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Phimosis 1 degree photo

Phimosis is not a deadly disease, but its presence in the lives of men makes significant adjustments to their lifestyle and, more tangibly for men, to their intimate life.

At the initial stage of the disease, extremely unpleasant symptoms appear only in the presence of sexual arousal, which inevitably affects relations with the opposite sex.

What is phimosis?

Phimosis - a narrowing of the skin folds of the genital organ (prepuce, skin dualism), which makes it difficult to lead the penis head during sexual arousal, during hygiene procedures, etc. This pathology, like many others, goes through several stages. The first is the lightest of them.

The diagnosis of stage I phimosis in clinical practice means the initial stage of narrowing of the foreskin, in which unpleasant symptoms are observed only in the presence of an erection. If the genital organ is in a completely relaxed state, the disease may not manifest itself in any way.

Nevertheless, even mild phimosis can lead to paraphimosis - pinching the head with a loop of the foreskin.

Paraphimosis is fraught with necrosis of the genital organ. In the absence of timely medical care, amputation of the penis may be required.

Stage 1 phimosis is observed in children and adults. In childhood, pathology can go away on its own.

Usually this happens to 6-7 years, sometimes earlier. Such clinical phimosis is considered physiological in clinical practice.

The problem with phimosis in adult patients is pathological in nature, and can’t pass by itself. The disease develops for several reasons, and is eliminated only by appropriate therapy.

Causes and symptoms of phimosis

A condition in which there is no possibility of exposing the glans penis due to a narrowed opening of the foreskin is called phimosis. In 90% of boys at birth, its symptoms are observed. Over time, during puberty, the foreskin becomes elastic, and the head opens completely in a natural way. Parents need to teach their child to observe personal hygiene rules to avoid infection.

Urologists distinguish two phimosis:

  1. Congenital, which occurs in boys and adolescents. If at the end of the transitional age no changes have occurred, then the foreskin is excised by the surgical method.
  2. Pathological (acquired) that appears in adult men. It can occur due to inflammation of the genitourinary system, balanoposthitis, postitis, injuries, infectious diseases. Often a similar form occurs in a chronic form and often leads to scarring and the appearance of adhesions.

Important! If the diameter of the opening of the foreskin by the age of seven does not allow to open the head, then this condition can be considered pathological.

General information

Phimosis is the narrowing of the skin fold of the penis, which greatly complicates its removal beyond the glans penis at the time of erection, as well as during hygiene procedures and in other situations. This disease, like most others, goes through several stages of development, the first of which is considered the easiest.

Phimosis of the 1st degree in medical practice means the initial form of narrowing of the foreskin. With such a pathology in a man, all unpleasant symptoms are reduced, as a rule, only to difficulty in erection. If the penis is in a state of complete rest, then the disease may not manifest itself at all.

But, despite this, even phimosis of the 1st degree is able to provoke the occurrence of paraphimosis - this is the name of the infringement of the head of the penis by the loop of the foreskin. This disease can lead to necrosis of the penis. And in the absence of the necessary treatment, even the amputation of the reproductive organ may be required.

The nature of phimosis

  • Physiological disease. That is the one with which the boy is born.
  • Pathological contraction. This is an acquired ailment, which must be combated by operation.

If you notice that your three-year-old baby does not have a naked head of the penis, you do not need to immediately undergo crumb surgery, since this is not the age when you should panic.

Perhaps later, the boy’s skin will become softer, expand, and the head will open.

Symptoms and signs of phimosis of the 1st degree

The physiological phimosis of the 1st degree in children does not manifest itself in any way. In adult men, pain occurs during erection of the genital organ.

This phenomenon is associated with excessive tension of prepuce on the head of the penis. In this case, the skin loop can shift behind the head, which is dangerous by the occurrence of paraphimosis, however, at the initial stage of the disease with special care, a man can help himself.

At the same time, in the absence of an erection, the penile duplication moves without any problems behind its head and returns to its original position.

Independent elimination of pinching the head with the foreskin is fraught with the formation of microtraumas, which can provoke the progression of the disease.

Against the background of morbidity, a man may develop an erectile dysfunction of psychological origin - the patient is worried about the upcoming discomfort even before the onset of an erection.

Phimosis in boys

In the photo there is a newborn boy and he has congenital phimosis, which is absolutely normal. The head and foreskin are connected by a film, which should begin to separate from the mucous membrane with age, making it possible to delay prepuce and expose the head.

At this age, it is impossible to open the head in a child. therefore you cannot try to do it by forceotherwise it may lead to injury and subsequent complications.

The following photo shows physiological phimosis in a boy of 4 years with normal development. The head still cannot be fully opened.

