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Phimosis surgery, after surgery. Phimosis. Methods of operative or surgical treatment of phimosis.

Phimosis is constriction foreskin, accompanied by the occurrence of difficulties or the absence of the possibility of exposing the glans of the penis. Among the main causes of the onset of the disease are the presence of congenital narrowing of the foreskin, inflammatory processes (balanoposthitis), diabetes mellitus... Treatment of phimosis is possible at home using conservative methods, but most often it is necessary to perform an operation, as well as adherence to some recommendations after the operation.

Treatment of phimosis in infants

When infantile phimosis is not very severe, it is possible to widen the prepual ring with gentle maneuvers and re-displacement after careful hygiene. In more serious cases, surgical expansion of the preputial ring is essential and sometimes postectomy. Doctors advise parents not to try to perform any maneuvers without training a pediatrician. Typically, boy boys are taught how to perform portable maneuvers before leaving maternity... If you have not received training from medical personnel, it is good to discuss this with your child's doctor, who will tell you if such maneuvers should be studied, and if so, they will show you what to do and how to do it.

Preparation for surgery for phimosis

With phimosis, simple preparation for the operation is necessary, which includes the passage of the patient's examination, delivery general analysis blood and urine. It is imperative to perform blood biochemistry, a blood test for syphilis, AIDS, hepatitis and a coagulogram. In addition, hair in the pubic area should be shaved off. In the case of an operation under general anesthesia you must arrive at the hospital on an empty stomach.

The mother finds out for the first time whether her boy is suffering from phimosis or not. In each bath, you need to take a close look at the baby's genitals and carefully remove the penis. If you do not try the first or second try, contact your pediatrician immediately. Phimosis has no other signs that can be observed than the impossibility of decapitation.

Don't hurt your child's penis. A violent maneuver or too harsh maneuver can backfire: in the event of a violent shift, phimosis can worsen, causing a wound that develops scar tissue, leading to paraphimosis. Don't put off specialized medical consultation because over time odors and mess build up between the gland and the skin, the area will irritate and the baby will feel uncomfortable. If you wait up to 6 months, local irritation and buildup can lead to serious infections.

Operation for phimosis

With phimosis, the operation can be performed using several methods:

  • conservative surgery;
  • prepucioplasty;
  • meatoplasty;
  • traditional operations;
  • circumcision.

In most cases, the operation is a procedure that will take no more than one day. It is performed on an outpatient basis: in the morning the patient is hospitalized, then the operation is performed, and after a few hours the patient is released home. During the operation, the use of local anesthesia is provided, in some cases general anesthesia is possible. In newborns, with proper patient fixation, circumcision can be performed under local anesthesia, but general mask anesthesia is preferred by most surgeons. In case of phimosis in older children, the operation is always performed using general mask anesthesia, which makes it possible to avoid severe psycho-physiological trauma to the child. As a rule, adolescents and adults perform circumcision using local anesthesia calmly, but intolerance to local anesthetics is possible, the presence pathological changes at the injection site of the anesthetic, expressed psycho-emotional excitement, which are contraindications to the use of local anesthesia.

The more the displacement is done, the more you avoid the risk of complications, and the feeling of pain caused by the maneuvers will be less, and the child will sooner forget this discomfort. Phimosis is a condition in which the foreskin is too dense to be removed. Phimosis is normal in all male boys and can be present for several years while the foreskin becomes elastic and stretched to pull it away to top part the penis was completely visible.

In some cases, the foreskin can get scarred, leading to permanent phimosis. Scars can be caused by infection or inflammation of the foreskin. Forced expansion of the foreskin can cause it to split before it is ready to stretch.

Local anesthesia can be carried out by using anesthetic cream blocking the dorsal nerve of the penis, annular block.

After operation

Immediately after the operation, the patient is transferred to the postoperative room or wake-up room. In the case of a smooth course of the postoperative period, after a few hours, the operated patient goes home.

Who needs circumcision

In most boys, the foreskin goes away on its own until the age of 1–2 years. For some boys, this process may take more than 2 years, but if there is no obvious signs scar, there should be no problem if it waits for several years. Boys who have either normal phimosis, a strain, or phimorphism cannot completely remove their flesh, and as a result of this problem, the foreskin can swell when filled with urine. Those boys with denser foreskins may experience some pain when they have an erection.

The postoperative period is characterized by a feeling of some discomfort and pain in the place where the circumcision was performed, but, as a rule, there is no need to use special pain relief. At home after the operation, dressings should be done every other day. It is important to ensure that urine does not get on the dressings, since if it gets on the wound, it may develop inflammatory process, as a result of which healing can take a long time. The stitches are usually removed after 7-10 days. The resumption of sexual activity is possible 2 weeks after the operation.

