Related articles: Phimosis
Definition
The phimosis consists in the narrowing of the preputial orifice, with impediment to the posterior retraction of the foreskin and partial or total closure of the glans. In practice, the subject suffering from phimosis cannot "uncover" the skin that wraps around the free end of the penis (called glande or balano).
The disorder can be congenital (present from birth) or acquired (the causes intervene after a normal pubertal development). In the latter case, it can result from dermatological diseases, traumas (eg abrupt retraction of the preputial skin), prolonged irritation or recurrent inflammation of the glans or foreskin (balanoposthites) which heal and lead to scarring.
Most common symptoms and signs *
- Erectile dysfunction
- Dysuria
- Pain in the penis
- Pain during sexual intercourse
- Erythema of the urinary meatus
- Urethral leaks, sometimes visible only after squeezing the glans
- Urethral itching
- Urinary retention
- Skin Ulcers
Further indications
The extent of the disorder is variable: in some cases the foreskin may block the glans exit with an erect penis or only partially (unfixed phimosis), other times it prevents this operation even when the male sexual organ is flaccid (phimosis serrata) .
The narrowing of the preputial orifice which characterizes phimosis makes it difficult or impossible to completely slide the prepuce along the glans.
In mild forms, the glans can only be discovered with difficulty during erection and can cause discomfort during intercourse. Medium-grade phimosis, on the other hand, occurs already at the flaccid penis and the glans is only partially discovered. This can make sexual intercourse difficult, causing pain. The preputial narrowing can also cause premature ejaculation and hygienic difficulties.
In severe cases, the glans cannot be detected and the phimosis prevents normal urine from escaping. When normal hygiene becomes difficult, infectious complications are frequent due to the accumulation of germs and urine. Such occurrences require targeted medical therapies.
The forcing of the glans uncovering can also cause paraphimosis, a serious complication that involves trapping the foreskin in a retracted and stenotic position. This causes a strangulation in the coronal sulcus, which can cause ischemic necrosis due to reduced blood supply.
Phimosis is generally treated surgically with partial postectomy (removal of part of the foreskin) or circumcision (complete removal of the preputial skin). Mild forms may respond to topical corticosteroids and gentle manual distension.