The photo shows an attempt to pull off the foreskin of a 5-year-old boy, but because of the narrowed foreskin, it does not work out to the end (this happens in most children at this age).

Photo of cicatricial phimosis The child has. On the tip of the foreskin visible small healed scars that not a good sign. If the boy stands out capillaries and veins from the tension of the foreskin, then best examined by a doctor.


Phimosis of the 1st degree occurs in both adult men and children. True, in the latter case, the disease can go away on its own, without medical intervention. As a rule, this happens by 6-7 years, in some situations even earlier. Doctors also call this pathology physiological.

But is it necessary to treat phimosis of the 1st degree in adult men? Such a disease in patients of this age category is exclusively pathological in nature and is not able to pass on its own. In adult patients, phimosis clearly requires compulsory medical intervention. The disease arises against the background of many diverse causes, and is eliminated exclusively through appropriate treatment.

Causes of pathological phimosis

  1. Genetic susceptibility to this disease. It happens that due to an insufficient amount of connective tissue (laid at the genetic level), this ailment arises.
  2. Inflammation of the external genitalia.
  3. Damage to the penis, resulting in scarring, and skin tapering.

Phimosis forms

Pathological phimosis is not always a continuation of the physiological. This is just one of the variations of the "delicate" ailment. There are several negative factors contributing to the development of pathology of acquired origin.

The first of them is balanoposthitis. With it, the head of the penis becomes inflamed, as a result of which edema of damaged tissues occurs, which leads to phimosis. Another cause of the pathological process is the trauma of the penis with the formation of scars, scars and adhesions. They lead to a narrowing of the foreskin.

The acquired form requires urgent treatment, as it provokes the development of complications. Phimosis classified on the:

  1. Hypertrophic, which leads to obesity with the deposition of excess fat folds in the inguinal region. Because of this, the foreskin grows excessively, overlapping the head of the genital organ. Bacteria, fungi and viruses, a warm environment and high humidity due to increased sweating is very suitable. They multiply in the shortest possible time and lead to the appearance of diseases affecting the genitourinary system.
  2. Cicatricial, in which tears, wounds and cracks form on the foreskin. During healing, severe scars form, which greatly violates the elasticity of the skin surrounding the head of the penis. If a person wonders what types of phimosis do penile plastic surgery, then this is the case. After all, a man with cicatricial phimosis is very painful to have sex. He puts himself and his partner at risk of infection, and psychological problems begin. In the future, the problem may spill over into impotence. The urethra also suffers, on which scars also form. As a result, the excretory function is disrupted.

Classification: relative phimosis and pathological

The connective tissue on the penis gains elasticity over time. Therefore, 95 percent of newborns have congenital phimosis. There are no reasons for excitement, and parents should make sure that the opening of the head occurs naturally. Usually this happens in 5 years, but sometimes (individually), the disclosure will occur only during puberty of the boy (12-13 years). Thus, urologists distinguish two options (photo before and after):

  • Physiological phimosis (congenital) - observed in boys and adolescents,
  • Acquired pathological phimosis is a pathology that appears for certain reasons in adult men.

Relative phimosis is characterized by the following sign: in a calm state of the penis, the head can be released, and this does not cause discomfort. However, with an erection, the release of the head causes pain. In infants, relative phimosis is a constant phenomenon, due to a genetic predisposition to adhesion of the foreskin. Parents must monitor the child in time to respond to the pathology:

  • Firstly, do not stretch the skin on the penis yourself until the age of two,
  • Secondly, you should monitor the process of urination (it is difficult for the baby or not, pain or curvature of the stream appears),
  • Thirdly, to hear the child’s complaints of itching and burning in the groin,
  • Fourth, to warn the teenager about the onset of emissions and explain that any discomfort with spontaneous excitement is the beginning of a pathology that he should immediately report.

Physiological phimosis rarely leads to inflammation. The child has not yet produced sperm and there is no discharge from the urethra except urine. Bacteria and microorganisms do not accumulate under the fold of the foreskin, but proper hygiene of the intimate area is the primary task of both the child and parents. In childhood, physiological phimosis is fraught with the appearance of senechia. This is an embryonic adhesion, due to which the head and foreskin are fused. Adhesions should disperse before the age of three, otherwise you will have to consult a surgeon.

Pathological phimosis is an acquired disease diagnosed in 5% of the male population. For adults, there is a classification where the stage and type of the course of the disease is determined.

Symptoms of the disease

In children, phimosis of the 1st degree does not manifest itself at all. But in mature men there is a systematic occurrence of pain at the time of penis erection.

