With the support of only phimosis is a condition in which it is impossible to completely withdraw the head of the foreskin of the pain. You can find 90% of the boys before the start of the puberty is a manifestation of physiological maturation of the penis. With the support of only phimosis in men with a pathological condition. He develops in 2-3% of adults and leads to many serious complications, reduces the feeling of sexual intercourse. In the early stages with the support of only phimosis can be successfully treated with conservative methods, therefore, it is important to monitor the disease and consult a doctor.
The mechanism of development of
The penis is the external genital organ of men, the main function of which is the deposit of sperm into a woman's vagina. The most sensitive part of the head is concentrated in the most nerve endings. It is covered with a delicate epithelium, which is similar to the structure of the red border in the mouth. At the top of the head to open the urethra. The lower part is fused, the cavernous bodies of the penis, which is in the trunk. This is the place the penis is a thickening of the coronary groove, can be felt immediately under the head.
Protects the delicate skin of the head, the injury, the skin-fold of the foreskin. The apartment consists of 2 disks:
- The external – the structure is identical to the skin's epidermis, there is an upper cornified layer;
- The interior is covered with a thin epithelium similar to that of the mucous membrane.
The foreskin begins in the coronal furrow and closely covers the whole head, forming prepucialis cavity. He opens the front opening, which easily expands and releases the head. The normal adult man, the foreskin moving easily, fully exposing the upper part of the penis. In the back of the head of inner leaf cavity closely fused tissue in the form of a bridle. The thickness of the bridle lies a huge number of nerve endings, capillaries, stimulate it during sexual intercourse gives a man pleasure.
The foreskin of the following functions:
- Protects the urethra against the penetration of pathogens, which is a hole;
- To prevent mechanical irritation, the damage to the thin epithelium on the surface of the head, sensitivity;
- It is easy to slip the intercourse, the production of smeg of a smooth inner layer;
- Increase the pleasure received during intercourse due to stimulation of the nerve endings in the glans, and the frenulum. This is an important factor in the evolutionary plan: without strong positive emotions in people is not the sex, it is less likely to procreate.
With the support of just moses, as a pathological condition develops after inflammation or damage to the foreskin. The resulting impact destroyed tissue and start an inflammatory process. Through certain stages, always in the end, the restoration of the integrity of the authority. Deep damage is replaced by the formation of coarse connective tissue, which significantly reduces the flexibility of the foreskin. The high activity of reduction processes leads to the formation of connective tissue septa between the internal leaf of the cavity, and the head of the penis. They firmly hold them together and prevent the kipreparálást the upper part of the penis.
It should be understood that support only phimosis is not a disease, but specific condition that is associated with the physiological characteristics of the organization (age), heredity, damage to the fabric of the foreskin. In this regard, the following forms of support only phimosis:
- Physiological – occurs in most boys before puberty, and the associated functional maturation prepucialis cavity. Not a disease, you solved after 7 years.
- Pathological – occurs inflammation, trauma, metabolic disorders, and require treatment:
- Hypertrophic (trunk);
The frequency of occurrence of a given form of support, just phimosis depends on the age. The children in most cases, physiological in nature, but in men caused by scarring.
According to the severity of the process is currently 4 degrees with the support of only phimosis:
- The relaxed state the head is released completely, during erection, the selection, the prevent and painful;
- The rest of the penis is excreted in the work, during erection was completely covered by the foreskin is not exempt;
- The head is partly withdrawn, just the rest;
- Head constantly hidden by the foreskin, does not appear. During urination urine added drop by drop.
Physiological support only phimosis
The genitals of the boy to emerge after 11-12 weeks of intrauterine development. The head of the penis and foreskin are formed in the common beginning of these the third trimester of pregnancy, the separation, where the coronal groove. The cells of the foreskin started to share, well below the growth in the tissues of the penis. In the end, they surround the head-shaped Cup, close to the entrance. Anatomical proximity, and the common fabric of the formation of the delicate epithelial walls, the inner leaf of the foreskin skin of the head.
A newborn child prepucialis cavity is completely closed to the environment, such fibres, which eliminates the penetration of the pathogenic organisms. By 3-4 months of life functioning sebaceous glands of the foreskin. Produce smeg and accumulates in a small volume of the cavity. The infection development inhibition of the inflammation of the epithelial septum in the region of the hole in the foreskin. Gradually these fine strands is destroyed, smeg and is moved to the exit and released through the formed free space. Can be seen in the form of small waxy flakes white canvas child.
What is the onset of puberty partitions fully or partially reduce the mobility of the foreskin increases. Masturbation during or after the beginning of sexual life the head begins to be fully released, although the first time, the process can be painful. Thus, physiological support, just phimosis self-solve the puberty, does not require treatment.
The treatment in case of inflammation
Despite the fact that the natural support of the only phimosis in some cases, need medical care. The little care of the boy, or the disregard for personal hygiene the prepucialis bag skin gets pathogenic microflora and inflammation develops. Clinically it is manifested by redness around the edge of the hole foreskin, local pain, unpleasant smell of the penis. The subsequent inflammation leads to the formation of cicatrice from support only phimosis that requires surgical treatment.
Upon detection of such symptoms, the child, the parents should consult a pediatric urologist. The previously widely practiced method is to simultaneously open the foreskin a sharp movement. This procedure is extremely painful for the boy, cause psychological trauma. In addition, simultaneously with opening damages the foreskin and can cause cicatrice from support only phimosis in the future.
