Phimosis - surgery or cream?

My child has a foreskin on the tip of his penis, is this normal?

In newborn boys, until the second year of life, the foreskin at the top is naturally glued to the head of the penis. It's a completely normal thing.

The role of the parents is to free their boy's foreskin from the glans by gently pulling it during the child's bath until he is two years old, and to teach his boy how to independently maintain the hygiene of the penis.

What is phimosis?

Phimosis is a narrowing of the foreskin at the tip of the penis, which makes it difficult, or sometimes impossible, to pull the foreskin over the glans penis. It occurs in both adults and children.

If the release of the glans is not possible because the foreskin is too narrow, then we are talking about congenital phimosis. In the most severe cases of congenital phimosis, the child has difficulty urinating and a bubble forms under the skin on the tip of the penis. Another condition called athesia of the foreskin can also make it difficult to retract the foreskin, but then it is not phimosis.

What should I do if I fail to peel my child's foreskin?

Contact a genital pediatric surgeon who, after examining the child, will make a decision on the best course of action to solve the problem.

In the case of mild narrowing, the doctor will recommend certain creams that soften the foreskin, and the narrowing will disappear after 3 to 4 weeks.

On the other hand, if the foreskin is very stuck to the glans penis, then the doctor will suggest removing the foreskin. It is a painful procedure and is therefore performed under local anesthesia. After rubbing the cream with a local anesthetic, the procedure is not painful and does not cause trauma to the boy.

The doctor recommended surgery. When is the best time to do it?

In case of serious changes on the foreskin of the tip of the penis, and when it is not possible to solve the problem with creams, the only solution is circumcision.

Circumcision is a surgical method of removing the diseased foreskin of the tip of the penis - the prepuce.

This type of treatment is not advised before the second or third year of life. A special case is when a child has difficulty urinating or has problems with constant urinary infections of the bladder and kidneys due to phimosis. Then phimosis is operated upon even before the first year of life.

Circumcision in children is always done under general anesthesia. During the operation, it is necessary to achieve not only functional but also aesthetic success of the operation with careful surgical technique. Excessive shortening of the foreskin, ugly scars and loss of sensation in the glans are just some of the possible complications that are avoided by precise micro-surgical technique and the use of extremely thin threads.

A genital surgeon has determined that we need surgery. What next?

What does the operation itself look like?

First of all, circumcision is not an emergency surgical intervention and it can be planned according to your needs.

All surgical interventions in children are performed under general anesthesia.

A few days before the operation, the pediatrician will check whether the child is healthy and fit for the operation under general anesthesia. On the day of the operation, you will be accommodated in the hospital suite. During the entire stay in the hospital, except in the operating room itself, you will not be separated from your child.

Is the procedure painful for my child?

The joint work of the anesthesiologist and the surgeon ensures complete comfort before and after the intervention. Before the operation, the child drinks syrup, the so-called premedication, so that the preparation for the operation goes without emotional trauma for the child and the parents.

The operation is always performed under general anesthesia. The intervention itself lasts less than 45 minutes, after which the child wakes up in the hospital suite in your arms. You usually stay in the hospital for several hours after the intervention. After leaving the hospital, you stay in close contact with your doctor for close postoperative monitoring and dressings. All bandages are removed 7 days after the operation.

The microsurgical sutures, which are used during these operations, dissolve by themselves 4 weeks after the operation, and then complete healing of the wound is expected.

I am 50 years old, my foreskin has changed, narrowed. I thought only children had such a problem.

Phimosis can occur at any age. The diseased foreskin bursts with every swipe, new painful scars are created that additionally narrow it to the extent that it is impossible to swipe the foreskin even in a relaxed state, let alone in an erection. Repeated injuries to the foreskin create conditions for the development of infection.

In adults, phimosis can occur at any age.

The most common causes of phimosis in adults are insufficient hygiene with repeated infections. A particularly progressive disease that leads to a narrowing of the foreskin of the penis in adults is called lichen sclerosus of the penis.

Lichen sclerosis, in addition to narrowing of the foreskin, changes in the color of the glans and skin of the penis, leads to progressive narrowing of the urinary canal. Lichen sclerosis requires a special treatment approach, mandatory circumcision and the use of corticosteroid creams, in order to stop this insidious disease. Cases of long narrowing of the urethral canal are often encountered due to this disease.

Phimosis has a serious effect on the quality of life. Sexual relations are not possible, the penis is constantly infected, and in the most severe cases, urination is also difficult.

Surgery is the only true permanent solution to the problem that will save you from further suffering.

I don't have any pain. Why do I have to have surgery? What do you suggest?

Contact your urologist and he will most likely suggest surgery to remove the affected foreskin. The most serious complications of phimosis can be fatal. Permanent coverage of the glans permanently changes the skin and creates serious problems, the most dangerous of which is penile cancer.

Is foreskin removal the only solution for phimosis?

It depends on the current condition of the foreskin. If possible, the urologist will suggest the use of corticosteroid creams to reduce inflammation and relax the foreskin. In some forms of phimosis, special surgical techniques can sometimes be used to preserve the foreskin and thereby maintain the unchanged appearance of the penis.

What does circumcision surgery itself look like?

Circumcision in adults is usually performed under local anesthesia. After proper anesthetic administration, the procedure itself is painless. The operation lasts about 30 to 45 minutes. After the surgery, you will have a special bandage that prevents swelling and promotes faster healing of the wound.

After leaving the hospital, you will stay in close contact with your doctor for post-operative follow-up. All bandages are removed no later than one week after the intervention. The sutures used are self-dissolving, so there is no need to remove them.

You can return to your usual activities the very next day after surgery. The only thing that is not allowed in the first three weeks after phimosis surgery is sexual intercourse, swimming in the pool or staying in the sauna.

Will my glans be sensitive after phimosis surgery?

Immediately after the intervention itself, you will not feel anything due to the prolonged effect of anesthesia. After the anesthesia wears off, you may feel slight discomfort until the glans adapts to the new environment without the protective effect of the foreskin. You can use anesthetic creams to relieve any pain. This period of adjustment and increased glans sensitivity usually lasts about 5 to 7 days.

Does circumcision affect my sexual strenght?

The operation of the foreskin does not affect the quality of the erection. Generally, after the operation, you will have better sexual relations due to the removal of the diseased hypersensitive foreskin.