This phenomenon is explained by the strong tension of the skin folds on the glans penis. In this case, prepuce can shift beyond the foreskin, which is fraught with the appearance of the same paraphimosis. But at the initial stage of development, with some effort, a man can very well help himself with his own hands.

It is noteworthy that in the absence of an erection, the skin fold without any problems shifts behind the head and comes back.

In addition, due to the appearance of pain in the patient, erectile dysfunction of psychological pathogenesis may occur. After all, every time a man even before sexual arousal will worry about the upcoming discomfort.

Self-elimination of paraphimosis can lead to microtraumas, which can only aggravate the course of pathology.

For a visual definition of the disease, it is best to read a photo of phimosis of the 1st degree. Knowing the visual signs of the pathology will help in time to identify the anomaly and begin treatment.

Disease categories

  1. The head opens only when calm. Urinating can be painful.
  2. The cone-shaped thickened part of the penis is excreted with difficulty.
  3. The head does not open at all.
  4. The thickened part of the penis is not exposed, urination is very difficult, while urine is released in drops or it flows in a thin stream.

Incomplete phimosis

To the most harmless degrees of phimosis refers to the incomplete narrowing of the foreskin, the diameter of the hole of which allows you to partially expose the head, although not completely. An abnormality with an erection is clearly visible. In a calm state, a man can easily free the head of the penis.

As a rule, such a problem is not a threat to health. But the sexual side of life is much worse. It is painful for a man to have sex; he experiences discomfort and discomfort.


Phimosis in a child - photo:

Phimosis is a disease that is accompanied by violation of the exposure of the glans penis. Such difficulties provoke discomfort and pain, which greatly disturb the young child.

The foreskin performs a special function, it is designed to protect delicate and vulnerable skin, directly, of the head.

However, if there is excessive overgrowth of the skin in the foreskin, this leads to the appearance of various kinds urological problems, including the development of phimosis.

Complete phimosis

With this type of disease, it is impossible to expose the head of the penis in both an erect and calm state. The foreskin is motionless, which does not allow you to properly care for the genitals. Smegma, moisturizing the head, accumulates. Bacteria multiply in it, leading to the development of infectious and inflammatory processes.

Have sex on this phimosis stage, photo which can be viewed on any medical site, is unrealistic. In addition to painful sensations, as the course and development of the disease develops, difficulties arise with urination, itching, burning.

How to treat grade 1 phimosis

It is advisable to get rid of this disease immediately after the onset of the first symptoms. In this case, you can use both surgical and conservative methods. The final choice of therapy depends on the severity of the pathology and the signs that appear.

For example, in the case of active formation of dense scar tissue and an intensive course of the disease, surgery is required.But hereditary phimosis can be completely eliminated with the help of physical influence on the foreskin, especially at the initial stage of development.


The elimination of the symptoms of a disease such as phimosis in children occurs individually. Often this condition in boys goes away on its own when it turns three years old. But if the child is already older than this age, then the doctor may decide on the appointment of surgery.

So, how to treat phimosis in a child? There can be three options:

  • with medication
  • by surgical method
  • mechanically.

Drug therapy consists in the use of special ointments that make the foreskin more elastic.

The mechanical method is based on daily training, the duration of which should not exceed 10 minutes. The baby needs to gradually stretch the flesh of the penis with his hands.

If with this ailment it is difficult for the boy to write, then even at a young age the surgeon can conduct a circumference of the head of the penis. Such a procedure is performed in the manipulation room directly in the clinic.

In this case, the head is exposed using a special probe, and the synechiae of the flesh is separated. Then the collected smegma is removed, and the head is smeared with petroleum jelly, and then everything returns to its place.

After this procedure, after 2-3 days you need to do baths: water with potassium permanganate.

The operation of phimosis in children can be prescribed only in the very least, when the doctor sees that other methods of treatment are ineffective.

Measures aimed at preventing the occurrence of the disease

Phimosis in children needs to be treated, because if you start this process, then because of the constant inflammation, the foreskin of the boy can grow to the head. And in this case, natural disclosure will not occur. In addition to everything, the baby forms the very last stage of this ailment, which can only be cured by surgery.

And in order for the peanut not to have an inflammatory process, one should know how to care for the genitals:

  1. Every day, you need to carefully rinse the baby's penis and make sure that water does not get into the prepuce sac.
  2. In no case should you independently and forcefully expose the head, since such a process can cause unbelievable pain to the child.
  3. The baby should not walk in a crowded diaper. You need to change it every 6 hours.
  4. Be sure to organize the baby air baths, even if at least half an hour he will be without a diaper. Such a process is an excellent prevention of inflammatory processes.
  5. In the summer, it is advisable to abandon diapers.
  6. Get panties for boys made from natural cotton fabric. There should be no synthetics.
  7. Make sure that the genitals of the crumbs do not shrink, and also do not overtighten underwear.

