When should the head of the penis in a boy open
Each newborn baby must undergo a thorough examination and diagnosis under the supervision of doctors, including checking the condition, development and structure of the genital organs. Further, at normal rates, all the necessary nuances should be monitored by parents. And the important question asked by parents is at what age do boys open their heads?
The head of the penis from birth and for some time is in a closed state, it is covered by the foreskin. In medicine, this area of the skin is called prepuce; when the penis swells, it will necessarily move away, exposing the head. For the baby, this is a kind of protection against the pathogenic flora entering through the urethral canal, doctors say that at a certain age the foreskin should fully open the head of the penis.
Pediatrician answers questions of the boy's parents
What is hidden in the boy’s panties is not called “he has it”, not “tip”, not “pendant”, not “pencil” and not even “pen” - this is the penis (penis), it’s even called that newborn boys. Get used to normal names from the very beginning.
External genital organs in a boy: penis, scrotum and testicles in it. The penis consists of the body, head, and foreskin over the head, at first the foreskin is firmly soldered to the head (normally the foreskin begins to be completely removed from the head at very different times - sometimes from the first months of life, and sometimes only to puberty).
Boys under 14 years old have cremasteris muscle (there are two of them, one for each testicle), also called “the muscle that raises the testicle” - this is a natural defense against testicular injuries when struck by the perineum. Therefore, sometimes when feeling the scrotum of a child, you may not find testicles in it - they "hid" in the inguinal canals.
It happens from a cold, from tickling, from fear, from pain, or on its own. But if the scrotum is always empty, or (more often) there is always only one testicle in it - this is an occasion to suspect cryptorchidism (undescended testicle in the right place) and discuss this with your pediatrician, such a child may need an operation to lower the testicle into the scrotum.
How it works
Erections in boys (swelling / hardening of the penis from a rush of blood) occur immediately after birth. At first they are lethargic and usually occur before urination. Experienced erection mothers understand that now the child will write, this is convenient when collecting a urine test.
Full-blown erections (at “twelve o'clock”) begin at 7–11 years old, usually from morning erections (immediately after waking up), and later from sexual arousal. Ejaculation (sperm eruption) normally starts from 10-15 years, happens in a dream and is called pollutions, they are accompanied by erotic dreams. This is a kind of “training” of the body, preparation for future sexual activity.
From the age of 14, almost all adolescents begin to masturbate regularly, and the pollutions cease (in order to “accumulate” sperm for a poll, you need to refrain from conscious ejaculation for about 2-3 weeks, this hardly happens with adolescents). In young men and men who abstain from sexual activity (including masturbation), pollutions continue 1-2 times a month until old age.
All this is the norm. Masturbation is not harmful, does not speak of future sexual licentiousness, does not “wear out prematurely” the genitals, etc. Down with the hypocrisy and ignorance, the 21st century is in the yard.
What can hurt there
What bad things can a parent notice from the child’s genitals (from common illnesses)?
- Testicular edema (size greater than 2 cm in a baby) is most likely dropsy (fluid accumulation under the testicle shells), it can go away on its own, or it may require surgery, it may be communicating or not communicating with the abdominal cavity, it may be associated with the inguinal or inguinal-scrotal hernia or not associated with it.
- Balanitis or balanoposthitis - redness, swelling, pain when touching the penis and urinating. Requires examination by a doctor.
- Paraphimosis is a dangerous condition when the foreskin has opened, the head has opened, but for some reason the foreskin has squeezed the head, it swollen and restrained (blood flow was disturbed in it).
It is accompanied by a sharp pain in the head of the penis and a sharp swelling of the entire penis, a frightening sight - an occasion to immediately call an ambulance or by gravity to go to the receiver of the urological / surgical department.
- Acute pain in the scrotum - it doesn’t matter if there is something else visually abnormal in the perineum or not, if the child cries from pain in the scrotum and walks abruptly - this is also an occasion to call an ambulance or go by gravity to the urology department, since the “acute scrotum” (according to analogies with an acute abdomen) is almost always an extremely dangerous condition, requires surgical intervention, and if the treatment is too late (more than 6-24 hours) it can even end with the removal of the testicle. The main reason is torsion of the testicle or hydatide, but there are others, surgeons know them and are able to treat them.
- Volumetric formations in the scrotum, like a third testicle, like a ball of worms, or like something else. This can be a cyst of the spermatic cord, varicose veins (varicocele), etc. - requires a planned visit to a pediatrician or urologist.
- Whitish deposits of 5-20 mm in diameter under the skin of the foreskin, above the glans penis, are smegmolites (deposits of smegma, a white matter secreted by the head). This is usually not dangerous, they will pass when the head opens spontaneously.
And so on: developmental anomalies, rashes, injuries, etc.
How to maintain penis hygiene
Adult men every evening should open the glans penis, wash it from smegma and all that is superfluous. The same rule applies to boys who already have the head open, with one difference: men do not need to close the head with the foreskin after washing, but boys do (the narrowed ring of the foreskin can work like a stranglehold around the head of the foreskin and cause paraphimosis - pinching the head).
While the head does not open, we wash it like any other part of the body when washing in the bath / shower. When the head opens only partially, we open gently, without violence, as far as it opens, wash and close it back.
In most newborn boys, the foreskin cannot be removed from the head, since it is tightly soldered to it, but over time, the foreskin spontaneously gradually "sticks off", this is an invisible and painless process.
Most boys often touch their penis and play with it. This is a normal part of their development, so they study their body. When the foreskin is ready for abduction, your child will most likely open his head himself.
In some children, the foreskin is cut off surgically, for religious, national or medical reasons. Such children / adults also need to wash their heads every evening with soap and water.
At what age should the glans penis open completely?
Already at the age of one year in most boys the head is completely removed from under the foreskin, by the age of 4 years, in 90% of boys, the head opens freely. However, in some children, the glans penis is hidden under the foreskin until puberty. This is normal, called physiological phimosis, and does not require treatment in itself.
In rare cases, even after puberty, the head does not open - this is no longer normal, called pathological phimosis and may require surgical treatment. Erections give normal natural traction (pulling) of the foreskin and contribute to the opening of the head. Sexual intercourse is not possible with the closed head of the penis due to pain (and masturbation is possible), therefore, after 14-16 years, we no longer wait for a spontaneous opening, but begin to force events.
Important! Vicious practice forced opening of the head Urologists and surgeons, without anesthesia, amassing, with a routine outpatient examination is pure evil. This is not only cruel, painful, provokes secondary infection and fears, but also ineffective: an unprepared head usually closes anew, moreover with the formation of scar tissue, and this in turn increases the risk that an operation will be needed in the future. Do not let the doctors do this, say that you are against forcibly opening the head from the very entrance to the surgical room - otherwise they can open sharply without warning and permission on your part.
A closed head with an “unblocked” foreskin is more prone to inflammation (balanitis and balanoposthitis), and if they become frequent (more than 4 per year) and / or there are other signs of regular discomfort of the child due to the closed head, then opening can be forced earlier adolescence.
Do not try to force your baby's foreskin to wash. There is no need to wash under the foreskin if it is not yet retracted. An attempt to forcibly remove (tear from the head) the foreskin can cause scars and problems in the future.
After the foreskin begins to deflect easily, your baby should be trained to deflect it and wash the head of the penis while washing. The penis is washed just like any other part of the body. Make sure that your child completely rinses the soap and only after that closes the head back with the foreskin - otherwise the remnants of the soap will provoke irritation.
