are clamped during erection.
Peyronie's disease (curvature of the penis) is progressing as a result of organ consolidation, the growth of fibrous tissue. Accompanied by painful erections.
The consequences of injuries are manifested by sharp pains, swelling, redness of the organ, rupture of the bridle, fracture of the penis.
The risk of developing stenosis of the external opening of the urethra increases after circumcision, catheterization.
Tumor diseases are accompanied by urination disorders, pain syndrome, problems with erection, the appearance of ulcers, nodules, bleeding, lymph node enlargement.
Melanoma (skin oncology) appears dark spots, progresses with regular sunbathing without clothes.
Benign neoplasms consisting of high-density tissue, calcium deposits, with a small size do not pose a threat to health, but can lead to the development of Peyronie's disease.
When you post, caused by a violation of hygiene, congenital features of the body, injuries, infections, inflammation develops in the foreskin. The disease is manifested by edema, hyperemia of the head, pain during sex, urination, fever (less often).
When balanitis is often combined with postitis (risk factors are similar), the skin of the organ head is inflamed, which is accompanied by itching, burning, cracks, the appearance of a white, yellow patina on the head, red spots.
Phimosis is a common disease found predominantly in childhood, which is characterized by a narrowing of the foreskin, as a result of which the head cannot fully open.
Paraphimosis, associated with phimosis, develops as a result of catheterization of the bladder, accompanied by intense pain, swelling of the head.
Mycoplasmosis, affecting the urethra, provokes swelling, redness of the head, pain during sex, urination.
Ureaplasmosis, which affects not only the head, but also the urethra, increases the likelihood of progression of urolithiasis.
When trichomoniasis occurs inflammation of the head, there are pain, discharge from the urethra.
Candidiasis is manifested by white ("cheesy") bloom, accompanied by burning, itching, and constant discomfort.
Penis skin diseases
Syphilis is accompanied by the appearance of a hard chancre on the skin of an organ (painless ulcerative compaction), an increase in lymph nodes, neurological, mental disorders, malfunctions of the internal organs.
Dermatitis develops when wearing tight linen, mechanical friction, exposure to allergens, infectious agents. The disease is manifested by redness, discomfort, burning, itching, the appearance of areas of weeping irritation.
In psoriasis, the penis member is covered with plaques (as is the case with psoriasis of other skin areas). The disease is manifested by acute pain.
Papillomavirus, herpes virus, for a long period without manifestation of severe symptoms, "declare" itself against the background of stress, overloading, hypothermia, weakening of the immune system. Bubbles are detected, later - sores, papillomas.
Oleogranuloma is an inflammatory process that develops as a result of the introduction of various substances under the skin of the penis. The result is cicatricial deformity of the organ, fistula, ulcers, pain, tissue necrosis, erectile dysfunction.
Diseases with urethral secretions
Chlamydia is accompanied by clear discharge from the urethra, painful sensations when urinating. Often proceeds without severe symptoms.
Gonorrhea is manifested by yellowish secretions, cutting, pain, damage to internal organs, with subsequent complications.
Urethritis is a common inflammatory disease of the urethra that develops as a result of infection or trauma. The presence of discharge in urethritis is a sign of severe illness.
Diseases affecting the entire penis
With cavernitis, the cavernous (cavernous) body of the penis is inflamed, which is accompanied by swelling of the penis, seals, pain, a sharp increase in temperature (up to 39-40 degrees), chills, weakness, pain in the joints.
Varicocele (varicose veins of the penis) develops as a result of circulatory disorders, manifested by unpleasant sensations, pain when moving. The disease causes an increase in the risk of infertility, cancer.
The most common functional disorder is the weakening or absence (impotence) of erection.
Priapism is accompanied by a long (4 hours or more) erection (without stimulation), accompanied by pain, discomfort, increased risk of damage to the penis. The probability of developing priapism increases with sickle cell anemia, abuse of drugs used to treat neurological and erectile disorders, alcohol poisoning, narcotic substances.
The diagnosis and prescription of the treatment course are made after:
- Examination, palpation, analysis of anamnesis.
- Laboratory tests (blood, urine, semen, smears, scrapings, PCR, ELISA).
- Radiographic, ultrasound studies.
- Doppler sonography, angiography.
- Magnetic resonance imaging.