Types of possible operations

There are several methods, using which you can deal with such a problem as phimosis:

  • conservative surgery
  • prepuceoplasty - a longitudinal section is made of the foreskin of the penis with transverse suturing, as a result, the phimous ring expands,
  • circumcision - circumcision of the foreskin.

Often with phimosis, the last version of the operation is used.


Treatment of phimosis in children by trimming the foreskin is performed under local anesthesia, but if the child is not yet 12 years old, then the doctors are reinsured and apply general anesthesia.

Before conducting such an operation, the baby is placed in a hospital, where he takes blood and urine tests, a urologist constantly watches him. The very procedure of surgical intervention is as follows: the surgeon excites the foreskin in a circle.

The duration of the procedure does not exceed half an hour, but the recovery process may be delayed.

Genital care after surgery

After the operation of phimosis in a child, it is very important to follow the doctor’s instructions regarding the care of the penis. The mother should know that the first act of urination will be very painful. In order to somehow help the child cope with the pain, it is advisable to prepare a bowl of warm water. You need to carefully put the baby in it and ask to urinate. In warm water, the muscles relax, and the boy will be able to do his job. It is very simple to treat the genitals: after urination, it is necessary to rinse the head with boiled water, and then change the dressing to a new one.

Now you know what phimosis is in children. In the article, we determined the causes of this ailment, as well as its degree. We learned that surgical treatment, drug therapy, as well as a mechanical method can be used to treat phimosis.

No operation

The only method for non-surgical removal of phimosis is to stretch the prepuce manually or using special medical devices. It is recommended to carry out the procedures daily for 15-30 minutes. You can increase skin elasticity by using moisturizers, as well as corticosteroid ointments.

Methodology of the procedure:

  1. Training. To begin with, the foreskin is recommended to be treated with a solution of Chlorhexidine or Miramistin. Then, after preliminary drying of the skin, you need to generously lubricate it with an external agent prescribed by a specialist.
  2. After absorbing part of the cream or ointment, the skin fold is carefully lifted with its delicate stretching to the sides. When discomfort occurs, stretching must be stopped. After the pain is relieved, the procedure is repeated.

  • The time of exposure to the foreskin without regard to preparation should be about 20 minutes. At the end of the procedure, the foreskin and skin are treated on the head of the penis with a chlorhexidine solution.
  • This method is inconvenient in that it requires a very long application - from 6 months.

    Surgical method

    Removal of the duplicate penis is considered the most effective method of getting rid of phimosis. This method is shown in the following situations:

    1. With a tendency to the progress of the disease.
    2. At high risk of relapse.
    3. Frequent cases of infection of the glans and foreskin (balanitis and balanoposthitis).

    All these phenomena inevitably lead to a deterioration in the condition of the man and a high risk of paraphimosis.

    To fix the problem, use one of the methods:

    1. Surgical intervention using a classic scalpel. The advantage of the operation is low cost. Disadvantages - long recovery.
    2. Removing the foreskin with a radio wave scalpel. The advantage of the method is minor trauma and a short rehabilitation period. Disadvantages - the relatively high cost of the procedure.
    3. Laser phimosis elimination. The advantages of the method are low trauma and almost zero risk of infection, a short rehabilitation period. The disadvantage is the high cost of the procedure.

    For circumcision for religious reasons, as well as for what nationalities it is accepted and what the Bible interprets, read this publication.

    Contraindication to circumcision of any foreskin by any of these methods is the inflammatory process in the acute stage.

    Progression of phimosis of the first degree

    In the absence of adequate measures to eliminate phimosis of the 1st degree, there is a likelihood of progress of the pathology. At the same time, a man has an increasingly pronounced discomfort due to a progressive narrowing of prepuce. Against this background, the patient may experience:

    • difficulty urinating due to squeezing the penis,
    • inflammatory processes
    • pain in the head of the penis in the absence of an erection,
    • the accumulation of large volumes of urine under the foreskin.

    Such situations require immediate response and serious therapy, including surgery or even amputation of the penis.
    The video below will tell you how to track grade 1 phimosis in boys so that it does not translate into a critical form of the disease as they grow older.


    Phimosis is in vain considered a condition that needs to be hidden from others and especially doctors. This problem can be solved relatively painlessly if you seek help at the initial stage of the development of the disease.