If we worry that the foreskin does not take too long, what are our options? There are only three of them:
- expectant tactics (doing nothing), most likely, will open itself by 11-15 years,
- applying topical steroids (Comfoderm ointment, Elokom ointment, etc.) to the glans penis through the entire foreskin for a couple of weeks (this will lead to a complete opening of the head, but after the ointment is canceled, it will begin to stick together again - you have to open it, follow it every night, sometimes until the same 11-15 years)
- circumcision (surgical removal, less often dissection of the foreskin).
For what reason does the head not open in boys?
In infants, the head does not open almost never, properly protecting the penis from the penetration of various infections. There are two reasons why a head is not completely naked at an early age:
- The birth of children with foreskin, which is in an oblong state.
- A hole in the glans penis that is not wide enough. The pathology of the foreskin, which has a narrowed character, bears the medical name - phimosis.
If phimosis in a child’s body is harmless to health, does not cause pain, and does not prevent urine from leaving the urethra, then there is no reason for parental panic. But if this disease no longer has a physiological nature and continues after 15 years, then this is already a dangerous phenomenon.
The structure of the male genital organs
To understand how the head opens in boys, you need to delve into the structure of the penis. It consists of three parts: the root (the scrotum with testicles is located here), the body (it is often called the trunk) and the head.
At the end of the head there is a hole through which urine comes out during urination, and in adults, the stronger sex and semen during ejaculation.
The head is covered by a patch of skin called the foreskin. It consists of two parts (petals). One of them is ordinary skin and is external. And the other (internal) is covered with mucous membranes. They contain special glands that secrete mucus - smegma.This is a unique fat-like composition, which, firstly, provides a smooth glide of the head, and secondly, prevents the growth of pathogenic microorganisms.
At what age do boys open their heads
There is an unlimited number of opinions on this issue, but in this article we will focus on the points of view of qualified specialists. At the stages of the first 6 months in newborns, the opening of the head in a natural way is quite rare in medical practice, but still real.
In most cases, the head opens in boys by three or four years. However, if this does not happen, then this should not be done artificially. These actions pose a threat to circulatory disorders and the appearance of an irreversible cessation of vital activity of cells caused by the influence of pathogens.
It is worth remembering that the process of the possibility of complete exposure is strictly individual. A child can get rid of natural phimosis in a year, and at 6 years old, and at 9, and at 10 and even 15 years. We strongly recommend that you register with a medical clinic and carefully, and most importantly, correctly observe this most important process for the future life of a man.
If the boy’s head doesn’t open, and he has already reached the age of 6–9 years and does not make claims on the issue of male health, then be patient and just wait for it to happen naturally. It is important to know that doctors who recommend surgery for children 6–9 and 10 years old are not competent specialists. Such creeps threaten lifelong problems with reproductive function and self-confidence.
Statistical data found that the optimal range for complete exposure of the penis in children is as follows: up to six months (but in single cases), by 6 years (in most cases), in the interval 9-10 years (in ¼ of the boys) and until puberty the rest.
It's important to know! Do not make independent efforts to move the foreskin to the glans penis if the child is 6 years old! This infringement of the head will entail complications of phimosis, which will require urgent help and can develop into a chronic pathology.
Should the head open in boys?
Some doctors independently open the head during a scheduled examination, citing the fact that such manipulation will avoid many problems in the future.
During the opening procedure, most babies experience pain, because the intervention is rude (the doctor literally breaks the commissures).
Since the space between the glans penis and foreskin is protected from smegma infections, the development of infections is reduced to zero. But smegma can perform its functions only under the condition of complete sterility, which is immediately impaired after contact with air. It turns out that the doctor, opening the head, violates sterility, which can trigger the emergence of many problems.
After discovery, experts recommend treating the foreskin with antiseptics to avoid infections. But if you do not interfere with the physiological structure, then everything will go on as it should. Only in a few percent of boys of the first year of life, the head can be movable and open without serious consequences.
Rules for personal hygiene when opening the head
Here the crucial role is played by smegma. This substance helps a more comfortable sliding of the head of the penis, has a white color and a greasy consistency, and most importantly - shows a bactericidal effect. Smegma is a fairly effective natural hygiene product.
Hygiene standards are not the same for everyone. For children subjected to the circumcision process, they are of a special nature. For the rest, they recommend taking a warm shower daily and washing the head of the penis with soap.
Dr. Komarovsky notes in his advice that the soap should be thoroughly washed and not accumulate in the head, so as not to cause skin burns.
If a boy at the age of 9-10 is still not completely exposed to the head of the penis, then it is worth paying special attention to hygiene standards. In the absence of any complaints about the head and foreskin, one daily wash is more than enough. Do not be zealous in this regard, since the risk of harm to health is greatly increased!
What time does the boys head open?
Opening the head is a purely individual process.
According to statistics, in about 4-5% of boys, the head can open in the first months of life. At 15-20%, the discovery becomes possible in six months or a year. In 90% of children, the foreskin becomes mobile and exposes the head only by 3-5 years. But in these cases, the discovery is most often carried out by doctors or parents, although it is still painless.
Independent discovery is usually observed at the age of 6-8 years. But in some boys, the head begins to open only in adolescence, that is, in 12-14 years.
Do I need to sound the alarm if the head does not open?
How many years the head will open in your child is difficult to accurately predict. Many parents start to panic and sound premature anxiety. The presence of natural phimosis is not a cause for concern. It can be observed up to 15 years, which is quite normal. By the age of 17, the head should fully open in all boys. If this still did not happen, then special ointments will serve as a help in exposing the head of the teenager.
If there is a painful exit of urine through the channels, unusual for the foreskin, expansion, penile edema, inflammatory processes, the occurrence of formations of a purulent nature - it is worth worrying about the health of the child. These factors indicate the formation of scars in the foreskin. Then phimosis is already pathological in nature and the head of the genital organ, which does not open, is not the only dangerous consequence for health.
Personal hygiene of the boy
If the boy does not feel discomfort, then the head should not be opened. Do not try to forcefully move the foreskin, because such actions can lead to tissue damage and infection.
If the head seems inflamed, and the child experiences pain when urinating, then you should consult a doctor.
In normal condition, the head can only slightly open. But in this case, do not try to open it completely.
During washing, wash the head well with baby soap. If it opens a little, then carefully move the foreskin (until it is possible), wash all the free space well, rinse the soap very thoroughly, dry the genital area with a towel and put on diapers or underpants on the boy.
Phimosis: when to sound the alarm?
Phimosis is a condition in which synechia does not allow the head to fully open.
Phimosis in most cases is completely physiological, that is, normal from the point of view of the anatomy of the male body.
There are several stages of phimosis:
- In the first stage, the head is withdrawn almost completely, painlessly, but with some effort,
- In the second stage, the head is not displayed, but it is clearly visible,
- In the third stage of phimosis, the head of the penis is visible only by 2-3 mm,
- In the fourth stage, the head is completely closed, which can disrupt the natural urination process and provoke the development of inflammation.
Phimosis can be complicated if an infection occurs. The main symptoms of complications:
- Bad smell
- Pus showing up under the foreskin and going out,
- Redness, hyperemia of the glans penis or foreskin,
- Burning, itching, pain in the foreskin or head,
- Difficulty urinating (the boy will push hard or cry when trying to empty his bladder).
Be responsible for the personal hygiene of the boy to avoid undesirable consequences!
What is phimosis in boys
In young boys, the head of the genital organ is closed with a skin fold - the foreskin. Its ring is narrowed and does not allow to expose the end of the penis.
This confuses inexperienced parents, leads them to think about pathology. In fact, this structure of the penis in infancy is considered normal. It is designed to prevent the penetration of infections into the body. As the child grows up, the foreskin ring stretches and the head opens.
But in this process, failures happen. The skin covering the end of the penis can grow to its head, become inflamed. Urination is difficult, painful. These are the signs of phimosis - an ailment that requires medical attention and treatment.
