Treatment for phimosis should be done by a urologist. A simple manual reduction of the foreskin may be sufficient to correct phimosis, provided it is done by a skilled practitioner to avoid complications.
The subsequent application of ice may help in the process, however, if there is swelling, it may be necessary to apply steroids based on corticosteroids to control inflammation and facilitate further reduction.
The surgical procedure (postectomy or circumcision) consists of partial or complete removal of the foreskin, with the approximation of the margins of the skin to the remaining mucosal border of the foreskin. The ideal is to be performed between 7 and 10 years of age.
The child leaves on the same day as the hospital and in about four days can resume normal activities, but physical exercise should be avoided for about three weeks.
Surgery for Phimosis:
In adults, circumcision is performed under local anesthesia, with the anesthetic being injected into the base of the penis just below the skin. The pain of the injection is not greater or less than in another part of the body. Despite the fear of the needle, those who undergo the procedure tolerate it very well.
The duration of the surgery is about 30 minutes. The operation consists in the removal of the preputial portion that is adhered to the glans or narrowed, or of the excess of foreskin, when necessary. Usually 10 to 20 stitches are needed to repair the wound. A simple dressing is done and the individual can go home soon after.
Postoperative:
Postoperative pain is moderate and controlled by analgesics. Penile erections at this stage do not usually cause problems. Swelling and penile bruising are common, but they subside in a few days.
The patient needs to rest for 1 to 3 days. After that period, you can drive cars or do jobs that do not require greater physical effort. About 15 days after surgery it is already possible to practice sports. Sexual intercourse is only released, on average, after 30 days.
Surgical stitches are absorbed by the body and do not need to be removed. Dressings are simple and do not require further care. It is common to have a slight reduction in the sensitivity of the glans, but rarely does this affect the quality of the sexual act.
- A true fimosis - is one that presents as a whitish scar and is rare before the age of five;
- Recurrent balloon-postitis - recurrent episodes of erythema and preputial inflammation, sometimes with purulent discharge, which do not respond to treatment with warm compresses, and local or systemic antibiotic therapy. Indicated after two years of age or in children with diurnal sphincter control;
- Recurrent Urinary Tract Infections - The lower incidence of urinary tract infection (UTI) in circumcised male infants suggests that an upstream infection is possible from the foreskin. Post-surgery may be appropriate in cases of recurrent UTI and in urinary, anatomic, or those with vesico-sphincteric dysfunction, which make clean intermittent urethral catheterism. A multicenter study examining patients with vesico-ureteral reflux and prenatal history of hydronephrosis reported an important statistical difference in 63% of uncircumcised boys with reflux and UTI, compared with 19% of circumcised, both in chemoprophylaxis. These findings suggest that removal of the foreskin may protect against UTI in boys with reflux and possibly also in some cases of obstructive anomalies;
- The adolescent who still can not fully expose his glans may have painful masturbation and difficulties in penetration at the onset of sexual activity.
In case of suspected phimosis, a doctor (preferably a urologist) should be consulted. He will be able to evaluate in detail, through anamnesis and physical examination, what his correct diagnosis is, guide him and prescribe the best treatment.
