Phimosis Totally Explained

Everything about Phimosis totally explained

Phimosis is a condition where the male foreskin can't be fully retracted from the head of the penis. The word derives from the Greek phimos (φῑμός, "muzzle"). As most boys are born with a non-retracting foreskin, the term is confusing because it denotes both a normal stage of development, and a pathological condition (for example a condition that causes problems for a person). This confusion is particularly pronounced in regard to infants. Conflicting incidence reports and widely varying post-neonatal circumcision rates reflect looseness in the diagnostic criteria. Phimosis has become a topic of contention in circumcision debates.
It is normal for a baby's foreskin not to retract, but as the child grows the foreskin is expected to become retractable. Some have suggested that physiological infantile phimosis be referred to as developmental nonretractility of the foreskin to more clearly distinguish this normal stage of development from pathological forms of phimosis. Different management is appropriate. In other words, there are different degrees of phimosis, and treatment may vary on the degree of phimosis.
Women can suffer from clitoral phimosis.

Infantile or congenital phimosis

For most of the Twentieth Century, most of the medical profession has recognized that most male infants have foreskins which are still attached to the epithelium of the glans penis

In the last three decades, as the circumcision rate in North America has declined, the most common official recommendations and guidelines from medical societies, as well as infant care books written by experts, have emphasized that it's normal not to be able to retract an infant's foreskin fully and that it need not be done. The American Academy of Pediatrics recommends gentle soap and water cleaning, but specifically recommends against forcible retraction.

Phimosis is sometimes used as a justification for circumcision,
   There are several management approaches to infant phimosis.
   When phimosis develops in an uncircumcised adult who was previously able to retract his foreskin, it's nearly always due to a pathological cause, and is far more likely to cause problems for the man.
   An important cause of acquired, pathological phimosis is chronic balanitis xerotica obliterans (BXO), a skin condition of unknown origin that causes a whitish ring of indurated tissue (a cicatrix) to form near the tip of the prepuce. This inelastic tissue prevents retraction. Some evidence suggests that BXO may be the same disease as lichen sclerosus et atrophicus of the vulva in females. Infectious, inflammatory, and hormonal factors have all been implicated or proposed as contributing factors. Circumcision is usually recommended though alternatives have been advocated.
   Phimosis may occur after other types of chronic inflammation (for example, balanoposthitis), repeated catheterization, or forceful foreskin retraction.
   The most acute complication is paraphimosis (Image. (External Link

)). In this acute condition, the glans is swollen and painful, and the foreskin is immobilized by the swelling in a partially retracted position. The proximal penis is flaccid. Paraphimosis is considered an emergency.

Treatment of phimosis

Phimosis in infancy is nearly always physiological, and needs to be treated only if it's causing obvious problems such as urinary discomfort or obstruction. In older children and adults phimosis should be distinguished from frenulum breve, which more often requires surgery, though the two conditions can occur together.
If phimosis in older children or adults isn't causing acute and severe problems, nonsurgical measures may be effective. Choice of treatment is often determined by whether the patient (or doctor) views circumcision as an option of last resort to be avoided or as the preferred course. Some adults with nonretractile foreskins have no difficulties and see no need for correction.

Circumcision is the traditional surgical solution for pathological phimosis, and is effective. Serious complications from circumcision are very rare, but minor complication rates (for example, having to perform a second procedure or meatotomy to revise the first or to re-open the urethra) have been reported in about 0.2-0.6% in most reported series, can be an effective alternative to full circumcision.

Stretching of the foreskin can be accomplished manually, sometimes with masturbation, also known as the Beaugé method. The stretching can also be accomplished with balloons placed under the foreskin skin under anaesthesia,or with a tool. The tissue expansion promotes the growth of new skin cells to permanently expand the narrow preputial ring that prevents retraction. Dilation and Stretching Skin that's under tension expands by growing additional cells. A permanent increase in size occurs by gentle stretching over a period of time. The treatment is non-traumatic and non-destructive. Manual stretching may be carried out without the aid of a medical doctor. The treatment is inexpensive. Relief of phimosis by a stretching technique has the advantage of preserving all foreskin tissue and the sexual pleasure nerves. The Beaugé Method has proved successful for many.

Incidence

A number of medical reports of phimosis incidence have been published over the years. They vary widely because of the difficulties of distinguishing physiological phimosis (developmental nonretractility) from pathological phimosis, definitional differences, ascertainment problems, and the multiple additional influences on post-neonatal circumcision rates in cultures where most newborn males are circumcised. A commonly cited incidence statistic for pathological phimosis is 1% of uncircumcised males. Others have described incidences in adolescents and adults as high as 50%, though it's likely that many cases of physiological phimosis or partial nonretractility were included.

Phimosis in history

According to some accounts, phimosis prevented Louis XVI of France from impregnating his wife, Marie Antoinette, for the first seven years of their marriage. She was 14 and he was 15 when they married in 1770. However, the presence and nature of his genital anomaly isn't considered certain, and some scholars (Vincent Cronin and Simone Bertiere) assert that surgical repair would have been mentioned in the records of his medical treatments if it had occurred.

US President James Garfield was assassinated by Charles Guiteau in 1881. The autopsy report for Guiteau indicated that he'd phimosis. At the time, this led to the simplistic speculation that Guiteau's murderous behavior was due to phimosis-induced insanity.Further Information

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