home Thyroid Phimosis. Treatment methods: operations, ointments, traditional methods. Negative consequences of pathology. Reasons for the development of balanoposthitis

Phimosis. Treatment methods: operations, ointments, traditional methods. Negative consequences of pathology. Reasons for the development of balanoposthitis

Sooner or later, any mother faces various “male” problems as her sons grow. It is the genital organ of a boy (even a very small one) that raises many questions, and along with them, fears. Doctors in maternity wards, before discharging a newborn home, must explain to young mothers all the features of proper care for the baby’s head and foreskin, but, unfortunately, such lectures are held only in a few institutions.

Most problems in boys usually begin due to the illiteracy of young parents regarding such an important issue. And the main rule here is a simple expression: “if you don’t want to harm, don’t touch.”

If you study a little anatomy, it becomes clear that all newborn boys are endowed with a temporary condition, and this is absolutely normal. The head of the penis is covered by a fold of skin (foreskin), and between them there are thin connecting adhesions -.

The head of the penis in a baby should not be freely exposed - congenital phimosis is a kind of natural protective mechanism. As the child grows, the genitals also develop. Hormones are produced that make the foreskin more elastic, which allows the glans to open naturally, for example, when a spontaneous erection occurs.

You should not compare one child with another and make a diagnosis yourself, because in one boy the discovery occurs at the age of 6-7, and in another only at the age of 10.

It often happens that the excessive care and concern of young mothers about the future sexual function of their son pushes them to completely thoughtless actions and actions, leading to the emergence of many problems.

Inflammation of the foreskin is medically called balanoposthitis. The disease often affects the head and has a very frightening appearance, but at the same time it does not pose a serious threat to the baby’s health unless it becomes chronic.

The most common cause of such inflammation in a child is the parents’ attempt to free the head on their own, believing that it is “time”, thereby violating the natural protection of the organ and allowing various pathogenic organisms free access to the preputial sac.

Sometimes the appearance of the disease also has physiological problems. Under the child’s foreskin, smegma usually accumulates (a mixture of dead skin cells and sebaceous gland secretions), which, with the gradual resorption of synechiae and the release of the head, is washed out on its own during normal urination.

But if the process is disrupted and the synechiae are only partially separated, a skin pouch is formed, from where the smegma cannot come out and forms a dense smegmolite, which becomes the cause of the inflammatory process.

In some cases, the appearance of balanoposthitis is caused by an allergic reaction, when the inflammatory process occurs due to a lack of hygiene procedures, the use of inappropriate hygiene products, due to untimely change of underwear or washing things with chemical powders.

Often the disease occurs in the presence of food (drug) or respiratory allergies, when the allergen that enters the child’s body is excreted in the urine and causes irritation of the foreskin, followed by an inflammatory process.

The recurrent form of balanoposthitis is often a symptom of existing phimosis, when the foreskin is very narrow and does not allow the head to open independently even in adolescence. In this case, circumcision is required - a simple and non-hazardous surgical operation.

Symptoms

It is not difficult to determine balanoposthitis, since its symptoms are severe. At the onset of inflammation, parents usually note that the head of the boy’s penis is swollen and there is intense redness on the surface. An older child complains that everything in the groin area hurts and itches.

You can often observe the appearance of purulent discharge, rash, whitish plaque and pain when urinating, indicating that the disease is becoming chronic, and this can lead to cicatricial phimosis.

Acute balanoposthitis is characterized by the sudden onset of difficulty urinating and severe pain, which is gradually supplemented by redness of the foreskin and severe swelling. In this case, discharge of purulent contents, which is white or yellowish in color, can be observed from the preputial opening.

Often the child’s temperature rises, which can reach serious low-grade levels. All this causes the boy great anxiety.

Treatment and hygiene

When symptoms of inflammation of the penis appear in boys, it is necessary to begin proper treatment. For this:

Organize frequent baths with a warm, weak solution of potassium permanganate, which can be replaced with furatsilin, sanviritrin or chamomile decoction. Any of these substances can have an antiseptic effect and remove the remnants of existing organic substances and secretions from the space of the preputial sac. Potassium permanganate has a drying effect, so it should be used in treatment only when there are no other means.
Lubricate the affected skin areas with aseptic ointment, for example, Streptomycin or Levomekol.
If after such treatment within 4 hours the boy does not experience improvement or a decrease in the intensity of symptoms, it is necessary to consult a doctor who will select antibiotics for subsequent therapy.
If positive dynamics appear after home treatment, you should continue the procedures (baths with antiseptics) and ointment treatment for several days, until the symptoms of the inflammatory process completely disappear.