If there is a possibility of scarring with phimosis, the boy should be seen by a pediatric surgeon. If the doctor believes that phimosis will not resolve on its own, it will most likely require circumcision. For circumcision, there must be some medical indications such as tight fit, scar-related phimosis - which prevents removal of the foreskin or recurrent severe recurrent infections of the penis and foreskin.

When should circumcision be done?

If phimosis is left untreated, some infections of the foreskin and even the urinary tract can occur. Circumcision is an operation in which the foreskin is removed. If possible, circumcision is done after the baby has been one year old. Neonatal circumcision should be avoided as there is a risk of serious complications in this age range. One of these complications could be: the opening of the urinary tract straightens due to scarring.

To ensure proper support for the penis, wearing tight-fitting underwear is recommended after surgery.

There may be a slight or moderate presence of pain after surgery. In case of discomfort or pain, the use of non-steroidal anti-inflammatory drugs is allowed. For the first few days after surgery, the dressings should be kept dry. When taking a shower, men are advised to use a condom. Many men, after circumcision or prepucioplasty, notice the occurrence of an uncontrolled erection, which causes a lot of anxiety in the first days after the operation, especially at night. An erection can be caused by pain syndrome, the blood supply to the penis is disrupted with a tightly applied bandage, sometimes this can be the cause of the dehiscence of the wound edges. After removing the bandages for the first time, the penis looks swollen and edematous. Puffiness after surgery may persist for 1 week or more.

Circumcision is usually an operation that does not require hospitalization. Under general anesthesia, the foreskin is removed with scissors and a scalpel. The edges of the leather are then sewn together with stitches that dissolve into themselves within 1-2 weeks. While the baby or child is asleep, the anesthetist blocks the nerves in the penis with local anesthesia. After the child wakes up, he should not be in too much pain, but he may be disturbed because he wakes up in a strange place and is hungry. The anesthesia should be for 6 to 8 hours, and then your son may need analgesics for one or two days.

After surgery, the only consequence may be a decrease in the sensitivity of the head. But in most cases, this phenomenon is desirable, because it increases the duration of intercourse and reduces the likelihood of premature ejaculation.


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Are complications possible after surgery?

If he feels comfortable, he can take a regular bath, even on the first day. The main side effects operations are bleeding and infection. If the bleeding from the incisions ends, the pediatric surgeon will have to examine the operation and again the child will have to return to the surgical room if necessary to stop the bleeding. If he develops an infection, it will appear 2 or 3 days after surgery and the penis will become more swollen, redder, and more painful.


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Orchitis is the development of inflammation in the tissues of the testicle. The development of orchitis is possible after the transfer of an infectious disease.

Phimosis is a pathological change in the tissues of a man's penis, a narrowing of the skin ring that encloses the head of the penis (foreskin), in which it becomes difficult or impossible to expose the head.

If this happens, he may need antibiotics. Sometimes the edges of the incision stick to the head of the penis and need a thin section after a few weeks of surgery. If the child has a small, abnormal penis or abdomen, the pediatric surgeon must first rule out the possibility of hypospadias before circumcision is performed. Hypospadias - congenital anomaly the penis in which the opening of the urinary tract is not at the apex of the penis. There is a certain layer covering the edge of the flesh, there may be a curvature of the penis, or sometimes the opening of the urinary tract is less than it should be.

This disease has different degrees and can lead to severe complications.

Disease on early stage can be cured with conservative methods, when the necessary stretching of the skin is achieved through exercise and medication. In this article, you will learn how an operation is performed to remove the foreskin for phimosis in children and adults.

Since the foreskin is useful for correcting the condition of Hypospadias, it should be kept in boys suffering from this anomaly. It is important that circumcision obtains a fairly good cosmetic and functional result with the correct number of excisions removed during surgery.

What complications can arise after circumcision? Complications after circumcision are rare. The most common complications are pain, bleeding, infection at the circumcision site or the outer end of the urethra, and irritation of the bare tip of the penis. Long-term complications of circumcision include deterioration of the external urethra, life-long low sexual arousal in the penis, and scarring of the penis due to mistakes in infection or surgery.

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But with neglected forms diseases are the only way to return to full image life becomes surgical intervention.

When should you resort to surgery for phimosis?

Have you ever wondered if you need surgery for phimosis? If at least a few of the listed signs are found, then it is necessary to urgently treat phimosis with an operation in both children and adults.

