Identifying & Treating Phimosis in Kids




Phimosis is the foreskin of a boy which has a narrow end and it leads to trouble in being pulled down. There are mainly two types of phimosis in the first type, the foreskin gets elastic so that it can be stretched wider at least to some extent while in the second type, there could be chances of scars or indurations around glans which makes it totally rigid. 

There are situations when phimosis is partial so that the foreskin can be pulled down, but cannot retract. And when the foreskin is trapped in a retracted position, it is called paraphimosis. This condition should be regarded as an emergency since the tight foreskin can cut off the blood supply to the glans.

Detection of Phimosis:

A kid usually has a narrow foreskin in his earliest years and the foreskin also is fixed to the penis head. Gradually the glans penis widens and the foreskin gets loose so that it can be pulled down. Usually, it is possible to remove the foreskin when the boy is 4-7 years old, and the diagnosis phimosis is therefore usually not done at a very young boy.

Risks of Phimosis:

If the opening in the foreskin tip is very narrow, it will get inflated by urine during voiding, an occurrence called ballooning. Phimosis can also cause inflammation in the foreskin and glans causing uneasy flow of urine, and subsequent growth of bacteria, leading to UTI. One of the best ways to prevent phimosis due to infections and scarring is to daily pull it back very gently so that the foreskin can retract as far as it gets without resistance, wash it well with some mild soap, and then flush it well. The parents should do this on young boys, while older boys, teens, and adults should do this by themselves. But remember one should never try to force the foreskin down, however. Usually, doctors warn against using any kind of soap and recommend pure water.

Treatment methodology:

There are great cultural differences regarding the treatment of phimosis between the regions of the World. At some places, the traditional treatment for phimosis has been circumcision. It has, however, been shown that phimosis can be cured in most instances without surgery. Especially, if itis the elastic type. In kids, before puberty, the simplest treatment is daily flushing with clean water under the foreskin to take away impurities, while waiting for the condition to resolve by itself. Complications or special susceptibility for infection, like in diabetic boys, can make the more specific treatment necessary at an early age. But some kids may also feel it be more comfortable after treatment.

Conclusion:

When consulting a doctor for treatment of phimosis, one should discuss the methods available to find that which fits best the interest for the patient.  If the doctor is rigidly inclined towards circumcision, a second opinion should be consulted as the circumcision is necessary for the proper functions of the urinary tract. 

Resource Box:

Meet Dr. AK Saini, who renown Pediatric urologist in Delhi and get the earliest possible treatment for your kid.

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