Sometimes, with balanoposthitis, acute urinary retention may occur, which is caused by blocking of the urethra by severely swollen foreskin. This condition requires urgent medical attention for emergency care.

Urinary retention should not be confused with a child’s simple refusal to urinate due to pain. During urination, drops of urine containing irritating substances fall on the inflamed skin of the foreskin, increasing the pain.

The baby simply refuses to go to the toilet even when feeling the urge. In this case, warm baths with a decoction of oak bark or medicinal chamomile can help, which will reduce pain and improve the child’s condition.

An important factor in the successful treatment of a child and elimination of the inflammatory process is proper care of the genital organ and hygiene procedures.

The following rules must be strictly observed:

Do not forcefully open the head of the penis by stretching and pushing back the foreskin.
There is no need to treat the penis with disinfectants every day.
It is important to wash it with clean warm water after each bowel movement.
Once every 1-2 weeks, warm hygienic baths using decoctions of celandine, string or chamomile can be carried out for the purpose of prevention.
During therapy, it is necessary to ensure that the baby consumes a lot of fluid, this helps to actively flush the canal and eliminate inflammation.
When treating primary balanoposthitis, you should treat the process with full responsibility, since only in this case can you avoid the disease becoming chronic.
If a relapse occurs, you should immediately consult a doctor without trying to treat the disease yourself.

Prevention

It is much easier to prevent any disease with the help of preventive measures than to cure it - this truth is known to everyone.

As mentioned above, often the cause of the inflammatory process is an attempt to forcefully open the head of the penis by parents or a curious child. Under no circumstances should you do this yourself. You should follow all the rules for caring for the genital organ, but do not interfere with natural processes unless absolutely necessary.

If the inflammatory process is caused by an allergic reaction, it is necessary to correctly identify and eliminate the allergen. You should change care products, the brand of diapers, and the products used to wash baby clothes.

It is necessary to buy your baby underwear only from natural cotton, avoiding artificial synthetic fabrics. It is important to avoid eating foods that cause a reaction.

If there are physiological reasons that contribute to the occurrence and frequent recurrence of balanoposthitis, it is necessary to seek help from specialists and subsequently follow all prescribed recommendations as preventive measures.

Treatment of inflammation of the foreskin in boys

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The male body is designed by nature in such a way that the intimate area requires special attention in terms of cleanliness. The development of bacteria occurs without proper hygiene. The place where unpleasant inflammation occurs is located under the foreskin of the penis and is called the preputial sac.

Men develop various diseases when exposed to bacteria: phimosis, balanoposthitis, paraphimosis. At a young age, the problem becomes especially acute, since children are less likely to think about the hygiene of their organs.

Diseases of the foreskin

The prepuce sac in boys can cause inflammation of the head of the penis and the skin around it. There are two types of disease development:

Diagnosis of problems consists of determining the patient’s condition through a survey and testing to determine the type of disease. When determining the source of the problems, a visual inspection of the head is carried out, and the foreskin is checked for inflammation. To exclude infectious development of the disease, appropriate studies are prescribed.

How to identify foreskin problems?

Symptoms of inflammation affecting the preputial sac:

Constant itching of the head of the penis.
There is a slight burning sensation in the foreskin.
Rarely can a boy detect purulent components.
Slight swelling of the skin around the preputial sac.
Redness of the flesh.
Rash on the head.
It's difficult to go to the toilet when you're small.
Pain when trying to move the flesh, as well as when the organ enlarges.

The pain goes away after some time, but recurs periodically. Severe conditions require prompt solution to the problem. Minor irritations can be relieved with the right ointment. It is important to establish the cause that caused the inflammation of the preputial sac.

Who can help?

With your problem, you can contact the following doctors:

therapist;
surgeon;
to a urologist.

Why does the skin around the head become inflamed?

After the rinsing procedures, use Levomekol ointment, which is injected into the preputial sac with a syringe. For children, warm herbal baths are used as a preventive measure.

Medical methods

Problems of the preputial sac caused by phimosis in boys are eliminated using presurgical methods:

The listed methods should be used only after examination in the clinic. In the case of infections, you can harm the child’s delicate skin and trigger the disease. It is impossible to achieve results using independent measures if there are scars on the flesh.

Non-medical practice

In medical practice, non-medicinal methods of tightening the foreskin are used. Through daily exercise, you can achieve gradual stretching while showering and after urinating. The duration is determined by the moment when the pain began.