Serious complications of circumcision are very rare. What are the consequences if circumcision is not performed? Males who are not circumcised have more high risk infections urinary tract in the first year of life than those who were circumcised. Later in life, uncircumcised men have a higher risk of contracting sexually transmitted diseases than those who have been circumcised.

You can access the article anytime, on any device, from your website or from a mobile app. Recommendations from a doctor. ... Newborn circumcision is usually performed by healthcare professionals in a clinic, hospital, or surgery center. - Place on a flat surface, usually on a wrapping table. - The child is immobilized by hooves that are passed through the arms and legs so that the child does not move during the procedure. - the toilet for the penis is made - a local anesthetic is applied in the circumcision area, the child remains awake.

  • Painful sensations when urinating;
  • Accumulation of smegma under the skin, causing inflammation;
  • Redness and swelling of tissues in the penile area;
  • Scars and adhesions.

What is circumcision or circumcision?

Circumcisia - one of the types surgical intervention, in which the foreskin is removed in whole or in part. As a result, the head becomes either completely naked or partially hidden under the foreskin.

Local anesthetics include penile nerve blockers. General anesthesia is used in children for 2-3 months. When children are under general anesthesia, the tail nerve can be blocked to relieve postoperative pain. - A clip or other sterile circumcision device is applied to the head of the penis. Doctors use the clamps with which they are most common, but you can choose between several types of clamps. Each clamp has advantages and disadvantages, but the differences between clamps are minor. - the foreskin is removed using a sterile scalpel or scissors.

This disease affects not only our contemporaries. According to ancient sources, it is known that circumcision was used even during the reign of the pharaohs in Ancient Egypt.

Traditions of some peoples make circumcision surgery compulsory for all boys during the growing up phase. This is what Muslims, Indians and many African tribes do.

After circumcision, the penis may have a reddish brown color due to the solution used to disinfect topically before surgery. The seam of the penis may be swollen and bleed. This condition will gradually disappear over the next few days. The child will be followed up 2-4 hours after the operation. Medical staff will monitor the penis for possible bleeding, and a bandage with scar ointment will be applied to the circumcision area. The dressing will be stored for 24 hours. When the bandage is removed, it is dipped warm water and then carefully cut off.

What is the dorsal incision technique?

Several clamps are applied to the foreskin, after which a dorsal incision is made at the 12 o'clock position in relation to the marking line.

The foreskin is cut off with scissors along the previously marked line. Only a narrow area of ​​the foreskin remains in the crown area, which is used to suture the skin in place.

After surgery, the child usually has following symptoms: - Pain in urine - Discomfort or pain can occur when the circumcised area to be healed comes into contact with urine or faeces. This discomfort usually disappears after 3-4 days, but may persist for up to 2 weeks. - irritability. The child may or may be agitated during the healing of the circumcised. - The appearance of a small yellow secretion in the circumcision area the next day after surgery. This is part of the healing process and will disappear after a few days.

In young children, the skin is not sutured up to the circumcision site. The suture is used only in older children and adults. Caring for the penis after circumcision Parents can make the baby feel better after the intervention and heal faster if: - each change of the diaper makes the penis toilet hot water and soap. It is not recommended to remove the bark from the incision site, it is removed by itself. - every diaper change is recommended with the use of a scar ointment. This applies to the tip of the penis and the edges.

Using Mogen and Gomco Clamps

These clips are reusable. But with pathological forms of phimosis, performing a surgical operation with these devices becomes problematic.

Mogen Clamp Method

The ointment prevents the diaper bark from sticking. - the diaper is fixed a little wider to avoid irritation of the penis. - Ask your doctor's opinion about acetaminophen for postoperative pain relief. - Adult children or adults can resume their activities soon after surgery, provided they avoid anything that can irritate or cause pain in the penis.

The baby's penis will be checked during routine medical examinations... If problems occur after the circumcision surgery, the doctor should be notified. The medical staff performing this intervention in young children is represented by: - ​​pediatricians - obstetricians - family doctors- urologists - surgeons Surgeons or urologists usually perform circumcision in older children, adolescents or adults.

This method is easy to perform, so the risk of postoperative complications is minimal.

Special equipment, except for the Mogen clamp itself, is also not required, so the surgeon can handle this operation himself, without the help of assistants.

The only downside is that it is not always possible to achieve a positive cosmetic effect as a result of the operation.

The foreskin is fixed with "holders" - clamps for vessels. The prepuce is pulled over the gap required for excision. After that, a clamp is applied, and the prepuce remaining above is excised.