Toddlers suffer from this disease. By 8 - 9 years of age, the incidence of it is reduced to 10%. By the age of 12 -13, it drops to 2%.
It is at an early age that parents need to monitor the development of the genitals in boys.
To teach children that in case of pain in the penis, difficulties with the administration of small needs, they should not be shy, but should address their problems to adults.
According to medical statistics, 96% of newborns can move the skin on the penis, expose its end, which is considered normal, should not bother parents. By the age of six months, the head of the genital organ freely opens in every fifth boy. By three years - 90% of babies.
This scenario of sexual development is considered optimal. If a child falls into the group of 10% of children whose 3-year-old penis has not yet opened, panic is not worth it. The release of the head of the penis can be delayed up to 6 years. And if the narrowed skin at its end does not cause the boy any inconvenience, does not interfere with defecation, does not cause itching or burning, there is no need to worry.
Although constant monitoring of the child's reproductive organs is mandatory. When preserving the foreskin narrowed after the age of six, consultation with a doctor - a pediatric urologist or andrologist is required.
Until the opening of the head has occurred (usually up to 3 years), ritual circumcisions are not recommended to eliminate the risk of damage to it. For medical reasons, circumcision can be performed at any age when balanitis (an inflammatory process in the area of the head of the penis), inflammation of the foreskin or problems with urine output are found.
For the development of pathological narrowing of the foreskin - phimosis in boys, there are various reasons. The following ones appear:
- hereditary predisposition to inelasticity of the connective structures of the body (physiological form of pathology),
- a violation in the development of the genital organ in the fetus in the womb due to chronic diseases of the mother or the adverse effects of external factors,
- an increase in the foreskin in volume due to the accumulation of fat deposits in it (hypertrophic form),
- penis injury (strokes during active games or sports, attempts by the child to reach the head of the penis), leading to a cicatricial form of the disease,
- infectious damage as a result of penetration of bacteria and viruses under the foreskin due to a violation of hygiene rules or as a complication after diseases of the genitourinary system,
- inflammatory processes (balanoposthitis),
- complication after surgery caused by damage to the tissues of the penis.
Different causes give rise to phimosis in boys. What is paraphimosis in boys and men?
Types of phimosis
Depending on the causes of the disease, doctors divide it into three main types: congenital, cicatricial and hypertrophic. This is required in order to more clearly identify the essence of the disease, to select the correct methodology for the examination and subsequent treatment of the patient.
The congenital form is the most common. It happens against the background of a genetic predisposition or impaired fetal development inside the mother’s womb. Finding out the prerequisites for it is sometimes quite difficult.
A characteristic feature of the disease is a narrow hole at the end of the penis, which prevents the exit of urine, which contributes to the onset of inflammation with the formation of further synechia (adhesions).
Cicatricial form is a little less common. The main reason for it is considered neglect of hygiene standards. Because of this, an infection penetrates under the skin covering the end of the genital organ and begins to develop there.
Sometimes there is congenital cicatricial stenosis (narrowing of the foreskin ring), which is characterized by lengthening of the skin fold at the end of the penis.
As a result of the penetration of pathogens into it, swelling occurs and scars subsequently form.
As a result, hygienic care becomes painful and the child may stop to carry it out. Which leads to the development of paraphimosis (a painful, acute condition when the skin at the end of the penis becomes inflamed and compresses the head).
The hypertrophic form is rare, but no less dangerous. It happens against the background of overweight in a boy, teenager or man. Especially when body fat is concentrated in the lower abdominal cavity, in the inguinal zone.
They form folds (skin-fat aprons), which not only create aesthetic discomfort, but also painfully squeeze the end of the genital member. Gathering of sweat secretions, urine.
They cause sputum, tissue irritation and create a favorable microenvironment for the reproduction of harmful microbes.
Cicatricial phimosis in adults and children
Stages of the disease
Medical experts classify phimosis and the stages of its development. In accordance with the classification, the optimal method of therapeutic effect is determined. There are four such stages:
- at the first, the head of the penis only opens when it is in a calm phase, and during an erection it is difficult or even painful to move the skin from it,
- the second stage is characterized by the difficulty of exposing the end of the penis even in its calm state and the complete impossibility of this action if the member is excited,
- the third stage is determined if the male member with difficulty and does not always open exclusively in the phase of complete rest,
- at the fourth stage it cannot be opened even in a completely calm state, plus a ring of skin tissue prevents free urination - urine comes out in the form of a thin stream or drips.
There is also a condition that doctors call the relative form of phimosis. With him, the disease manifests itself only during the period of erection. At other times, his symptoms are not expressed in any way.
The fundamental symptom of the disease is the difficulty or inability to expose the end of the genital organ. But in newborns and children under three years of age, if this does not cause problems with the excretion of urine, swelling, pain, doctors tend to consider this condition normal.
Some caution is caused by the narrowing of the ring of the skin folds above the penis that does not pass in boys from three to six years. With uncomplicated urination, this is also permissible. Although it needs medical supervision. After the age of six, the narrowed foreskin is recognized as a pathological condition.
The child may experience pain when urinating
And, of course, when the boy noticeably pushes, meeting a small need, cries at the same time or complains of pain, burning, and urine is allocated dropwise or with a weak stream, it is necessary to immediately take him to a children's specialist in the genitourinary system.
A clinic should be visited if there is a swelling at the end of the penis, pus secretions, an increase in the child’s body temperature, and inflammation of the lymph nodes in the groin.
The presence of pathology and the degree of its development is detected by the doctor during a visual examination of a small patient, a survey of his parents. If the specialist does not understand the whole picture of the disease, he can prescribe a number of additional studies, send the patient to pass the appropriate tests.
This happens when the disease is aggravated by complications in the form of swelling and purulent discharge.
In this case, the patient must submit to the laboratory for analysis:
- blood (to detect inflammatory processes in the body),
- urine (in order to detect impurities in it),
- discharge from the penis (to diagnose an infectious lesion).
If necessary, the patient will also be referred for ultrasound (ultrasound) of the urogenital organs to find out what pathological changes in their structure have occurred due to the disease.
Phimosis ointment in boys and adults
Ignoring phimosis, circumventing without timely medical attention can lead to extremely negative scenarios of the development of the disease.
With the 1st - 2nd degrees of pathology, problems can appear in a child during the period of growing up, when pain begins to arise during an erection.
3rd - 4th degrees are fraught with the fact that under the skin at the end of the male penis various secretions will begin to accumulate: sweat, smegma (greasy secretion), urine, sperm. As a result, a pathogenic environment is created there, ideal for bacteria and viruses. Difficulties in maintaining hygiene will result in an infectious lesion of the tissues of the head of the penis and foreskin.
At the 4th degree, there are cases when, due to difficulties in the outflow of urine, it stagnates and the infection through the urinary tract enters the bladder, causing damage to the entire genitourinary system. The disease is aggravated if an increment of the skin folds to the head of the penis is observed and synechia occurs.
To the last degree, it is also possible to pinch the end of the penis with a ring of leathery tissue - paraphimosis. In this situation, if it is not possible to independently adjust the head inside and at the same time its swelling, blueing is observed, it is urgent to contact a medical institution.
An immediate examination of the doctor is also required at the 3rd - 4th stage, when the disease is caused by injury to the penis, inflammatory processes in it (balanoposthitis), redness, itching, burning, and pain.
Since the formation of the reproductive system in boys occurs up to 6 years, phimosis at an early age requires therapy for exacerbation. In other cases, doctors choose a wait and see tactic.
Conservative methods are used in the form of manual stretching of the foreskin hole in the shower (when the skin is steamed and becomes more elastic), using masturbation. Perhaps under local anesthesia. The use of a special device is practiced - a silicone retractor ring, a bandage.
