Almost every boy is born with physiological phimosis. Not all parents know how to behave in this case. The famous pediatrician E. Komarovsky advises not to worry ahead of time. Before taking any measures, you need to understand the causes of the violation. In addition, pathological and physiological phimosis in boys should be distinguished. Komarovsky believes that medical treatment is not always required for this diagnosis. In what cases it is really necessary, let's try to understand today's article.
Features of the disease
The formation of the penis in the boy begins in the mother’s womb, and in the very first weeks of pregnancy. However, in a newborn baby, it is not fully developed. The process of final ripening ends in the puberty. According to medical statistics, 90% of male infants are diagnosed with phimosis, and in 50% this phenomenon does not pass up to a year.
In a newly born baby, the foreskin slightly sags. The skin-mucous membrane is always motionless and serves as a kind of shield. It protects the head of the penis from the effects of urine and contamination with feces. This is the first sign of phimosis. Violation is not a symptom of pathology and is considered a normal condition. During this period, the full opening of the head is impossible, since it does not pass through a narrow hole. The situation independently normalizes by about 5 years. In rare cases, the process drags on to adolescence.
Phimosis can be pathological. In this case, a pronounced narrowing of the foreskin is observed. The child begins to experience difficulties during urination, discomfort is often accompanied by an inflammatory process. Pathological phimosis in boys Komarovsky advises to treat with medication. If conservative therapy is ineffective, the pediatrician recommends surgery.
Main reasons
The etiology of the disorder is not fully understood. However, physiological phimosis has a clear genetic trace. At the same time, there is a lack of certain components in the body that are responsible for the elasticity of connective tissue.
The causes of the disease should be considered only in the case of its pathological form. The foreskin can narrow against the background of inflammatory processes, the appearance of scars in the genital area. Inappropriate actions of parents during bathing or rubbing clothes - these factors contribute to traumatic damage to the head of the penis. Therefore, when choosing linen, preference should be given to natural fabrics and the absence of rough seams.
An allergic reaction can also provoke phimosis in boys. Komarovsky symptoms of the pathological process suggests evaluating in the first place. According to the clinical picture, you can try to independently determine the cause of the disease. For example, in the case of an allergy, the genital organ swells, and the skin changes its color towards cyanotic. A similar reaction of the body may appear on powder for washing underwear, personal hygiene products for bathing.
The degrees and symptoms of pathology
Dr. Komarovsky phimosis in boys is classified into 4 stages. Its initial stage in adolescents is manifested by the inability to completely expose the head of the penis during erection. In a calm state, all manipulations end in a positive result. The second stage is characterized by a difficult process of exposing the head of the penis even in the absence of an erection. In the future, this becomes impossible. Then the pathological process is complicated even more. For example, pain appears during urination. Such a sign indicates the final stage of development of phimosis.
Komarovsky names the following symptoms of the pathological form of the disease, which parents should pay attention to:
- difficulty urinating;
- pain, discomfort in the genital area;
- incomplete head closure;
- inflammation, pronounced drooping foreskin;
- discoloration of the head.
How to identify physiological phimosis in boys? Komarovsky clarifies that in newborns this disorder manifests itself in a slightly different way. First of all, the child becomes overly restless, he can constantly cry and refuse to eat. Another symptom is a change in the appearance of the genital organ (cyanotic shade, swelling, swelling). Older children usually constantly correct their underwear, since the onset of inflammation brings discomfort.
Parents should pay due attention to any changes in the behavior of the boy. If suspicious symptoms appear, you should immediately consult a doctor who can give useful recommendations.
Possible complications
Many parents, having learned about the diagnosis of phimosis, decide on their own to cope with the problem. They are trying to forcibly expose the head. However, the inept actions of mothers and fathers often lead to a complication of pathology - paraphimosis.
In this condition, the head of the penis quickly swells as a result of being pinched by the foreskin ring. Lack of urgent surgical care can lead to tissue necrosis and even amputation. Before the arrival of the medical team, you can try to correct the situation yourself. To do this, gently squeeze the head of the penis with your fingers and apply something cold to it. Due to the physical effect, the edema should decrease, but it still costs to see a doctor.