Today, doctors recommend a gradual opening of the head 1-2 mm., It is carried out after a warm bath, preferably with the addition of antiseptic: a decoction of chamomile, marigold, sage. How to 2 times a week for 10-15 minutes. After the water treatment the foreskin treated with healing ointment or baby cream to increase elasticity and prevent tearing. Skin push not more than 2 mm in a procedure. This method can cure with the support of only phimosis at home for several months.
The ineffectiveness of the above-described method, the surgeon or urologist dissects the adhesions formed by the probe. He performs the procedure in an outpatient setting, without anesthesia or local anesthesia. The doctor inserts prepucialis bag thin metal rod with a rounded end, leading them to the circumference of the glans of the penis. After that, you must daily wash the penis of the boy is the use of antiseptic solutions.
Abnormal support only phimosis
Causes of abnormal support only phimosis:
- A genetic defect of the connective tissue;
- The metabolic disorders;
- Inflammatory diseases of the foreskin and the penis head;
- Trauma to the penis;
- To transmit the infection sexually;
- Age-related changes.
Hypertrophic support just moses or an excessive development of the prepuce, which is a long trunk hanging out of the penis. At the end of the "snout" down, opens the dense ring removal of the head, through which is not always possible.
A long snout extends in the path of the excretion of urine, smeg of that favorable conditions for the growth of the pathogenic micro-organisms. The increased humidity prepucialis the bag, the accumulated sebum is a perfect breeding ground for the bacteria. This can cause damage to the epithelium of the glans and the inner layer of the foreskin of the development of the inflammatory reactions. In children, the diabetes prepucialis bag often multiply yeast that seem unbearable itching of the genitals and a thick, white discharge. Balanoposthitis often ends with the formation of scar forms support only phimosis.
The other reason pathology – hypoplasia of penis, normal size of the foreskin. Be detected in the process, the pubescent boy, and generally associated with the inadequate secretion of testosterone by the testes. In this case, support just phimosis, combined with low growth, lack of muscle mass, excessive hair growth, lack of growth of facial hair, high voice, depression.
Cicatrice from support only phimosis is the most common form of the disease among adult men. Reasons, in a condition that leads to inflammation of the foreskin or the head. Including genital infections, the most common cause of balanoposthitis the result of Treponema pallidum. The virus in the genital herpes, human papillomavirus, Candida is often caused by inflammation of the acorn. The children cicatrice from support only phimosis is rare, approximately a third case could not be established cause of the disease.
The disease progresses gradually. The first week after the inflammation is formed of a thin connective tissue bridges, which slightly restricts movement of the foreskin. Just a few months, they're significantly thicker, dense, hard. The mobility of the foreskin is reduced, the head remains in the closed condition during erection, but we know to discover them is accompanied by severe pain. The forced exposure of the head leads to a small tear, bleeding and the formation of new scars.
The final degree of support only moses, a violation of the self-cleaning of the cavity of the process of urination. In the end, the patient developed a urinary tract infection: urethritis, cystitis, pyelonephritis. In addition, cicatrice from support only phimosis interferes with the normal flow of sexual intercourse. There is no need for additional lubrication, a man is not getting enough stimulation, feel pain when stretching the foreskin.
Treatment of the pathological forms of
Diagnosis, treatment support, just phimosis continue urologist, surgeon. If the disease was the reason for the a sexually transmitted disease, the patient also looks at the dermatologist, who prescribed antibiotic therapy. The treatment in this case, each of the partners.
Treatment conservative treatment is carried out, the first two degrees with the support of just phimosis, adhesions, if it wasn't more than a month ago. In such cases, the patient is recommended a gradual stretching of the foreskin after a hot bath. The glans of the penis applied anti-inflammatory ointment containing glucocorticoids, absorbed cream. Open the head carefully, avoiding injury to the foreskin. After the procedure, visible healing agents.
Surgical method of treatment of circumcision. The operation involves the complete removal of the foreskin of the glans will continue to be permanently open. The procedure is performed under general anesthesia in children and local anesthesia for adults. First, the surgeon makes an incision, bend the outer leaf of the foreskin, then carefully cut adhesions. After each card selected, cut them to the coronal groove. The resulting wound, the surgeon stitches the suture material, which later dissolves, which after removal of the stitches from the surgery is not necessary. In the postoperative period, perform 1-2 bandages, discharged the patient home. Complete tissue healing occurs within 2-3 weeks, and then after that, you can resume sexual activity.
Complications, and prevention
Among the complications with the support of only phimosis that arise most often:
- Infringement of the head – it develops in the attempt to forcibly bring the head of the penis the cavities. Tight ring of the foreskin compresses the tissue in the head swell and increase in size. As a result, the reverse reduction becomes impossible, disturbed blood supply to the tissue without a medical emergency at the end of a necrosis – necrosis of the strangulated part of the head.
- Inflammation of the foreskin and the penis head.
- Urethritis, cystitis, pyelonephritis advanced 4 degrees with the support of only phimosis due to violations of current the urine.
- The increment of the foreskin to the glans of the damaged areas due to the tight junction to each other, to heal one wound, cut, which is not always possible.
As preventive measures the most important are the following:
- Careful genital hygiene, daily wash the child time to change nappies or diapers;
- Use barrier methods of contraception (condom) during sex with a casual partner;
- Treatment of serious diseases (diabetes).