The clamp is removed and the skin is pulled back. Vessels that have begun to bleed are sutured.

This type of operation involves the imposition of small, neat sutures, especially in the area where the bridle is attached. After that, a bandage is applied.

Gomco clamp method

When using the Gomco clamp, the flesh is pulled over the installed bell and the clamp is installed.


A plate is applied to the top of the bell, the structure is fixed with a nut, excess flesh is removed with a scalpel, the clamp is removed, the remaining flesh is straightened.

In both cases, operations, if they are done for children and adolescents, do not require stitches. And adults need stitches.

Using a disposable plastic clip

When using a disposable plastic clip resembling the outward signs bell with a longitudinal recess and a handle, usually no fixing sutures are required.


After a dorsal incision is made, the doctor places the construction on the head of the penis. The foreskin is located above the bell and is secured with a groove.

The excess foreskin is cut off. Now all that remains is to break off the handle. After a week, the plastic ring spontaneously falls off.

Circular resection method

The the method allows you to achieve a very good cosmetic effect... This does not require excellent preparedness of the surgeon, and the operation is performed with the indispensable participation of an assistant assistant.


The surgeon makes marks of the external incision - the line is located under the section of the crown of the head and has a V-shape, with the upper corner located in the region of the bridle. The skin is pulled towards the base of the penis, a line is drawn along which the incision will be made.

The skin and part of the subcutaneous tissue are dissected along the outlined lines. After that, the resulting piece of skin is carefully separated from the penis with special scissors.

On the final stage sutures are applied to fix the skin. In the absence of bleeding, all that remains is to apply a bandage.

Prepucioplasty

Prepucioplasty is alternative method treatment of the disease. The operation is indicated for those patients who do not have scars further than at the tip of the prepuce.

The doctor makes a longitudinal incision of the foreskin, just like a dorsal incision. However, in this case the cut is much smaller.

The adhesions fastening the head and prepuce are dissected. Transverse sutures are applied to the wound. This operation usually lasts 20-25 minutes..

During the postoperative period the risk of development is excluded possible complications , and the pain after the operation goes away rather quickly.

This method cannot be applied if the disease is severely neglected, the flesh is covered with numerous scars, and the hole is excessively narrowed.

Meatoplasty

With this type of treatment, a narrowed opening urethra adjusted surgically... In fact, this is the treatment of complicated phimosis.

The urethra is dilated by incisions, after which the edges of the urethra are sutured to the edges of the head of the penis. The dimensions of the urethral opening become normal.

When is it better to refuse surgery?

Surgery is not required when the disease can be treated with conservative methods. The disease in the milder stages can be successfully treated by using special ointments with a hormonal composition and antibiotics that remove inflammation.

This shows special exercises, contributing to the opening of the foreskin and sufficient stretching of the skin.

What should parents do before the operation of phimosis in children?

  • Observe hygiene standards and rules. The child must himself, after the advice of the parents, wash the penis after each urination.
  • Read as much literature on this topic as possible in order to postoperative period there was no confusion and fear for the boy's condition;
  • Visit your urologist regularly and strictly follow his advice.
  • Provide the child psychological support to reduce the feeling of fear before surgery.

Postoperative care for boys and men

After an operation to treat phimosis in a child, he will be taken to the ward, most likely, he will sleep for some more time.

Waking up from anesthesia, the boy will be frightened by the feelings he has experienced, so the parents should be close at this moment. After a few hours, the child will want to eat and drink - this can be allowed to him.

The first act of urination will be very painful.... It is advisable to prepare a container with warm water. You need to gently and slowly lower the tip of the penis into the water and ask the child to urinate. In warm water, the muscles relax and the boy manages to empty his bladder.

At severe pain demanding the child to continue the process is pointless. You need to calm him down, take his hand, talk on abstract topics, and after twenty minutes try again.

But how to handle after the operation when urinating, it's easy to rinse the head every time. On the second and third day after the operation, the child will be able to urinate on his own. After each urination, you need to wash the glans penis and change the bandage to a new one.

Usually, the surgeon prescribes the use of dressings with special antibacterial ointments that contribute to more fast healing... After a week, after the wound has healed, the dressings can no longer be used.

Complications after any type of surgery aimed at treating phimosis, in the vast majority of cases, are not detected. The main thing is to observe simple rules above and proceed as directed by your doctor.

Now you know what to do after phimosis surgery. And in next video you will be able to see footage of operations for phimosis and learn more about how they go. Also in the video, schemes of techniques are presented for more extensive information about operations for phimosis.