The second method is to stretch the preputial sac with your fingers. Using these methods you can get rid of congenital pathology. In 7 out of 10 patients, complete cure of phimosis was observed.

It is recommended to begin physiological treatment no earlier than the onset of puberty. In 70% of children this phenomenon goes away over time. If there are no serious complications, preventive measures are taken to reduce inflammatory processes in the foreskin using traditional methods.

The exception is infectious and bacterial problems. It is not recommended to delay dealing with this type of disease. Visiting a doctor will be the best decision for parents. Constant monitoring of the ongoing inflammatory process will be required. Particular attention is paid in cases where the foreskin has already expanded, but at some point in time narrowed again. Here we are talking about the pathological development of the organ.

It is difficult to imagine more unpleasant diseases for men than diseases of the reproductive system. Some of them pass painfully and for a long time, others proceed completely unnoticed. There are also those that do not interfere with our lives, but at one point they can become a big problem and force us to see a doctor. Phimosis can also be classified as such a pathology. Let's figure out what it is.

What is phimosis?

With normal development in childhood, from 3 to 5 years, the foreskin usually completely covers the head of the penis, the skin hangs slightly with a narrow opening. In the process of further development, the head moves apart the preputial sac (this is a fold of skin or foreskin), and its removal becomes easy and free.

By definition, phimosis is an anatomical narrow opening of the foreskin due to its insufficient elasticity. This makes it difficult to expose the head of the penis in a calm or erect state, leading to compression, accumulation of secretions and further inflammation of the head and foreskin. A very unpleasant and painful condition occurs.

We have determined what phimosis is. To make a full diagnosis and further prognosis for treatment (whether circumcision is necessary), it is important to determine its type and stage. There are two different types.

Hypertrophic type - with strong, excessive development of the foreskin, excess skin around the head.
Atrophic type - the foreskin is poorly developed, thin, completely encircling the head. As a result, a small hole with compacted edges is formed.

Regardless of its type, the course of the disease depends on the stage and the complication that arises.

Stages of phimosis

Complications include inflammation and compression, and there are only 4 stages:

In the presence of the first stage of narrowing, it is difficult or painful to expose the head during the period of excitement.
In the second stage, it is difficult to remove the head even during rest. During erection, the head of the penis is completely hidden or slightly protruded.
In the third stage it is impossible to bring the head out either at rest or in a state of excitement; the head is always hidden under the foreskin. Light squeezing may occur.
During the fourth stage of narrowing, it is not only impossible to remove the head at rest, but also compression of the surrounding tissues and difficulty urinating. This manifests itself as pain and swelling.

It is clear that if at the first stage you can still think for a long time about how to cope with it, then at the third and fourth stages it is necessary to take urgent measures. To understand how you can improve the situation, you need to know the reasons for the development of phimosis.

Read also: Truncal hypospadias, causes and treatment of pathology

How does phimosis occur?

The causes of this disease are different. This may be a congenital pathology of skin development in the womb or caused by inflammation due to an infection.

Also common causes of phimosis are:

Mechanical injury caused by trying to remove the head with excessive force.
Contact with substances that cause allergic reactions. They can be excreted in urine or contained in personal hygiene items;
Any stress on the body that lowers immunity. For example, severe hypothermia.

With poor hygiene, an accumulation of secretions occurs, which serves as a medium for the development of microbes, which also leads to the formation of inflammation of the head and foreskin. After an inflammatory process at the site of the hole, the skin always becomes very thick. Reduced elasticity leads to problems with the removal of the glans penis and impaired urination.

Symptoms and manifestations of phimosis

Now that you have become familiar with the causes of the disease, let’s consider how it manifests itself. Classic signs of phimosis are disturbances in urination and the inability to partially or completely remove the head of the penis. During urination, filling of the preputial sac occurs along with a narrowing of the urine stream. At later stages, infection occurs and an inflammatory reaction occurs. There is pain in the area of the glans penis and foreskin. Severe swelling (swelling) and redness appear. With further complications, the disease worsens, pus begins to be released, and severe pain occurs.

If you encounter this problem, you should consult a doctor. He will prescribe local treatment or surgical treatment (dissection of the preputial sac). If you do not neglect the disease and start treatment quickly, you can cure it without circumcision. You can look into possible treatments, but it is not recommended to try them on your own. A timely examination by a good specialist will prevent the development of complications, unnecessary expense of money and nerves.

