Can you have kids with phimosis

Possible complications can include trouble urinating and death of tissue necrosis in the tip of the penis. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child. Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

Know what to expect if your child does not take the medicine or have the test or procedure. If your child has a follow-up appointment, write down the date, time, and purpose for that visit. This is important if your child becomes ill and you have questions or need advice. Search Encyclopedia.

Phimosis and Paraphimosis in Children What is phimosis and paraphimosis in children? What causes phimosis and paraphimosis in a child? What are the symptoms of phimosis and paraphimosis in a child? Symptoms can be a bit different in each child.

The most common symptoms of phimosis include: Bulging of the foreskin when urinating Not able to fully retract the foreskin by age 3. The most common symptoms of paraphimosis include: Swelling of the tip of the penis when the foreskin is pulled back Pain Not able to pull the foreskin back over the tip of the penis Tip of the penis is dark red or blue in color Pain when urinating Decreased urinary stream The symptoms of phimosis and paraphimosis can seem like other health conditions.

They are also less harrowing and devoid of psychological trauma which is commonplace with circumcision [ 56 ]. Studies have shown that retractability declines several months after completion of therapy [ 33 , 40 ]. However, a second course of topical steroids proves useful in such cases.

Of concern to parents and providers alike is the degree of risk of systemic absorption of steroid and suppression of hypothalamic-pituitary-adrenal HPA axis. But this risk is minor considering the fact that the amount of steroid cream used and surface area of application is small. Besides, steroids are used only for 4—6 weeks.

Topical steroids could be used as a first-line treatment for pathologic phimosis and is a viable option prior to surgery. However, patients with BXO respond poorly to topical steroids. This may serve as a screening tool in such cases [ 57 ]. If a patient has concomitant balanitis or balanoposthitis, depending on the etiology, he may be treated with topical antibiotics or antifungals [ 60 ]. Proper serum glucose control is vital in diabetic patients [ 61 ]. In this, gentle preputial retractions are carried out by a doctor on an outpatient basis.

This nonsurgical adhesiolysis is found to be effective, cheap, and safe treatment for phimosis [ 23 , 62 — 64 ]. Eutectic mixture of local anaesthetics EMLA could be used prior to attempts at release of the preputial adhesions [ 65 ].

The technique was simple, safe, cheap, less painful, and less traumatising then the conventional circumcision. It was found to be more beneficial in younger children with no fibrosis or infection [ 66 ]. Combination therapy using stretching and topical steroids has also yielded excellent results [ 67 , 68 ]. These invasive measures are to be reserved for recalcitrant phimosis that fails to respond to medical management.

It is a conservative alternative to traditional circumcision which is fraud with many complications, problems, and risk [ 7 , 69 — 88 ]. Preputioplasty is the medical term for plastic surgery of the phimotic prepuce. This procedure has faster less painful recovery, less morbidity, less cost, and more preservation of foreskin and its various projectile, erogenous, and sexual physiologic functions [ 7 , 86 ].

The disadvantage is that phimosis can recur [ 89 ]. Dorsal slit with transverse closure is recommended by many doctors due to its simplicity and good results [ 80 ]. The lateral procedure described by Lane and South provides cosmesis [ 85 ]. Frenulotomy and meatoplasty is also beneficial. Some of the procedures such as Y- and V-plasties The Ebbehoj procedure are complex and require skilled hands.

Hence they are not favoured much. In this case, the phimotic foreskin is totally excised. Circumcision is one of the oldest elective operations known in humans. But gradually it became a routine neonatal procedure in USA and in some countries of Euro pein view of its reported hygiene and cancer-preventing benefits [ 91 ]. It cures phimosis and prevents recurrence [ 92 ]. It also prevents further episodes of balanoposthitis and lowers incidence of urinary tract infections [ 26 , 93 — 95 ].

But it is besot with its own innumerable short, and long-term problems. Pain, difficult recovery, bleeding, infection, psychological trauma, and high cost are seen with circumcision [ 96 , 97 ]. The literature is full of reports of morbidity and even deaths with circumcision. Besides, circumcision could lead to keloid formation.

Possibility of decline in sexual pleasure for both circumcised males as well as their female partners due to loss of erogenous tissue has been reported [ 96 , 98 — ]. With advent of newer plastic surgical procedures for phimosis, this traditional surgery is gradually getting outdated. Circumcision is to be avoided in children with genital anomalies where the foreskin may be needed for later corrective surgery for the anomaly.

Prolonged antibiotic therapy, intralesional steroid injection, carbon dioxide laser therapy, and radial preputioplasty alone or with intralesional injection of steroid have all been described as therapies for phimosis, but there are no proper randomised controlled trials of their efficacy and long-term outcomes.