Performing preventive medical prescriptions allows you to minimize the risk of developing painful processes.
Prevention includes strict adherence to the rules of hygiene, avoidance of casual sex, the use of condoms at every sexual contact, the treatment of concomitant diseases of the urinogenital and other systems.
Also important is maintaining the normal functioning of the immune system, avoiding hypothermia, injury, harmful radiation, increasing stress resistance, avoiding bad habits, visiting a urologist (at least once a year during the detour of all doctors).
The manifestation of one of the above pathologies requires an immediate visit to the doctor. Many diseases can be successfully cured without any complications with the timely start of therapy. Self-medication increases the likelihood of adverse effects on physical and sexual health.
Causes of inflammation of the head and foreskin
A variety of diseases of the penis, head occur due to a number of influences of external and internal order, in aggregate, increasing the risk of developing negative symptoms. Predisposing factors are:
- lack of personal hygiene,
- high secretory activity of the glands of the foreskin,
- reduced immunity
- metabolic disorders, such as diabetes,
- infectious process in the urogenital tract,
- long stay in countries with hot climatic conditions,
- injuries, for example, during long manipulations with the head,
- organ bites by parasites, insects,
- genital herpes, the incubation period of which lasts up to 6 days and the signs are hidden,
- inflammation of the prostate gland,
- syphilis, chlamydia, gonorrhea,
- infection under the foreskin.
Pathology can be local and concern only the head, but most often the diseases of the head of the penis are accompanied by inflammation of the foreskin, which explains the characteristic clinical picture of the disease.
Types and forms of diseases
Forms of pathologies differ:
- Infectious - the cause of which is an infection that enters the patient’s body,
- Circinate - caused by yeast-like spores, affecting the outer membrane of an organ,
- Herpes - infectious diseases, the cause of which is the herpes virus,
- Traumatic - is a consequence of the violation of the integrity of the skin or muscle tissue of an organ,
- Anaerobic - developed by anaerobic bacteria,
- Allergic, appearing as an immune response,
- Candida - caused by fungus,
Forms of pathologies may be similar in symptoms and clinical picture, vary by reason of occurrence, the infectious agent. There are more rare and common diseases of the glans penis and the organ's foreskin. It should be remembered that most pathologies bypass men with a circumcised penis - this is due to the lack of smegma accumulation in the bag, which naturally reduces the level of bacteria accumulation and the risk of developing infectious pathologies.
These are head diseases in men associated with significant narrowing of the foreskin. Due to this phenomenon, it is impossible to expose the head of the organ, which threatens to complete atrophy of the tissues. The development of pathology increases the risk of violation of the evacuation of urine, and the absence of outflow causes the accumulation of urine in the bag and swelling of the end. The blood supply to the organ gradually deteriorates and necrosis develops. Causes of pathology:
- genetic abnormality present at the birth of a boy,
- infection or scar tissue resulting from trauma and / or chronic inflammation,
- balanitis - leading to scarring and sealing of the foreskin.
Appeal to the doctor should be prompt.
This disease is also called the "Spanish collar". The foreskin is delayed, and can not return to its former place, inflamed and surrounding the head with a tight ring. Causes of development:
- strong and prolonged erection or sexual activity,
- head damage.
The consequences of the formation of a tight compression ring around the end of the penis are sad: impaired blood flow, swelling, pain, gangrene and amputation.
These are diseases of the glans penis, which during development infect the foreskin (balanoposthitis). The causative agent is most often a fungus of the genus Candida, sexually transmitted or appearing due to lack of personal hygiene. Symptoms look like swelling, redness of the head, cracks, foci of erosion appear, itching develops.
Infectious infection of the tissues of the foreskin occurs quickly, it becomes difficult for the patient to move the flesh away to expose the head, the process of removing urine is disturbed, which provokes the further development of pathology.
Important! In small boys and adolescents, balanitis / balanoposthitis occurs due to a rare change of diapers, lack of intimate hygiene..
Other causes of the appearance of pathology include:
- allergic reactions to substances or contact allergies,
- sexually transmitted diseases (gonorrhea, syphilis, herpes),
- diabetes mellitus - high urinary sugar content is the best nutrient medium for bacteria accumulated under the head.
Tip! Balanitis and balanoposthitis do not threaten men with circumcised foreskin. Bacteria simply have nowhere to accumulate, and caring for a circumcised genital is much easier.
