Phimosis, condition affecting the penis.
Phimosis, or preputial stenosis, is a term that usually means any condition where the foreskin of the penis cannot be retracted.
Most infants are born with a foreskin that cannot be retracted and the prepuce may be tight until after puberty.
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A fully retractable foreskin occurs in 50% of ten year olds, 90% of 16 year olds and 98 to 99% of 18 year olds.
1. Failure of foreskin to loosen during growth.
2. Infections such as balinitis
3. Deformities caused by trauma and diseases of the genitals.
1. Phimosis is usually painless condition.
2. Infection may result from an inability to carry out effective cleaning of the area.
3. Swelling, redness and discharge may all be present making the area tender and painful.
4. A very tight foreskin can cause problems during intercourse and urination.
Once phimosis is diagnosed, the available treatments include topical corticosteroids, manual stretching, preputial plasty and circumcision. Conservative treatments should be tried in the first instance and surgery as a second line of treatment.
A number of studies show that phimosis can be safely and effectively treated by the application of topical steroids in some cases. Betamethasone cream 0.05% should be applied to the exterior and interior of the tip of the foreskin 2-3 times daily. The treatment should be discontinued as ineffective after 3 months if the foreskin has not become retractile during this time.
A number of plastic surgery procedures are available for the treatment of phimosis. This includes preputial plasty and circumcision.
A minor surgical procedure performed as a day surgery under local anaesthetics and twilight sedation. It involves making a cut through the constrictive band of the foreskin. The restricted band released and the cut/incision is closed in a special way to prevent future constriction. This procedure allows the prepuce to be retained. It takes 45min.
It is also performed as a day surgery procedure. It includes removal of the excess foreskin and the constricted band. The wound is repaired with dissolving sutures. The procedure takes 1 hour.
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