Drug therapy involves the use of corticosteroid (based on synthetic hormones) creams and ointments that soften the skin tissue of the genital member, increasing their elasticity and ability to stretch.
Glucocorticoids are often used - anti-inflammatory drugs that eliminate swelling of the tissues, contributing to the healing of tears.
With a hypertrophic form of pathology, specialists prescribe a special diet for patients, exercise, observing the regimen of the day.
When therapy with other methods is unsuccessful, the doctor may suggest surgery for the patient:
- separation of adhesions of the skin with the head of the penis,
- prepuceoplasty (partial dorsal incision of the foreskin),
- Schloffer operation (with a zigzag incision, skin shear and subsequent stitching),
- 3 longitudinal incisions with transverse seams,
- partial excision of the foreskin,
- either complete circumcision.
What therapeutic tactics to choose is decided by the treating urologist together with the child's parents.
Care after surgery
After surgery for 3 to 4 months, the patient needs some care. It implies, in addition to regular medical examinations and dressings, treating tissues with anti-inflammatory drugs.
During the first postoperative month, t restrict the child in physical activity: sports, playful games. In the diet, it is recommended to increase the proportion of protein foods (meat, fish, legumes) and products containing amino acids (vegetables, fruits).
After the doctor’s permission, you can gradually switch to the usual physical exercises for the boy, to standard hygiene of the urogenital organs.
To prevent complications, parents of newborn boys should carefully observe the hygienic rules for the care of the genitourinary system of babies.
Use caring cosmetics that do not contain strong perfumes, alcohol and other aggressive ingredients that can provoke allergies. Do not overtighten when changing soiled diapers.
And then you need to instill in children a habit of hygiene. To teach them twice a day (morning and evening) to wash the genitourinary organs. With phimosis, you need to visit a urologist with a child at least twice a year.
Phimosis in children: diagnostic methods and treatment
- Phimosis in boys - the impossibility of exposing the glans penis at rest or during an erection, limiting the mobility of the foreskin due to its excessive narrowness.
- This is a fairly common condition, usually not causing much discomfort.
- Such a birth defect is observed in almost 90% of newborns in the second year of life.
- This is due to the formation of the head and foreskin from one connective tissue.
- In 50% of children occurs at the age of 3-6 years.
Physiological phimosis in children, as a rule, by 5 years spontaneously and without a trace passes. But there are times when the head by a given age in boys can’t freely come out of the narrow opening of the foreskin. According to doctors, a deviation from the norm in some cases in children under 12 years of age is possible.
If the head does not exit with age and the problem remains with the boys during puberty, then it requires eradication, sometimes surgery. Although, of course, everything is at the discretion of the doctor. There are other more sparing non-drug methods of treating phimosis in boys.
Why does the disease appear?
Everyone knows that the genital organ in future men begins to form in the womb in the second or third month of pregnancy. With such a pathology, when the organ at the birth of the baby remains in an underdeveloped state, the reasons can be different.
Doctors today do not consider pathology, even if, due to the narrowness of the foreskin, the organ cannot freely go out in boys under 5-6 years old. A delay of this kind is possible up to puberty, and the problem can be solved by simple manipulations by conducting a light massage to stretch the muscles in the part of the narrow opening, contributing to the release of the organ to the outside.
In many newborns, this phenomenon is noted and in 5-10% of cases persists up to 1 year. Usually by the age of 6, the separation of the head and foreskin occurs on its own.
Some mothers, in an attempt to accelerate this physiological process, resort to unauthorized stretching of the flesh, not realizing that improper manipulations can only do harm, injure delicate tissues and aggravate the situation.From here begins the inflammatory process and one of the reasons for the development of already acquired phimosis.
Congenital physiological phimosis in boys by absenteeism of the glans penis from the foreskin is not fully understood.
There are suggestions that the reason for this may be:
- genetic predisposition (if close relatives suffered from the problem),
- abnormalities in the structure of connective tissue or musculoskeletal system,
- flat feet
- heart disease,
- trauma to the narrow foreskin by brutal violent actions to correct phimosis,
- the formation of adhesions between the foreskin and the mucous membrane,
- the presence of a preputial cavity between the head and flesh,
- the development of secondary pathology with scarring of phimosis on the background of inflammatory processes in the prepuce bag.
It should be understood that physiological phimosis in a child is a normal condition until a certain age in boys.
Pathological phimosis can be a consequence of:
- improper hygiene (when the foreskin sticks to the head of the penis),
- causing injury
- the course of the inflammatory process on the head,
- scarring, which can lead to a narrowing of the foreskin and the subsequent development of secondary phimosis,
- wearing tight synthetic or coarse underwear when rubbing occurs and then inflammation develops,
- internal irritation of the foreskin due to the use for hygiene of a number of cosmetics, a lubricant cream with abrasive particles in the composition,
- genital irritation when wearing dirty or poorly rinsed with particles of powder underwear,
- uneven development of the reproductive system,
- genetic predisposition
- lack of necessary elements in the body that prevent the formation of elasticity of connective tissue.
Regardless of the cause of the appearance, phimosis requires close attention. If the condition does not go away when the boys are 5 years old, then you need to see a doctor.
Video: “What will happen if phimosis is not treated?”
How to recognize phimosis?
Congenital physiological phimosis is a condition when the head of the penis is soldered to the inner leaf of the foreskin.
Doctors in no case advise separating the penis from the tissue by violent acts. This can only lead to erosion, the development of inflammation, the transition of physiological phimosis to a pathological state. Illiteracy of parents can lead the boy to sad consequences in the future.
Phimosis usually does not bother and does not cause much discomfort to babies. No soreness and problems with urination. The main thing is to regularly wash the perineum, genitals and the cavity of the preputial sac with water without detergents.
Physiological phimosis is not dangerous in itself. On the contrary, it protects the delicate epithelium of the glans penis and the inner part of the foreskin sheet from aggressive external influences. Perhaps, only in the absence of hygiene rules against the background of an excess of the leaf from the inside of the flesh or allergic reactions do minor symptoms appear in the form of itching and redness.
But this is easily eliminated by washing the prepuce bag with water with Furacilin (warm solution) by introducing a syringe (10 mm). Unpleasant symptoms will pass quickly.
If the kids are prone to allergies, the appearance of exudate at the exit, together with urine, you should contact a pediatrician or pediatric urologist. These are already alarming symptoms. Especially when urination becomes painful, difficult, with a thin stream coming out, the area of the foreskin and penis head is red, swollen, hyperemic.
It is the accumulation of urine in the preputial sac that leads to pain during urination. The discharge of purulent exudate, fever and a pronounced increase in lymph nodes - all this indicates the development of inflammation.In addition, there is a blueness of the foreskin, an increase in the genital size.
Signs of inflammation with paraphimosis are:
- lack of opening of the head of the member,
- the appearance of adhesions,
- decreased potency
- soreness during an erection,
- the appearance of itching and burning in this area,
- lack of full removal of the penis head out,
- the appearance of a blue tint on the head.
All these are suspicious signs and most likely require surgical intervention. Although questions and the appointment of a treatment course are exclusively dealt with by a doctor on the basis of a visual examination, the results of analyzes.
Babies have characteristic signs of phimosis:
- external changes in the penis,
- constant correction of underwear,
- an increase in the preputial sac in size when scarring the foreskin,
- hypertrophy of this area, which is observed in children with overweight.
Moms need to be more attentive to their sons. If, with a suspicion of phimosis in boys, the symptoms appear unpleasant, then you need to contact experienced specialists. Diagnosis will be made, the correct treatment is prescribed.
Concerned about health, parents ask themselves: what to do?
If phimosis is physiological, then the most likely cause is a lack of personal hygiene. You can fix the problem by washing with Furacilin, introducing a syringe with a solution into the area of the prepuce bag.
