Dr. Komarovsky about boys phimosis
Very often, parents of young boys hear the diagnosis “phimosis” from a pediatric surgeon. And this causes confusion and confusion, since it is completely incomprehensible what to do, how to treat the child, and whether it is necessary to resort to surgical intervention.
Not in all cases should be alarmed, says authoritative children's doctor Komarovsky. For the most part, the diagnosis that the surgeon made to the baby does not need treatment. But to understand the essence of what is happening is necessary. Evgeny Olegovich tells about the phimosis in boys and the correct attitude of the parents towards him in more detail.
About the problem
Medical reference books say that phimosis is a pathological narrowing of the foreskin, which results in difficulties with exposing the head of the penis. You should not consider this a disease, because almost all the newly born boys have such a problem.
Only 3-4% of the male babies born have movable foreskin, for all the others it is not possible to bare a member. It does not carry any danger, since it is a physiological feature.
The physiological phimosis passes by itself, as the child grows up, together with the onset of production of male sex hormones. They influence the ability of the foreskin to stretch - the more hormones, the more elastic the flesh. Already by half a year, according to statistics, the head of the member freely opens in 20% of children, and by the age of one and a half - in every third.
About 90% of boys get rid of physiological phimosis by 3 years. In the remaining 10% of children, the narrowing of the flesh can be observed until the end of puberty, and this, according to Evgeny Olegovich, will also be a variant of the norm.
Only 1% of these “belated” boys have a real phimosis, which is a pathology. For a proper understanding of this problem, Dr. Komarovsky explains that of this 1% in 98% of young men who have not opened their penis by the age of 16, phimosis can be completely cured with the use of corticosteroid ointments and simple exercises to increase the elasticity of the flesh. In most cases, the doctor says, the boys themselves successfully solve this problem, because all adolescents are engaged in masturbation.
Thus, the need for surgery is so insignificant that it is not worthwhile to immediately go to the doctors with the requirement to cut, trim and open the head as soon as possible. Moreover, you should not worry, panic and worry! Komarovsky argues that doctors' statements about the severity of phimosis and strong recommendations in conducting therapeutic measures are rather commercial in nature and rather far from medicine.
What should parents do
First and foremost, says Yevgeny Komarovsky, mothers and fathers should clearly understand that if a pediatric surgeon diagnoses a child “phimosis” for a child, then this is often a diagnosis for the sake of diagnosis: the doctor only states a fact - the boy has a physiological narrowing of the foreskin. The fact that it is quite natural, we already know.
If such an unpleasant verdict is issued to a teenager aged 15-16 years old, and conservative measures (corticosteroid ointment and stretching) did not help, you should contact the surgeon to perform simple manipulations - circumcision. This does not at all worsen the life of a man, and in some ways even improves it.
What not to do
Komarovsky does not advise parents at home to forcibly open the penis to the boy. Such advice, as practice shows, can be given not only by “all-knowing” girlfriends and grandmothers, but also by district surgeons in an outpatient clinic. If the child does not hurt anything, he does not have difficulty urinating, there is no redness, inflammation, no need to touch anything.
When bathing and washing away, do not try to rinse anything under covered flesh, especially soap. Between the foreskin and the head of the penis will allocate a sufficient amount of special lubricant - smegma, which has excellent antibacterial properties, and therefore there is no need for washing. But the soap, which can fall under the foreskin, can cause severe chemical burns.
When you need medical care
There are several situations in which parents should seek qualified medical assistance as soon as possible:
- Paraphimosis;
- Balanoposthitis;
- Adhesions between the foreskin and the head of the penis.
- Paraphimosis may occur when parents, contrary to common sense, decided to do their own hands to stretch the very flesh with physiological phimosis. At some point, everything went wrong: the head came out, but it turned out to be squeezed in the foreskin from below, and it just cannot get it back. If this happens, you need to deliver the child to the surgeon as soon as possible, the bill goes on for minutes. Otherwise, the head pinched by the ring of constricted flesh, devoid of normal blood supply, is at risk of developing gangrene, which, in turn, is fraught with the amputation of an organ so important to the future of men.
The faster the child is delivered to any nearby medical facility, the better. With timely treatment, the doctor can do manual reposition of the penis head in place. In no case should not try to do it at home on their own! But what you need is to immediately slightly compress the head of the penis and attach something cold to it, but do not allow frostbite.
In some cases, this is even enough to remove the swelling and return the foreskin to its place. But it’s still not worth counting on it and delaying the referral to a doctor.
- Balanoposthitis and other inflammatory diseases of the penis also should not be treated at home with popular recipes. A child who has pain when urinating against the background of physiological phimosis (he cries before peeing), the foreskin reddened and swelled up, definitely need to be shown to the pediatric surgeon. These diseases in children are more common than in adult males, which in itself is dictated by physiological age-related narrowing.
If infectious agents enter the favorable environment, which is smegma, which smegma itself cannot cope with, then inflammation may begin. You don’t need to open and wash anything in this situation, but you should immediately go to the medical facility with the child. This also applies to inflammation in babies who already have a head of the penis. Balanoposthitis alone can lead to scarring and secondary phimosis.
- Synechia (adhesions). The fusion of the extreme flesh and the head of the penis can be congenital, and it can develop gradually, especially in children, often suffering from inflammatory processes of the extreme flesh. To establish the degree and localization of fusion should a doctor He will prescribe treatment, which is not necessarily surgical. About 40% of synechiae are successfully treated without the use of surgical instruments and manipulations. Extensive adhesions require surgery.
Tips of Dr. Komarovsky
Daily hygiene procedures for boys with physiological phimosis should include washing with plain water. While bathing, every 2-3 days you can wash your baby with soapy water (use baby soap for the solution). In this case, the washout should be external; it is not worth opening the head of the penis.It is not necessary with the help of a disposable syringe, as it is advised by numerous websites for moms, to try to wash the head of the penis without opening the foreskin. Such actions can injure and infect the baby’s genitals.
The development of inflammatory processes in the constricted foreskin is facilitated by factors such as the wrong choice. diaper, too tight panties for the boy, as well as aggressive means for washing clothes. Parents should make sure that the sexual organ is loose enough so that the underwear and diapers are comfortable, nothing is clamped.
Pampers need to be changed more often, so that the child has less contact with urine and feces, and pants need to be washed with hypoallergenic baby powders.
Physiological phimosis will not be complicated by inflammation if parents remember: infection with smegma is most likely if the child is sweating a lot and is overheating. It is best to maintain the optimal microclimate parameters in the house - the temperature is 18-20 degrees, the relative humidity of the air is 50-70%.
You can also find out about the children's phimosis in the following video below.