Anomalies and physical damage
Deviations from the norm in the structure and shape of the body lead to diseases of the head and foreskin. The disease of curvature (anomaly of the cavernous bodies), the underdevelopment of the urethra - leads to the fact that the trunk of the body leans towards the location of the anomaly, which provokes the development of the disease.
As for the injury of the genital organ, the violation of the integrity of the skin - a clear reason for the resettlement of bacteria, infection. An internal hematoma can also provoke head disease, as a result of which the blood circulation, lymph circulation, and urinary organ are damaged.
One of the types of pathologies that cause the member to bend. A characteristic feature is the formation of plaques, leading to abnormal deformations of the trunk and head of the organ. The plaques appear as local areas of seals that cause irritation, swelling and subsequently transform into a hard scar. The scar reduces the elasticity of the entire body and its end, causes pain. The disease can be both congenital and acquired.
There are no obvious reasons for the pathology, but the disease can occur in:
- acute form - when the inflammation becomes permanent and the patient experiences an unbearable pain in the head, and during an erection the trunk is bent by an arc,
- soft form - passes without treatment for 6-18 months, but is aggravated by the inflammatory period.
Sometimes pathology develops quickly, lasts a short time and is most often caused by injuries / microtraumas of the penis. But most often Peyronie's disease has a long incubation period and is detected in an acute form, requiring immediate treatment. What factors can trigger plaque formation syndrome:
- Vasculitis is the destruction of blood and / or lymphatic vessels, leading to scarring of tissues.
- Anomalies of connective tissue development not only of the phallus, but also of other parts of the body. Thickening or thinning of the connective tissue leads to the formation of seals in certain areas, which causes pain.
- Heredity. Some studies confirm that if the male half of the family is faced with Peyronie's disease, the risk of developing the pathology in boys increases several times.
This is the name of the erect condition of the penis, observed for a long time. Sometimes an erection lasts 6 hours or more with no apparent reason for arousal. Pathology is accompanied by pain and has various causes: from nervous overexcitement (stress) to impaired blood flow to the penis. Common causes of priapism:
- Narcotic substances (cocaine),
- Some drugs of the antidepressant group and medicines for lowering blood pressure,
- Spinal problems
- Genital trauma,
- Anesthesia, performed incorrectly or causing allergic reactions,
- Injection therapy for the treatment of erectile dysfunction.
Priapism is often the result of blood disorders, in particular leukemia or sickle cell anemia. The disorder leads to severe pain, while the man can not affect the weakening of erection.
Diseases of the skin of the penis
This is a group of diseases that lead to pathologies of the head and foreskin of the penis. Diseases can cover any area of the male genitalia, but most often start from the end.
Cancer of the glans penis is a rare disease that occurs in men with uncontrolled cell division and growth. Possible development of benign tumors in malignant due to the development of infection. Initially, oncology looks like a small nodule on the head, with an unpleasant odor and bloody secretions. Развитие рака отягощается нарушением лимфотока, что обуславливает увеличение лимфоузлов.
The causes of the disease are not fully elucidated, but there are a number of provoking factors:
- Inflammation of the foreskin - affects uncircumcised patients.
- Human papillomavirus (HPV), which includes more than 100 types of viruses that cause the formation of warts on the head of the penis and pain around them. Some papillomaviruses can also affect the area of the anus, transmitted through sexual contact.
- Smoking is the entry into the body of many carcinogens and chemicals that settle in the lungs and provoke the formation of cancer in different parts of the body.
- Smegma - fatty secretions that accumulate under the foreskin and are not washed out due to poor hygiene - a breeding ground and nutrient medium for microbes, viruses, bacteria. Accumulations of smegma can cause irritation around the glans penis, triggering the development of pathologies.
- Phimosis. The narrowing of the foreskin prevents the normal blood circulation of the head, which causes necrotic phenomena and leads to cancer of the head of the penis.
- Treatment of psoriasis and other skin rashes that cause pain in the phallus, involves exposure to UV rays and taking drugs that increase the risk of developing oncology.
- Age. More than 58% of cases of head penile cancer are found in men over 68 years old.
Explicit symptoms are a signal to contact your doctor, but in some cases the cancer develops extremely slowly, making it difficult to make a diagnosis in a timely manner.