Children under 1 year old do not need to be manipulated. If the head opens poorly, then this is the physiological norm up to 3 years.
- If in 4-5 years the head does not partially come out of the flesh, smegma is released from the opening of the foreskin, enuresis and pain appeared during urination, it is worth the alarm, consult a doctor.
- Video: "Phimosis in boys and what to do?"
Usually, boys themselves can bare the glans penis while urinating. But in some older children, residual adhesions, a decrease in the elasticity of the foreskin are observed. Usually in such cases, children under 10 years of age are shown medication.
Drug treatment of phimosis in children Betamethazole, Clobetasol, wound healing ointments, glucocorticosteroids are usually prescribed to increase the elasticity of the epithelium, activate and heal microcracks, relieve inflammation, and reduce manifestations of phimosis.
If the problem of phimosis in boys is not resolved after 11-12 years and cicatricial phimosis is diagnosed, then the operation is indicated.
Surgical intervention consists in removing accumulations of pus from the prepuce sac, separating the foreskin and from the head by small incisions. Further, washing the genitals with Furacilin.
For the house, baths with the addition of potassium permanganate or a decoction of chamomile will be prescribed. In addition, antibacterial ointments for violation of urination, painkillers are prescribed. A catheter can be inserted into the urethra if urine outflow has worsened after surgery.
An operation or circumcision is fraught with complications or development of balanoposthitis. There may be a violation of urination with cicatricial phimosis.
There is no certain age for the operation. If at the initial stage conservative treatment at home did not bring tangible results, then a phased operation under anesthesia to excise the foreskin, cut the skin round, without affecting the frenum, is prescribed regardless of age.
Usually use the method of regularly stretching the flesh with your hands, slowly pulling the flesh on the head until moderate pain. A month later, in this way you can achieve positive results.
A manual method is also used to introduce 2 fingers into the prepuce sac, dilute them in different directions until pain occurs.
Phimosis in boys (photo) - causes, symptoms and treatment
Phimosis in boys is a pathology characterized by the inability to release the head from the foreskin of the penis. Translated from Greek, "phimosis" means "contraction" or "contraction." Parents should not panic after learning about such a diagnosis from their child. First, you need to go through a series of studies to understand whether the newborn has disorders and how they should be treated.
Each boy has physiological phimosis at birth, since the skin of the foreskin is connected to the head of the penis by peculiar adhesions. They impede or completely restrict the free removal of the head. This condition is the norm for boys under 3-6 years old. Only in 10% of young patients, the head of the penis is fully or partially released in the first year of life.
Experts consider phimosis as a protective barrier, which reduces the risk of viruses entering the cavity between the foreskin and the head of the penis and the development of the inflammatory process.
Over time, the penis grows, which leads to the extension of the foreskin by the head. This process can drag on up to 12-14 years, when a teenager begins puberty.
In rare cases, boys are diagnosed with pathological phimosis. This disease requires surgery.
Doctors distinguish 2 types of pathological phimosis:
- atrophic or cicatricial
Cicatricial phimosis in boys has a characteristic feature - rough scars that narrow the foreskin.
There are two types of phimosis: cicatricial (left), hypertrophic (right)
With hypertrophic phimosis, the child has an excess of the foreskin, which prevents the release of the head.
There are 2 causes of pathological phimosis:
- Balanoposthitis. The inflammatory process occurs in the foreskin and head of the penis.
- A complication that occurs after abnormal gross movements on the penis associated with the removal of the head.
Pathological phimosis has the following symptoms:
- impaired urination
- acute urine retention,
- Concerned condition
- abdominal pain
- bladder enlargement.
In case of acute urinary retention, emergency medical attention is required. In this case, the child is given a cleansing enema and given drugs with an anesthetic effect.
If the child was not provided with timely treatment, then such unpleasant consequences can occur:
- The inflammatory process in the foreskin and head of the penis. Often occurs when there is insufficient hygiene or if infectious pathogens enter the urinary tract. High probability of infection in children with reduced immunity or with concomitant infectious diseases. In addition to inflammation, the child has edema of the foreskin and pus, scarring of this area occurs.
- Paraphimosis With intimacy or masturbation, the foreskin is displaced and the head of the penis is pinched, which leads to a violation of the blood supply. Without a course of therapy, the tissue of the head gradually begins to die. After some time, purulent inflammation and sepsis appear.
- Cancerous education. The development of pathology provokes the accumulation of secretion between the foreskin and the head of the penis.
- Psychological problems. The guy has complexes due to the fact that his cock is different, he is shy about it.
- Problems during sex associated with psychological and physiological abnormalities.
Complications after surgery occur in 0.2% of all cases. These include the following:
- suppuration at the wound site,
- acute urinary retention.
Specialists distinguish between such chronic complications:
- Meatitis - an inflammatory process in the external opening of the urethra,
- meatostenosis - compression of the external opening of the urethra.
Important! The presence of left flaps of the foreskin after surgery requires a repeated circumcision
In the postoperative period, it is recommended to adhere to several rules:
- Change the bandage daily.
- Check that dirt and urine do not get on the bandage.
- Wear loose natural fabric underwear for your child.
- To be examined by a doctor.
In order to avoid infection in the children's body, hygiene rules must be followed. The child should be washed and washed daily after bowel movement.
It is advisable to wash the baby's penis at least once every 7 days with baby soap or special cosmetic bathing products. It is not recommended to use gels and soaps with a bactericidal effect every day.
With regular use, they can upset the balance of skin microflora.
To prevent pathogens from entering the urinary tract, the child must be washed from front to back. When washing the penis, do not move the foreskin.
Note! A lot of nerve pain endings are concentrated on the head of the penis, so careless manipulations on it can lead to fear and mental disturbance in the baby.
Calendula has a good bactericidal effect.
- It is necessary to dry its flowers.
- Add 15 g of dry raw materials to a glass of boiling water.
- Insist for 1 hour, then filter and make baths.
The infusion should be at room temperature so as not to burn the head of the penis.
To soften the skin and avoid inflammation, it is recommended to make baths and lotions from decoctions with the use of chamomile. It is able to reduce pain and eliminate itching. To prepare a therapeutic agent, the following algorithm of actions should be performed:
- Take 10 g of dry raw materials and pour 250 ml of boiling water.
- Insist for 5 hours or cook on low heat for 15 minutes, then cool.
- Strain the resulting mixture.
For the treatment of phimosis at home, chamomile broth is used - it reduces pain, eliminates itching, and prevents inflammation
You can replace chamomile with grass of clover medicinal. To prepare the broth, you should take only the ground part of the plant.
To relieve irritation in congenital phimosis, it is useful to use a decoction of barley. Just add 2 tbsp. l barley grain in 500 ml of boiled water and leave for 12 hours. After the time has passed, take the infusion and boil for 10 minutes, then leave for 1 hour in a dark place. Then strain and use for washing.
An effective antiseptic in the fight against the signs of phimosis is a decoction based on blackberries. It should be prepared according to the following scheme:
- Dry and grind the leaves.
- Take 60 g of crushed raw materials and brew in 500 ml of boiling water.
- Leave the mixture to simmer for 10 minutes over low heat.
- Insist remedy for 30 minutes.
- Before use, strain and cool to room temperature.
What does Dr. Komarovsky think about phimosis?
Famous Ukrainian pediatrician Yevgeny Komarovsky considers childhood phimosis to adolescence to be normal if it is not accompanied by urination problems.
The process of releasing a narrow hole, according to the doctor, should take place without third-party interventions. According to him, the exact age when the operation is necessary has not yet been established.
The pediatrician believes that the problem with urgent need can be solved at any age.
