Phimosis

Phimosis

  Autor NN Team Data: 02.04.2009

Phimosis
Phimosis is a men condition, when the foreskin opening is too tight to allow the foreskin fully retract to the penis base, during erection. The foreskin is the double-layered fold of skin, whose inner side is covered by a membrane which covers the glans when not erect. Although it is removed in some cultures, the foreskin has a role for the penis health. 

There is a myth saying that whenever the foreskin doesn't retract, it is about phimosis. Actually, why what we call phimosis in an adult, it's a perfectly normal state in infants, preschool children or teenagers. During the first years of life, the foreskin is sealed to the glans, as the nail is sealed to the fingertip. This attachment is formed early in the fetal development, being a protective cover for the sensitive developing glans. It is the same with the non-retractable foreskin during the first years of life. The glans which is developing until adolescence, is very sensitive and must be completely protected against the mechanical trauma which might be caused by the contact with a diaper or against the chemical trauma caused by the contact with urine. Besides all these, the membrane that covers the inside of the foreskin has a protective role against bacteria which might infect the respective area. 

As long as the foreskin opening is enough big to allow urination without problems, we are talking about a perfectly healthy boy and a normal penis. With time, the foreskin will become retractable. 50% of the boys have a retractable foreskin at 1 year of age, 90% by three years of age and 99% by age 17. Therefore, a non-retractable foreskin might be considered normal up to and including adolescence, unless the doctor notices scars or other problems. 
We may talk about phimosis when the young men feel a discomfort, the erection is painful and the sexual intercourse is difficult, or even impossible sometimes, because of the non-retractable foreskin. In such a case, the problem is solved by circumcision generally, but there are even less invasive treatments, depending on the disease severity. 

Because not many things about the foreskin and its role have been known until recently, especially that some cultures urged to circumcision, the doctors considered that the non-retractability of the foreskin was pathological even in young boys, and recommended circumcision. After this, the doctors started recommending the gradual stretching of the penis, at each bathing. The mother's attempts meant a lot of tears and pain for the little boy, and the benefits were absent. On the contrary, the risk of complications (even real phimosis) is bigger when the partially stretching is done. When stretching the foreskin which is sealed to the glans, we cause small injuries, which turn into scars, narrowing the fibrous ring at the foreskin edge. Which is the consequence? True phimosis, when the boy becomes an adult. Besides this, a severe complication, paraphimosis might occur, when the glans becomes strangled by the foreskin and must be released fast, by an emergency surgery to avoid the gangrene of the tissues. 
Unfortunately, even today there are doctors who recommend the forced retraction of the penis in infants, although most specialists agree that the retraction is not necessary and it does more bad than good. This might also be a trend coming from other countries such as USA, where phimosis is often used as pretext to obtain a free circumcision surgery. 

Actually, the retraction is not necessary as the foreskin is not retractable because it is not ready for this, and it shouldn't retract yet, in infants. If mothers are still worried about this, they can ask for a doctor's help, who will examine the penis in order to see the possible abnormalities or scars. 




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