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Phimosis: surgery improves penile hygiene and helps prevent STDs

Phimosis: surgery improves penile hygiene and helps prevent STDs

The skin that covers the head (glans) of the penis is called the foreskin, it is elastic and during erection or when the skin is pulled back the glans is exposed . Fimosis is when the difficulty or even impossibility of exposing the glans due to a narrowing of the foreskin occurs, forming a ring. This narrowing of the foreskin may occur congenitally (from birth) or be acquired throughout life following repeated inflammation of the foreskin. About 8% of children may develop phimosis. In the first months of life, there is a natural adhesion of the foreskin to the glans. However, up to age three, this adherence disappears in most boys.

Infections and inflammations of the foreskin are called balanoposthitis and can occur at any age. They are more common in diabetic patients and when penile hygiene is not done properly. The main cause of these infections is the growth of a fungus called candida albicans. It occurs redness with itching in the foreskin, formation of white secretion, small fissures in the skin of the penis and also bad smell.

Among the Jews and some Muslims the foreskin is removed in the first months of life. As a result these children have a lower chance of having penile cancer and their partners less chance of cervical cancer. In this way, we believe that childhood surgery brings better hygiene conditions during life, reducing the risk of penile cancer (which has as its main risk factor poor hygiene), HPV infections and the incidence of other venereal diseases. In the face of this information, post-surgery (surgery to remove excess foreskin) has become increasingly common in children.

Post-surgery, also called circumcision, is small surgery, requires no hospitalization, and fast recovery. In this surgery is carried out the removal of the excess of foreskin where the skin narrowing is present. It can be done at any age, from babies to adults or seniors. And doing the procedure when adult or older brings no problem or greater risk to the patient. In both adults and children the evaluation of a urologist doctor or pediatric surgeon is always indicated. There are cases where conservative treatment, without surgery, can resolve phimosis. Follow-up with a specialized physician may also provide guidance so that adults do not develop phimosis.

The main recommendation for avoiding the formation of phimosis is hygiene care. Frequent cleansing of the glans area covered by the foreskin, leaving the region well dried is the best way to avoid repeated infections and inflammation leading to fibrosis formation and foreskin narrowing. Many times the consultation with a professional urologist is necessary for the treatment of these recurrent infections through the use of ointments or tablets.

- Campbell-Walsh Urology, 10th Edition By Alan J. Wein, MD, PhD (hon), Louis R. Kavoussi, MD, Andrew C. Novick, MD, Alan W. Partin, MD, PhD and Craig A. Peters, MD, FACS, FAAP


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