Treatment of phimosis without circumcision

In the early stage, inflammation of the glans penis and foreskin responds well to treatment. The point is to rinse with medicinal solutions, wash out pus and germs, and apply ointment to the area of the preputial sac.

You can rinse with the following antiseptic (antimicrobial) solutions:

A weak solution of potassium pergamanganate.

Furacilin solution 1: 5000.
A solution of dioxidine at a dilution of 1%.
An aqueous solution of chlorhexidine together with lidocaine.

Washing should be done frequently, two to five times a day for 4-7 days.

Technique for washing the preputial sac

To wash yourself, you need to know the technique of doing it. It should be performed carefully, without injuring the inflamed skin. If you know a medical worker, ask him to help. If you decide to do it yourself, do this correctly:

Draw the selected warm solution into the syringe.
Pull the skin upward without exposing the head.
A syringe without a needle is inserted into the hole formed.
The solution is released under slight pressure, washing out the accumulations from the preputial sac.
Repeat until completely washed out several times.

Diseases of the foreskin

The prepuce sac in boys can cause inflammation of the head of the penis and the skin around it. There are two types of disease development:

How to identify foreskin problems?

Symptoms of inflammation affecting the preputial sac:

Constant itching of the head of the penis.
There is a slight burning sensation in the foreskin.
Rarely can a boy detect purulent components.
Slight swelling of the skin around the preputial sac.
Redness of the flesh.
Rash on the head.
It's difficult to go to the toilet when you're small.
Pain when trying to move the flesh, as well as when the organ enlarges.

Who can help?

With your problem, you can contact the following doctors:

therapist;
surgeon;
to a urologist.

Why does the skin around the head become inflamed?

After the rinsing procedures, use Levomekol ointment, which is injected into the preputial sac with a syringe. For children, warm herbal baths are used as a preventive measure.

Medical methods

Problems of the preputial sac caused by phimosis in boys are eliminated using presurgical methods:

Non-medical practice

The second method is to stretch the preputial sac with your fingers. Using these methods you can get rid of congenital pathology. In 7 out of 10 patients, complete cure of phimosis was observed.

It is recommended to begin treatment of physiological phimosis in boys no earlier than the onset of puberty. In 70% of children this phenomenon goes away over time. If there are no serious complications, preventive measures are taken to reduce inflammatory processes in the foreskin using traditional methods.

- this is an inflammation that involves the head of the penis and the inner layer of the preputial sac (foreskin). Balanoposthitis in boys is characterized by itching and burning in the glans area, swelling and redness of the foreskin, difficulty urinating, and purulent discharge from the preputial sac. Balanoposthitis in boys is diagnosed on the basis of external signs and laboratory data (CBC, FAM, results of bacteriological culture of discharge, PCR, ELISA). Treatment of balanoposthitis in boys includes local baths with disinfectant solutions, washing the head of the penis, removing smegma and secretions, using antimicrobial and anti-inflammatory ointments; for chronic balanoposthitis, circumcision is indicated.

ICD-10

N48.1 N48.6

General information

Balanoposthitis in boys is an inflammatory process involving the glans penis and the inner layer of the foreskin. Balanoposthitis is diagnosed in approximately 6% of boys and 11% of adult men who have not previously been circumcised. Inflammatory diseases of the glans penis (balanitis) and foreskin (posthitis) most often occur in boys under 5 years of age and in men who are sexually active. Treatment of balanoposthitis in boys is a serious problem in pediatrics, pediatric urology and pediatric surgery. Prevention, timely and high-quality treatment of balanoposthitis in a child is the key to his reproductive and sexual health in the future.

Causes

The main cause of balanoposthitis in boys is the lack of proper hygienic care of the genitals. This leads to the accumulation under the foreskin of the secretion of the prepuce glands - smegma, which serves as a favorable environment for the proliferation of microorganisms that cause inflammation.

The development of balanoposthitis in boys is facilitated by the so-called physiological phimosis, which normally occurs in children under 3-5 years of age and complicates hygienic care due to the inability to completely expose the head when retracting the foreskin. Often, balanoposthitis in boys occurs when parents try to forcefully open the head on their own - in this case, various pathogens easily enter the preputial sac from the external environment. Severe synechiae of the foreskin can interfere with self-cleaning of the preputial sac. The most common causative agents of balanoposthitis in boys are streptococci, Escherichia coli, staphylococci, Proteus, herpes virus, and yeast fungi (candida).

