The phimosis It is a very common condition in children that worries parents a lot because most babies have it (physiological phimosis), because it takes a long time to resolve itself and because many professionals are in a hurry to solve it and indicate the retraction of the skin from very young (at risk of injury) or phimosis operation to solve it.
Like putting the child in the operating room and having their parts touched, it is quite scary (both the child and the parents), we are telling you today what is the phimosis operation and when do you recommend it.
What is phimosis?
Before we talk about the intervention, we talk a little about phimosis, because sometimes a child ends up being operated by a phimosis produced at home and this should be avoided.In Babies and more A warning: do not let pediatricians or nurses lower the skin of the penis to the baby to cure his phimosis
The phimosis is the inability to lower the skin of the foreskin of the penis In babies it is physiological, completely normal, because the foreskin and the glans are attached from birth. With the passage of the years, these adhesions are disappearing and the skin can go down more and more. Sometimes, although the adhesions disappear, the skin may present a kind of ring that also prevents lowering the skin. That ring is also disappearing over the years. I show you here more graphically with an image of the Peruvian Urology blog that represents it perfectly:
How do you solve all this alone? Well, with the passage of time, thanks to the fact that children touch and stretch their skin, thanks to the fact that they begin to have erections and because the penis is increasing in size. Many people recommend slowly retracting the skin at home, so that it goes down. At first the recommendation is not to do it, not to lower the skin, because some parents, with the good intention of preventing the operation of phimosis, lower more strongly than necessary and injure the skin of the foreskin. These wounds can cause phimosis to stay longer, make the skin harder, less elastic (the scars have less elasticity than the skin) and then, yes, the child must be operated. That is why the recommendation is to do nothing. That you also want to lower the skin? Well, it goes down a little from time to time at the time of bathing, for hygiene, but always without forcing.
When is phimosis operation recommended?
Therefore, the ideal is to wait for phimosis to resolve itself over time. If this does not happen, or if there are associated symptoms (that phimosis generates other problems), then something must be done. For some time this part is using treatments with ointments or creams with cortisone To avoid the operation. It is applied to the skin of the foreskin and after a few days, in addition to applying the cream, the skin begins to retract little by little. The success rate is very high, because with the application of betamethasone, about 85-95% of cases are resolved.
What cases? That is to say, When to apply the cream? When is the time to solve phimosis? Well, in case:
- Beech pain and inflammation when urinating because the urine accumulates (it has such difficulty getting out that it hurts because the urine output pressure is higher than the skin and the hole can assume).
- For the child to do urine infections.
- To suffer balanitis, which are infections caused by accumulated smegma (smegma is a substance that generates the cells of the glans and the foreskin that must be cleaned so that it does not accumulate).
In these situations, no matter how old the child is and it is indicated to try to resolve phimosis. The first option is to do it with the ointment because as we have said it solves many cases. The second option, if the ointment does not work, is to operate. So, answering the question (when is the phimosis operation recommended?), It is recommended operate phimosis when any or several of the three situations mentioned above occur and the corticosteroid cream has not been effective.
And by age?
The other possibility is to intervene because of the child's age. It is possible that there are no symptoms, that it does not bother, but that phimosis does not resolve over the years. I do not know how it will be where you live, but in the area where I reside the usual few years ago was to operate at 4-5 years. Now it seems that they are waiting a little longer, probably because they give time to solve itself or try the cream. This is totally logical, if we consider that many phimosis do not disappear by themselves until ages from 10 years.
Experts say that the ideal, to avoid general anesthesia, is to operate phimosis from 8 years old, which is an age in which thanks to the time that has passed and thanks to corticosteroid treatments there are very few children to to intervene.
What is the phimosis operation?
The phimosis intervention it is called circumcision and it consists of cutting and removing a part of the skin of the penis, so that it ends when the glans begins and so it is discovered. The skin sutures are made with absorbable thread that takes about 2 weeks to disappear. Once the intervention is performed, the child usually leaves the same day. Parents should keep in mind that:
- The wound may take up to 3 weeks to heal.
- Children have to avoid exercising, running, jumping, etc. until it heals completely.
- In the event that the wound blood in the first 24 hours a sterile gauze should be applied to the area and pressed for at least 10 minutes (bleeding may occur because the wound, despite being sutured, has not yet closed to stop to bleed).
- It is advisable go cold compresses (ice that is not in direct contact with the skin) at times, about 15-20 minutes, stop for a while, put it back on, ... it helps lower inflammation and pain.
- After 24 hours the dressing must be changed so that it is not stained or moist and the application of an antibiotic cream to prevent infection is probably indicated.
- Except contraindication, the child can bathe or shower (The first will hurt less surely), at which time you can wash the wound with a mild soap, always carefully.
- They probably also prescribe anti-inflammatory and pain syrup the first few days.
Call the pediatrician or the hospital where you had surgery if:
- The wound bleed again, although we have pressed it for a few minutes.
- The wound start to suppurate.
- The pain, instead of going less, goes to more.
- If the penis It swells and gets red.