Phimosis needs to be differentiated from non-retractile prepuce, which is the rule in young children. Doctors should be taught on distinguishing these two types of phimosis in order to avoid parental anxiety and needless referrals to urologists for circumcisions. Newer nonsurgical modalities such as topical steroids and adhesiolysis are effective, safe, and cheap for phimosis in children. Parents should be made aware of these measures to treat phimosis.

If surgery is indeed needed, conservative plastic surgical techniques should be performed rather than the traditional circumcision. This would help the patients, their family, and the healthcare as well as the society at large.

National Center for Biotechnology Information , U. ISRN Urol. Published online Mar 5. Author information Article notes Copyright and License information Disclaimer. Received Nov 22; Accepted Dec This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC.

Abstract Phimosis is nonretraction of prepuce. Penile Development and Anatomy Penile formation starts from 7th week of gestation and is complete by 17th week [ 8 ]. Etiology of Phimosis Physiologic phimosis is the rule in newborn males. Clinical Features The incidence of pathological phimosis is 0. Diagnosis Diagnosis of phimosis is primarily clinical and no laboratory tests or imaging studies are required [ 35 ]. Management When a child is brought with history of inability to retract the foreskin, it is important to confirm whether it is physiologic or pathologic.

Reassurance and Vigilance When it is certain that phimosis in the child is not pathologic, it is vital to reassure the parents on normalcy of the condition in that age group. Topical Steroids Topical steroids have been tried in cases of phimosis since more than 2 decades.

Dilation and Stretching In this, gentle preputial retractions are carried out by a doctor on an outpatient basis. Surgical These invasive measures are to be reserved for recalcitrant phimosis that fails to respond to medical management. Conservative Surgical Alternatives It is a conservative alternative to traditional circumcision which is fraud with many complications, problems, and risk [ 7 , 69 — 88 ].

Conventional Male Circumcision In this case, the phimotic foreskin is totally excised. Other Experimental Options Prolonged antibiotic therapy, intralesional steroid injection, carbon dioxide laser therapy, and radial preputioplasty alone or with intralesional injection of steroid have all been described as therapies for phimosis, but there are no proper randomised controlled trials of their efficacy and long-term outcomes.

Summary Phimosis needs to be differentiated from non-retractile prepuce, which is the rule in young children. References 1. Steadman B, Ellsworth P. To circ or not to circ: indications, risks, and alternatives to circumcision in the pediatric population with phimosis. Urologic Nursing. Circumcision for phimosis and other medical indications in Western Australian boys.

Medical Journal of Australia. The incidence of phimosis in boys. British Journal of Urology International. Dewan PA. Treating phimosis. Van Howe RS. Is neonatal circumcision clinically beneficial? Argument against. Nature Clinical Practice Urology. Neonatal circumcision: associated factors and length of hospital stay. Journal of Family Practice. Cost-effective treatment of phimosis. Penile embryology and anatomy. The Scientific World Journal. The prepuce.

Fine-touch pressure thresholds in the adult penis. Sub-preputial wetness—its nature. Annals of National Medical Science. Immunological functions of the human prepuce. Sexually Transmitted Infections. Conservative treatment of phimosis in children using a topical steroid. Gairdner D. The fate of the foreskin, a study of circumcision. British Medical Journal. Analysis of shape and retractability of the prepuce in Japanese boys.

Journal of Urology. Imamura E. Phimosis of infants and young children in Japan. Acta Paediatrica Japonica. Ishikawa E, Kawakita M. Preputial development in Japanese boys. Acta Urologica Japonica. Further fate of the foreskin.

Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Archives of Disease in Childhood. Is phimosis overdiagnosed in boys and are too many circumcisions performed in consequence?

Annals of the Royal College of Surgeons of England. Griffiths D, Frank JD. Inappropriate circumcision referrals by GPs. Journal of the Royal Society of Medicine. Gordon A, Collin J. Save the normal foreskin. Why are children referred for circumcision? Preputial adhesions—a misunderstood entity. Indian Journal of Pediatrics. Phimosis—a diagnostic dilemma?

The Canadian Journal of Urology. Phimosis as a presenting feature of diabetes. An argument for circumcision. Prevention of balanitis in the adult. Archives of Dermatology. Phimosis and diabetes mellitus. Clinical features and therapy of lichen sclerosus et atrophicus affecting males. Clinical and Experimental Dermatology. Pathologic and physiologic phimosis: approach to the phimotic foreskin. Canadian Family Physician. Diseases of the foreskin, penis, and urethra.

You will get the elasticity and you will be able to retract the foreskin completely. In case if there is no result from the above massage, you can always go for a minor surgical procedure called circumcision. Take care. Suggestions offered by doctors on Lybrate are of advisory nature i. Content posted on, created for, or compiled by Lybrate is not intended or designed to replace your doctor's independent judgment about any symptom, condition, or the appropriateness or risks of a procedure or treatment for a given person.

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