However, in some cases, balanoposthitis in boys, on the contrary, may be caused by overzealous hygiene and frequent washing of the glans penis with soap or other irritants. Allergic reactions (contact dermatitis) can result from the use of baby creams, laundry with residues of detergents, etc. Children's cosmetics and household chemicals can provoke not only balanoposthitis, but also inflammation of the buttocks and perineal area in a child (so-called diaper dermatitis ).

The development of balanoposthitis in babies can be facilitated by infrequent changes of diapers or their incorrect selection (using diapers that are too large or too tight). At an older age, balanoposthitis in boys can occur due to constant trauma to the foreskin with tight panties, seams on underwear, etc. Endocrine diseases (diabetes mellitus, obesity), urological diseases (cystitis, pyelonephritis, urolithiasis) can predispose to the appearance of balanoposthitis in boys ), hypothermia, vitamin deficiency.

Symptoms of balanoposthitis in boys

Balanoposthitis in boys often develops acutely. Usually, after going to the toilet, the child begins to complain of burning and itching in the area of the glans penis, pain or difficulty urinating. Small children become restless and cry when urinating. Examination reveals redness and swelling of the head of the penis and foreskin; when the head is exposed under the foreskin, accumulated smegma is discovered, which has an unpleasant odor. With balanoposthitis in boys, there may be abundant cheesy or serous-purulent discharge from the preputial sac. A rash, cracks or diaper rash may appear on the skin and mucous membranes of the genital organs. With further progression of balanoposthitis in boys, erosions and peeling of the skin may appear.

In addition to local signs, with balanoposthitis in boys, general symptoms are expressed: malaise, lack of appetite, poor sleep, irritability. Often in children, the body temperature rises to 37-38°C, and the inguinal lymph nodes become enlarged. Due to the fact that the child tries to hold back urination due to its pain, daytime and nighttime enuresis may develop.

Symptoms of acute balanoposthitis in boys increase over 4-5 days; Self-healing is possible if you independently open the preputial cavity and clean it of smegma. However, more often, in the absence of proper or correct treatment, acute balanoposthitis in boys transforms into chronic. Chronic inflammation is fraught with the formation of scars on the foreskin with the development of pathological phimosis and paraphimosis, chronic urethritis, and deformation of the glans penis.

Diagnostics

If you suspect balanoposthitis in a child, you should contact a pediatric surgeon, or better yet, a pediatric urologist for an individual solution to the problem. In most cases, the diagnosis of balanoposthitis in boys does not require special instrumental studies. The pediatrician receives the necessary information by analyzing complaints, examining the child’s genitals, and performing a number of laboratory tests.

A general urine test in children with balanoposthitis reveals leukocytosis and bacteriuria. To identify the pathogen, a bacteriological examination of urine is carried out, as well as discharge from the preputial sac (if indicated, culture for candidiasis). In some cases, to clarify the type of pathogen, PCR and ELISA diagnostics may be required.

To exclude concomitant diseases, the child may need to be examined by a pediatric endocrinologist, pediatric nephrologist, pediatric dermatologist, blood glucose determination, ultrasound of the kidneys and bladder, and other studies and consultations.

Treatment of balanoposthitis in boys

In most cases, with acute balanoposthitis in boys, local treatment is sufficient. It is recommended to carry out sitz baths with antiseptics (potassium permanganate, furatsilin) or herbal decoctions (chamomile, etc.). It is possible to instill antiseptic solutions (chlorhexidine, miramistin, etc.) under the foreskin. After washing the glans penis, you should carefully retract the foreskin, remove smegma and pathological discharge, put ointment (synthomycin liniment, clotrimazole for fungal balanoposthitis in boys) into the preputial sac and return the foreskin to its normal position. If it is impossible to independently expose the head of the penis, separation of the synechiae of the foreskin and cleaning of the preputial sac is carried out by a pediatric surgeon or urologist.

To reduce pain and swelling, you can use NSAIDs, in particular ibuprofen. In severe forms of balanoposthitis in boys, systemic administration of sulfonamides, antibiotics, and antifungal drugs may be required.

For chronic balanoposthitis in boys and the development of pathological phimosis, circumcision (circumcision) is indicated.

Prevention

To prevent balanoposthitis in boys, it is enough to observe and accustom the child to daily hygienic care of the genitals. Small children need careful selection and frequent changing of diapers, regular toileting of the genitals and perineal skin care, and the use of hypoallergenic hygiene products.

At an older age, useful everyday skills include a hygienic shower, removing excess smegma, and changing underwear. Normalization of body weight and treatment of concomitant diseases are important for the prevention of balanoposthitis in boys.