What is the foreskin for?
Many people do not fully understand why nature had created the foreskin on the glans penis. In medicine, it is believed that such a two-layer skin flap, equipped with blood vessels and innervated, is intended to respond to the stimulation of the penis.When the foreskin begins to glide over the head, it reduces friction and also enhances the sensation of stimulation.
But not every parent knows for sure at what age boys usually have to open their heads completely without excessive extensibility and injuries of the foreskin. This process is extremely important for the further sexual life of a man; it will provide pleasure and vivid sensations from sexual intercourse in the future. Initially, the foreskin serves as a protector of the head of the penis and urethra from the penetration of pathogenic microflora.
Physiological phimosis in boys
Physiological phimosis in infants is diagnosed in 96% of cases. This anatomical feature of the penis is due to the fact that the organ in the boy in the maternal womb does not fully develop.
In fact, physiological phimosis is a natural and completely normal state. Doctors do not attribute it to abnormalities or diseases. In this regard, the need for its treatment does not arise.
The foreskin covering the glans penis in boys normally easily moves up. In newborns, its displacement is impossible due to the fact that the inner part of the skin fuses with the head of the genital organ with the help of adhesions (they are called synechiae).
Of course, the presence of such a problem requires consultation with a doctor, but it is not worth treating physiological phimosis with medications or surgery.
How should the head open in boys
From the first days of life foreskin in boys connected to the head with special gentle adhesions. They do not allow the head to open partially or in full. How should the head open in boys, depends on age, as it is temporary. Over time, the condition normalizes. As the penis grows, the foreskin gradually separates from the head, which contributes to its full opening. The exact age for this process is difficult to name.
Physiological phimosis: ICD code 10
Physiological phimosis in ICD 10 has an individual code N47. Children's urologists and surgeons use it to clarify the diagnosis and prescribe the right treatment. This code is also assigned to pathological forms of phimosis and diseases of the foreskin associated with its atrophy, hypertrophy, infringement of the head of the penis.
Physiological phimosis - it is stored until what age?
In 99% of boys phimosis physiological problem is completely eliminated with the onset of puberty, when begins the active development of male sex hormones. It hormones have a powerful influence on the ability to stretch the foreskin. Often the elimination of physiological phimosis occurs much earlier, when the child is 4, 5, 6, or 7 years old.
If you look at the data of medical statistics and photos of physiological phimosis in boys of different ages, you can see one interesting feature. In 20% of cases in the 6-month-old boy penis head opens freely and without problems.
After one and a half years of life, physiological phimosis disappears in every 3 boys, and at 3 years, the problem resolves itself in 90% of small patients. In 5-7 years, 92% of boys are no longer the problem.
By the age of 12-13 years, the congenital anatomical feature of the foreskin disappears in 97% of male children, and in 14-17 years of age, this disease is absent in 99% of boys.
In this case, the need for surgical treatment of phimosis occurs in only 1% of cases. Doctors advise that surgery be performed no earlier than the child reaches adolescence. Until this time, phimosis is considered a variant of the physiological norm and may well disappear on its own.
What does Komarovsky say about physiological phimosis? Useful tips of the famous pediatrician for the care of the external genital organs of newborn boys
Good and informative talks about physiological phimosis in boys Komarovsky (video). A well-known pediatrician, who leads his own program on TV, gives some useful tips to parents who had to face the diagnosis of physiological phimosis in a boy for the first time.
- Every day, the child should be washed with warm water without soap.
- Once every 2-3 days in the process of bathing, you can wash the baby's penis with soapy water. To prepare a soap solution, it is better to take a baby soap.
- In no case should you force the genital head to be opened during washing.
- It is unacceptable to clean the head of the penis with a syringe with warm water (such recommendations are often given in special forums for mothers). Such actions often lead to infection under the foreskin, injuries and the development of inflammation.
- Inflammation of the hypertrophied foreskin in newborn boys can be triggered by too tight underwear, the use of aggressive detergents for washing children's panties, the wrong choice of diapers, and an infrequent change of diapers.
- Parents of a boy with physiological phimosis should remember that smegma (anatomical lubrication of the head) can be infected by pathogenic bacteria in cases where the room has an inappropriate microclimate. If the baby constantly sweats, and his body overheats, the risk of developing pathological phimosis increases. The optimum temperature in the room where the boy lives should be 18-20 ° C. Humidity in this room should not exceed 50-70%.
Physiological phimosis in children, according to Dr. Komarovsky, is a natural process. The pediatrician recommends that parents do not panic, monitor the condition of the baby's genital organ and consult a doctor if there are disturbing symptoms, an inflammatory process, redness and swelling in the external genital area.
Delicate problem: the boy's penis is inflamed
All future men from birth have physiological phimosis. This is a normal condition in which the head of the genital organ is closed by a fold of skin connected to it by commissures, or synechiae. Under the foreskin, a cavity forms where smegma accumulates - a mixture of secretions of the sebaceous glands and desquamated epithelial cells, which is washed out by urine. However, if the synechiae are not completely resolved, and the natural cleansing procedure is violated, inflammation may develop (we recommend reading: photo of the initial stage of synechia in girls).
The pathological process most often occurs due to trauma, infection (including intrauterine), allergies, or parents' attempts to push the foreskin ahead of schedule, which leads to a violation of natural protection. The disease manifests itself gradually when more pathogenic bacteria accumulate between the head and the skin fold that covers it.
Causes, symptoms and treatment of pathologies
Penile inflammation occurs acutely or has a chronic course, but the first form of the disease is more common. For diagnosis, it is enough for a specialist to interview parents and examine the baby. With a stable pathological process, urine and blood tests are necessary. The chronic form of the disease is more difficult to treat, the inflammatory process subsides from time to time, but poorly healing cracks and scars can remain on the penis.
Fasting (inflammation of the foreskin)
Fasting occurs in children for several reasons:
- skin irritation due to accumulated smegma or urine,
- the penetration of bacteria due to the baby’s habit of tugging the genitals,
- allergic reaction,
- kidney disease
The process of inflammation of the foreskin is accompanied by edema of the surrounding tissues - parents notice that the baby's penis is swollen. Other symptoms are present:
When the parents discovered the development of the inflammatory process, they should conduct a series of procedures:
- Make a bath with a pale pink solution of potassium permanganate, a tablet of Furacilin or a few drops of Sanguirythrin. Antiseptics will destroy the pathogenic flora and wash the particles of accumulated organic substances.
- Use streptomycin or levomekol to lubricate the reddened area of the skin.
If there is a tendency to decrease inflammation, the above procedures should be performed until recovery. To reduce discomfort, you can use decoctions of chamomile and oak bark.
Balanitis (inflammation of the head)
Balanitis is quite common in infants, but can also occur at an older age. The glans penis becomes inflamed due to related factors:
- poor hygiene
- improperly sized diapers or tight underwear,
- a rare diaper change,
- aggressive substances used in washing clothes,
- frequent use of soap,
- fungal infection
- endocrine disorders.
The incubation period of the disease lasts up to three days, after which symptoms begin to manifest. Moms rarely pay attention to the fact that the head of the genital organ reddened slightly, but then a small rash forms on the tip, merging with time into spots. Further signs become more pronounced:
- the head takes on a burgundy red, sometimes cyanotic shade,
- purulent exudate secretion,
- itching (sometimes the child combs the area around the genitals)
- problems with urination
- fever or fever
- when a disease occurs due to a yeast infection, a white coating is visible on the penis.
Balanitis at the initial stage of development does not require complex treatment. Therapy includes:
- washing the genitals with a soap solution,
- baths with Furacilin (1 tablet per 200 ml of liquid), Miramistin or potassium permanganate,
- the use of ointments (Levomekol, Syntomycin),
- ozone therapy, electrophoresis.