Another common complication of untreated phimosis is a violation of urination. The disorder, in turn, is often accompanied by inflammatory processes and infectious diseases of the kidneys. Difficult urination can also result in damage to the foreskin. Over time, this inflammatory process takes on a chronic form.
We must not forget that phimosis can lead to psychological problems. When the appearance of the boy’s genitals differs from the genitals of their peers, the child often closes. At an older age, this problem can lead to difficulties with erection and sexual intercourse.
What to do with physiological phimosis?
This question arises with most parents. Komarovsky does not recommend treating physiological phimosis in boys, but advises him to wait for puberty. Otherwise, irreparable harm can be caused to the newborn. Inaccurate exposure to the foreskin often results in the appearance of microcracks. When they heal, a more pronounced narrowing may form.
If physiological phimosis has not passed by the age of 14, you need to consult a doctor for advice. Based on a physical examination, he will be able to prescribe medication. In rare cases, surgical intervention is required. According to statistics, only one boy out of 2 thousand children needs surgery.
Treatment of the pathological form of the disease
When the pathological process is supplemented by problems with urination, the doctor prescribes a conservative treatment. First of all, they try to use non-drug therapy methods, namely special massage exercises. What it is? This is a gradual extension of the foreskin, aimed at exposing the head of the penis. Such exercises are recommended to be performed daily. Only a constant effect on the problem area can cure pathological phimosis in boys. Komarovsky recommends following these rules:
- sharp movements during procedures should not be allowed;
- all manipulations should be carried out with clean hands;
- it is important to pay attention to the reaction of the child (if the baby cries or feels discomfort, the stretching must be stopped);
- it is better to start procedures after swimming.
With competent and constant physical exposure, the first positive results can be observed after 4-8 weeks.
A good effect is given by drug therapy with a diagnosis of phimosis in boys. Komarovsky treatment advises starting with corticosteroid drugs. Most often, children are prescribed “Prednitop” ointment. It promotes the rapid healing of microcracks on the skin, increases its elasticity and significantly reduces puffiness.
Surgical intervention
What other treatment methods does Komarovsky say with a diagnosis of phimosis in boys? The operation, according to the pediatrician, is indicated in extreme cases. We are talking about the cicatricial form of the disease and the ineffectiveness of previous conservative therapy.
Surgery involves a circumcision procedure. The operation lasts no more than 20 minutes. However, it does involve general anesthesia. If the disease is not in a neglected form, the solution of the problem is reduced exclusively to the separation of adhesions. This minimally invasive intervention is performed under local anesthesia.
Proper hygiene is the basis of prevention
Can phimosis be prevented in boys? Komarovsky sees the causes of this disorder in poor hygiene of the genitals. It is worth noting that this is a pathological form of the disease. Physiological phimosis does not provide for treatment and prevention.
What does a pediatrician mean by good hygiene? Komarovsky advises daily to wash the child with warm water. You should also use special wet wipes when changing the diaper. Bathing foam is not recommended. It contains a large number of chemicals that can cause irritation. It is better to replace it with baby soap. In no case should you try to expose the glans penis or pour foam under the foreskin for better cleansing. Such manipulations often end with an inflammatory process.
It is important to change the baby’s underwear daily. For washing, it is better to use powders and non-allergenic products. Breasts need to change their diapers as often as possible. This is necessary to prevent prolonged contact of the penis with urine and feces.
To summarize
One should not be afraid of the diagnosis of phimosis in boys. Komarovsky, whose photo is presented at the beginning of the article, considers this violation a variant of the norm. So the body of a small person is arranged. The pathological form of the disease is also not dangerous. It can be cured by strictly following the doctor's recommendations. If the child is scheduled for surgery, you should not abandon it. Surgical intervention is rarely accompanied by complications and practically does not affect future sexual activity.