Physical, chemical, other effects on the penis
Head diseases are often caused by injuries to the trunk of the penis, the scrotum. Here are some of the most common:
- Damage to the frenulum is more common in patients with a short frenulum. This is a hereditary or congenital anomaly, when, during an erection, the frenulum prevents the normal introduction of the penis and tears. Trauma leads to infection, increasing the risk of head diseases.
- "Fracture" or "dislocation" of the trunk - a phenomenon that occurs with excessive exposure to the body. As a result of aggression, a hematoma appears inside the body of the penis, making it difficult for blood to flow to the head, which can lead to necrosis. In the practice of urologists, there are frequent cases of rupture of the internal ligaments and pharynous corpus cavernosum, explaining the reason for the appearance of inflammations on the head.
- Pinching an organ is a disease that occurs due to the overstretching of an erect penis with threads, elastic bands and other improvised means.
All cases of exposure to the phallus should be promptly treated to prevent the development of tissue atrophy and the subsequent amputation of the organ.
Methods of treatment and prevention
An obligatory condition for effective treatment is to establish the cause of the disease and eliminate it. Diagnostic tests will be required:
- Urine, blood, urethral smear,
- Ultrasound, CT,
- Bakosev smear,
- Visual examination, palpation,
- Collect patient history.
Based on the test results, the specialist diagnoses and prescribes drug therapy or reveals indications for surgery. Treatment of all genital pathologies in men should be initiated at an early stage. The delay in accessing a doctor leads to a progression of diseases, the appearance of purulent complications. Each pathology requires individual therapy, taking such means as:
- Anesthetic ointments, solutions.
Well help drugs: Diflucan, Clotrimazole, washing with a solution of manganese, furatsillina, hydrogen peroxide. Briefly consider treatment options for the most common pathologies:
- Priapism. Emergency medical care is required, as a prolonged erection causes pain in the phallus, which leads to a decrease in erectile function. Treatment: blood drainage through the needle penetrating into the head, medication, narrowing the blood vessels.
- Balanitis (balanoposthitis). Acceptance of antibiotics, antifungal drugs. In severe cases, circumcision of the foreskin is required.
- Phimosis. Applied drug therapy for prolonged exposure. Surgical intervention is indicated in extreme cases. This may be the complete removal of the foreskin or the separation of the flesh from the head - a less traumatic option with a short rehabilitation period.
- Paraphimosis. Sometimes there is enough ice applied to the area of the tumor to reduce the swelling. Ineffectiveness of measures recommends injection therapy or incision of the foreskin to release the head.
- Cancer of the glans penis. Surgical intervention is considered at any stage of the pathology. It may be:
- wide excision of the tumor site,
- the scraping of tumor formations with the subsequent use of electric current to destroy cancer cells,
- cryosurgery - freezing of abnormal cells with their subsequent destruction,
- microsurgery with removal of cancerous and parts of normal tissues,
- exposure to a laser beam to eliminate formations
- Amputation of the penis is an effective method of eliminating cancer and eliminating all or part of the phallus.
- Peyronie's disease can go away on its own, while doctors offer an expectation of up to 24 months. Otherwise, apply medical or surgical therapy. The second option has a high risk of complications, for example, reducing the size of the body. Without surgery, treatment involves the introduction of drugs in the plaque to soften the seals, reduce pain and correct the curvature.
Treat the pathologies of the head and foreskin of the phallus to the urologist, andrologist. Experts will recommend home ways to care for the head of the penis, prescribe the necessary treatment. When diagnosing a venereal or fungal cause of the disease, sexual contact should be minimized until complete healing.
When to see a doctor:
- Pain syndrome does not go away for a long time
- There are formations on the head, foreskin, alarming,
- The state of erection lasts more than 3 hours,
- The disease has no apparent reason or is difficult to explain.
Preventive measures of pathologies of the glans penis are quite simple. Men should pay attention to the condition of the body, carefully monitor the hygiene, do not overcool and wear clothes in size. Synthetic underwear is one of the reasons for the accumulation of smegma, pinching of the organ, which leads to impaired blood flow and the development of infections. It is extremely important to streamline the sex life or use condoms, limit the consumption of alcohol, cigarettes. And do not forget about regular inspections by specialists - this will help to identify the disease at the earliest stages and ensure the timely start of treatment.