The procedures are performed 2-3 times a day for 5 days. At an advanced stage, antibiotics and even surgical intervention may be needed. During the operation, the foreskin is dissected, circumcision is sometimes done (we recommend reading: how is circumcision of the foreskin performed in children?).
Do I need to help the boy open his head?
Boys who are at a young age and do not have health problems, measures to open the penis head surgically are not required. If the baby is worried about adverse symptoms, we recommend that you consult a doctor.
It is worth remembering that the presence of the foreskin provides proper protection against the ingestion of harmful microorganisms, and also makes a huge contribution to human immunity. For this reason, this procedure is not favorable for health and is prescribed only from the motives of religion.
Self-disclosure tests undertaken ahead of time have a detrimental effect on the entire body and cause psychological trauma to the child.
If the boy does not open the head of the genital organ and, plus everything, a difficult movement of urine through the channels, accompanied by pain, inflammatory processes, swelling, and redness in the foreskin, is revealed, immediately consult a doctor. He should help the child. It is important to find a qualified doctor so as not to harm the health of the boy. In other cases, helping to open the head is not recommended!
Balanoposthitis (inflammation of the head and foreskin)
Balanoposthitis develops due to such reasons:
- lack of hygiene
- deposition of urine salts in the folds of the skin,
- the formation of constrictions between the head and foreskin,
- rubbing the skin with linen,
- endocrine diseases
There are several forms of the disease:
- acute - develops spontaneously without any concomitant pathologies,
- gangrenous - in the inflammatory process of the preputial sac, the head is clamped by adjacent tissue, blood flow is disturbed,
- purulent - develops with partial overlapping of the mouth of the urethra, accompanied by the release of pus,
- erosive - when the epithelium is destroyed, cracks appear, which form scars after healing.
At the beginning of the development of the disease, parents notice that the penis in the area of the head is swollen and inflamed. The child may complain of pain and itching in the groin. Also, the ailment is accompanied by symptoms such as:
- Sudden problems with emptying the bladder
- temperature rise
- burning during urination
- peeling of the affected area,
- rash and microcracks,
- whitish plaque and yellow curdled discharge,
- enlarged lymph nodes in the groin,
- refusal of food.
It is better to treat balanoposthitis in the initial stage with the use of baths - they are the most effective means against inflammation. They are prepared on the basis of a decoction of chamomile and Furacilin. Dryness and irritation are removed by the usual baby cream or Bepanten. At night, the penis should be treated with Levomekol, and even better - wrap a bandage soaked around the medicine around it.
When joining a fungal infection, ointment Clotrimazole is used, and with a bacterial infection, Erythromycin, Nitroxoline, Biseptol and other drugs. An abscess with purulent discharge, formed when a disease is started, is a dangerous condition, since it can provoke tissue necrosis. Therefore, treatment is best started at the first sign of an illness.
Why phimosis develops
If you look deeper, then in essence, phimosis in boys is more likely not a disease, but a physiological feature.
For the simple reason that the penis does not have the opportunity to develop to the end, while the baby is in the uterus. And there really is no reason for parental concern.
Experts in no way consider physiological phimosis a deviation. This means that there is no need to treat it.
In a normal state, the foreskin, which hides the head of the penis in boys, should easily move. In infants, it is almost impossible to shift.
Because the inner side of the flesh connects to the head of the penis thanks to adhesions. Which are also called synechia. Yes, medical consultation in this case will not be superfluous.
But there are no serious reasons to treat a baby's phimosis with either medication or surgery.
Basic parameters of physiological state
In most medical reference books, this physiological condition is classified as a pathology of the narrowing of the foreskin.
Which means minor difficulties associated with the release of the glans penis.
And yet, most boys who are still in their infancy have a similar characteristic of the penis. But in this age, it can hardly be called abnormal.
The foreskin fuses with the head, thus preventing it from being exposed. The foreskin of the penis is mobile only in about 4% of infant boys. Until a certain age, the presence of such a condition does not threaten the boy’s sexual health in any way.
As soon as parents learn that their baby has phimosis, most often they immediately begin to ask the doctor about how dangerous it is and what can be done about it. Here is what the members of the world association of pediatricians say about this: it is impossible to touch the foreskin of babies and make attempts to move it. As the boy grows up, all physiology will return to normal by itself.
If you try to move the flesh by force, it can end:
- The formation of scars on the inner lobe of the foreskin.
The consequence may be the initial stages of development of pathologies of the foreskin.
All that parents need to do in this case is to closely monitor the condition of the penis of a small child. Seeking medical help will be truly justified in such cases:
- In the process of urination, the foreskin swells,
- During urine output, the boy complains of discomfort or pain in the penis,
- There are problems with the release of urine,
- Delayed the flow of urine from mochevika,
- Urine from the penis is drip or a thin stream.
Just a manifestation of such symptoms has meant that medical help prevent. After all, it is these signs that are the first signals of pathological phimosis. The likelihood is high that the foreskin of the penis head ached.
Phimosis (narrowing of the foreskin)
Phimosis is the norm for a newborn. By six months, the head opens in a fifth of children, and by 3 years - in 90%. At 7 years old, she should be completely freed from the foreskin, but there have been cases when this happens after 10-11 years. Due to the tight fit of the foreskin, hygiene is difficult, as a result of which balanoposthitis develops. Physiological phimosis is transformed into pathological.
When trying to expose the head, the child complains that the penis hurts. The head does not open or is exposed with effort, edema is formed. A closed urethral opening makes urination difficult. This condition threatens with constant relapses of balanoposthitis. Phimosis can also be triggered by a long inflammatory process of the foreskin, as delicate tissues undergo scarring, become rough and contract.
Sometimes the appearance of inflammation is associated with an allergy. It can be caused by:
- lack of hygiene
- the use of hygiene products and diapers that are not suitable for the baby,
- allergens contained in urine due to taking drugs, eating foods.
The disease is manifested by redness of the penis, which is localized at the urethra or spreads to the entire genital area, rash, itching, and tearfulness of the child. To eliminate discomfort, the first thing to do is to identify and eliminate the irritant, and local therapy is carried out using the above-described means (baths, ointments). Parents should change their baby care products and the brand of diapers.
In case of a violent response caused by food or drug allergens, the doctor prescribes oral antihistamines: Suprastin, Zirtek, Cetrin, etc. The course of therapy almost never lasts more than 2 weeks.
ICD Code 10
ICD stands for International Classification of Diseases. The ICD code 10 phimosis in children, in accordance with this classification, has an individual number 47. Children's doctors use it to specify the diagnosis and in order to prescribe a more accurate treatment. The same code number is assigned to any pathology of phimosis and other diseases of the foreskin.
How old can he be observed in a child
In almost all small patients, this peculiar disease resolves itself at the age when puberty comes. The fact is that just at this time, sex hormones are actively being produced. And it is they that have a significant impact on the elasticity of the foreskin. But most often, phimosis goes away even before the age of seven.
If we turn to the information provided by medical statistics, we can see that in almost a quarter of all cases, phimosis in boys begins to "resolve" on their own from about six months of age.
This occurs most actively at the age of four to five years. By the age of seven, phimosis ceases to bother 92% of all boys. Between fourteen and seventeen years old, only one percent of young men can complain about him.
And it is in the case of this single percentage that there is a need for surgical intervention. According to medical recommendations, it is advisable to conduct treatment with a surgical method not earlier than when the child becomes a teenager. Until this time, there is still a chance that phimosis will disappear on its own.
In infants, the foreskin does not separate
The question of how many years the head of a member should be fully revealed in a boy arises with parents for a reason. It is known that in newborns and infants the foreskin does not separate at all from the head, acting as a serious protective barrier between the delicate skin of the head and pathogenic microorganisms in the environment. Thanks to the foreskin, the head is protected from infections and contamination.
Also, with the help of the foreskin, the urethra is guarded in babies. If an inflammatory process is suddenly observed in the urethra, due to the foreskin and the closed head, the narrowing of the urethral opening is prevented. Doctors also note another important fact: the foreskin produces lysozymes and other substances that destroy any pathogens with their action.
Disorders associated with impaired opening of the head
In addition to the structural features of the genitals in the boy and how and when the head will open, parents should be aware of the possible pathologies associated with the foreskin in children. Today, medical specialists distinguish two pathologies - phimosis and paraphimosis. Each disease can be prevented, knowing its features, course and causes.
Another serious pathology of the development of the child's reproductive organs is paraphimosis. In this case, the foreskin is shifted to expose the head, as a result of which it is squeezed. Over time, squeezing the head causes an accumulation of blood in this area of the penis, which is expressed by the formation of severe edema.
If paraphimosis is not diagnosed on time, the child may urgently need surgical intervention. Therefore, when identifying such a disease, you need to urgently call a doctor or take the child to the clinic to prevent the necrosis of the head tissue, the appearance of ulcers. The causes of paraphimosis may be the following factors:
- phimosis in a boy and forced release of the head,
- child masturbation
- all kinds of medical manipulations in this area,
- swelling in the head area,
- allergic reaction of the genitals.
Paraphimosis can be identified by the following signs and clinical picture:
- bouts of acute pain in the head area,
- sudden swelling and enlargement of the head,
- bluish tint of the head,
- a kind of head resembling a compression ring,
- the discomfort,
- low sensitivity of the head or its complete absence,
- the formation of ulcers of black or purple.
It is especially important to take into account that after 10-15 minutes after the manifestation of such symptoms, the boy may disappear pain. This may be a consequence of the onset of tissue death and necrosis of nerve endings, which is a serious complication of paraphimosis.
How to open the head in boys
If the process of urination in the child does not cause uncomfortable sensations, the genitals look healthy, then no action should be taken. That is, it is not necessary to open the head by force. A large number of nerve endings are concentrated in the boys' genitals, so this procedure will cause severe pain.
Unsuccessful attempts to independently open the head can lead to negative consequences in the form of the development of paraphimosis. This condition requires only surgical intervention.
It is enough for the baby to follow the rules of personal hygiene, that is, the mother needs to wash it after each diaper change and bowel movement.And also, when bathing, the penis should be thoroughly washed in a natural way, using baby soap. In no case do you need to make an effort to open the head during washing. So you can injure the penis, which will lead to the formation of cracks. They will also discourage the discovery of the foreskin in boys. In addition to injuries, the following factors can contribute to the appearance of cracks:
- long stay in one diaper,
- allergic manifestations to the diaper,
- non-compliance with the rules of genital hygiene,
- infectious diseases.
Therefore, regardless of at what age does the child's head open, care must be taken to his personal hygiene. This will help to avoid negative consequences in the future. Because a complication of the disease or cracks in the penis can cause problems in sexual life already in adulthood. The proper care of the mother for the son’s sexual organ will help him to lead a normal healthy sex life, as well as conceive children.
What is the danger of untimely opening of the head
If the boy’s head does not open at 2, 3, 4, 5 years, then there’s nothing to worry about. Due to male physiological characteristics, the foreskin can be completely retracted from the main part of such children. But in some cases, this process has a protracted nature. I.e, the head of a boy of 9, 10, 11, 12 years does not open. If this feature is not accompanied by inflammation, suppuration, discoloration of the genital organ, then there is no cause for concern either. The process of urination should also not cause discomfort. Therefore, when should the head of the penis open in the boy, is determined individually.
If the boy’s head does not open well, this condition is accompanied by painful urination and other unpleasant symptoms, what to do the specialist will prompt. Most often, this condition requires surgical intervention. If measures are not taken in a timely manner, this can lead to such dangerous consequences:
- Balanoposthitis. This pathology is chronic infectious in nature. When treating balanoposthitis in a boy, it is extremely important to strictly observe the rules of personal hygiene. Effective antibacterial therapy is also performed.
- Urinary obstruction. The narrowing of the foreskin interferes with the normal excretion of urine. The process of urination in this case causes severe pain, a burning sensation. In this condition, the child needs only surgical intervention. Discovery of the foreskin in a boy will happen after surgery.
- The accumulation of residual urine and natural secretions under the foreskin. This usually occurs as a result of poor penile hygiene when the boy’s head doesn’t open. The secretions are converted into a dense solid mass, which interferes with the normal development of the penis in the future.
These pathologies can lead to serious consequences for the boy, which will be irreversible in the future, namely:
- as a result of constant pressure, the glans penis swells and loses its sensitivity,
- there is a fusion of the head and foreskin, which leads to complete obstruction,
- inflammatory processes extend to other organs of the genitourinary system.
If the child does not open the head For a long period of time, the doctor usually prescribes surgery.
What to do if the child does not open at all or the head does not open well
In some cases, in boys, the disease can be pathological. This condition requires mandatory appropriate therapy, since in the future it can lead to problems with erectile function.That is, a rush of blood to the penis will cause not pleasant, but painful sensations, up to the formation of cracks. In addition, it can cause difficulty in having sexual intercourse.
What to do if the boy does not open his head at 14 and older? This condition requires immediate surgical intervention. The main indications for the operation are:
- pathological changes in the foreskin as a result of the formation of scars and scars,
- regular inflammatory processes in the foreskin,
- violation of the urine excretion process.
Modern medicine offers several types of surgical intervention. The most effective and common way to eliminate the disease is circumcision.
Circumcision: pros and cons: how to make a decision
Regardless at what age does the head open in a child, if this process causes difficulties or pathological processes, this requires surgical intervention. The best option in this case is circumcision. The essence of this operation is a partial or complete excision of the foreskin with a surgical scalpel. After this procedure, the glans penis opens. Most often, circumcision is recommended for boys who are diagnosed with stage 2, 3 or 4 of the disease.
Since they come to this procedure at a more conscious age, it is performed under general anesthesia. The operation is carried out in several stages, namely:
- the introduction of anesthesia,
- excision of the foreskin,
- relief of blood vessels,
- stitching the leaves of the foreskin,
- applying a sterile dressing to the penis.
The duration of these manipulations takes about half an hour. The condition of the child during the rehabilitation period does not require being in stationary conditions. And also the healing process does not cause pain. It is only necessary to regularly change the sterile dressing, at least 2 times a day.
Most often, circumcision does not cause subsequent complications. Therefore, if the child has such ailments, you should immediately consult a doctor:
- severe swelling of the head of the penis,
- color change of the penis,
- pain is pronounced,
- purulent discharge with blood clots,
- urination is accompanied by pain longer than 5 days after surgery.
These are atypical symptoms for the postoperative period. Usually when circumcised the head of the penis should open in the boy completely.
Preventive measures, baby hygiene
When the boy should open his head completely, but this does not happen, an important point is personal hygiene. Every mother raising a son must adhere to such rules:
- you should not carefully call the penis with soap during each bathing procedure, this can disrupt the microflora,
- soap should be used once a week, while the scrotum should also be treated,
- do not try to open the head with effort,
- do baths using medicinal herbs.
It is also necessary to wash the baby after defecation, not only the anus, but also the genitals completely.
The foreskin serves as a protective barrier between the environment, pathogenic microflora and the organs of the genitourinary system. All children have a head closure with the foreskin at birth, but with age it will gradually expose the head. Doctors do not name the exact age when the head should open. At the same time, parents are warned that failure to open the head can lead to the development of phimosis or paraphimosis.