    Otherwise, the pathology threatens rapid progression and the occurrence of life-threatening complications. Independent attempts to eliminate the narrowing of the foreskin can end in failure, so it is better to treat phimosis under the guidance of a doctor.

    Conservative Techniques

    Treatment without surgical intervention provides only one way to eliminate phimosis - by stretching the skin fold manually or using special medical devices. The necessary manipulations should be carried out every day for approximately 20-30 minutes. In addition, you can increase the plasticity of the skin through the use of special moisturizing gels and corticosteroid ointments.

    The procedure is standard and involves several important steps. Namely:

    • Training. First of all, the foreskin must be treated with a weak solution of Miramistin or Chlorhexidine. Then, after drying the skin, you should generously lubricate it with the selected external preparation. To select a medication, you need to consult a specialist.
    • Actually stretching. After partial absorption of the applied cream, gently lift the skin fold and carefully stretch it to the sides. If you experience pain or minimal discomfort, the manipulation must be stopped. After the cessation of pain, the procedure can be repeated.
    • The time of exposure to the genital organ, excluding preparation, should be approximately half an hour. At the end of the manipulations, the foreskin and skin of the penis must be treated with the solution used at the beginning of the procedure with the addition of “Chlorhexidine” or “Miramistin”.

    Home Therapy Feedback

    Reviews about the treatment of phimosis of 1 degree in this way indicate the inconvenience of this technique. Indeed, to obtain the effect of stretching sessions should be arranged daily for six months. Such activities, according to the numerous responses of men, are burdensome and time consuming.

    In addition, not all patients have the opportunity to arrange such intimate procedures every day. However, the final choice still remains with the man - for many patients, the treatment of phimosis of the 1st degree at home was an excellent solution. After all, not every patient will decide to have surgery in such a sensitive place.


    The elimination of prepuce of the penis by surgical intervention is deservedly considered the most effective treatment technique for phimosis of any degree. The operation is advisable when:

    • high probability of relapse,
    • the observed trend towards the rapid progression of pathology,
    • regular infections of the head of the reproductive organ and foreskin.

    All these processes clearly provoke a deterioration in the patient's condition and indicate a high risk of paraphimosis.

    For the treatment of phimosis of 1 degree in adults, one of the options for surgical intervention can be used:

    • Using a traditional scalpel. The main advantage of such an operation is its material accessibility. But the disadvantages include a long recovery period of the damaged organ.
    • Elimination of the foreskin with a radio wave scalpel. The advantage of such a technique is considered to be minor organ trauma and a rather short rehabilitation period. But the disadvantage is the rather high cost of such an operation.
    • Removal of skin folds by laser. The advantages of this operation are minor damage to the organ, a short recovery period and minimal risk of infection. But the disadvantage is, of course, the high cost of the procedure, which is clearly beyond the means of many patients.

    A contraindication to the operation by any of the methods described is the stage of exacerbation of the inflammatory process.

    Likely Consequences

    In the absence of appropriate measures to get rid of phimosis of the 1st degree, the likelihood of rapid progression of pathology is extremely high. The disease goes to the next stage of development, which is characterized by a more pronounced clinical picture. A man experiences increased discomfort, which is explained by an aggravated narrowing of the skin fold. Because of this, the patient may appear:

    • inflammatory processes of the reproductive system,
    • the accumulation of a large amount of urethra in the foreskin,
    • pain in the head of the penis, even in the absence of sexual arousal,
    • difficulty urinating due to squeezing the penis.

    Such manifestations need immediate medical attention and serious treatment, including surgical intervention or even amputation of the penis.

    Pathology stages

    Due to the severity of the disease, stages of phimosis in men divided into four types. Each of them is distinguished by its symptoms and features:

    1. Phimosis of 1 degree allows a man to expose the head of a penis when he is at rest. If an erection occurred, it will be quite problematic to do this. When the flesh moves, pain occurs. You can’t try to open the head yourself, since such actions can lead to paraphimosis, a complication that requires urgent medical attention.
    2. Phimosis 2 degrees allows you to free the head alone, but with effort. With an erection, exposing it is impossible. There are cases when only the edge of the head is exposed, which is still spontaneously covered by a skin fold.
    3. Phimosis 3 degrees even at rest, it does not allow to expose the head of the genital organ, and with an erection it is completely closed. This form of the disease makes urination difficult. Urine is excreted in a thin stream, and the natural process itself is accompanied by pain. When lowering the foreskin in an erect state, bleeding is possible.
    4. Phimosis 4 degrees characterized by absolute head closure in any condition. The man has difficulty urinating, feeling sharp pain. Inflammatory processes begin to develop with an increase in body temperature, swelling of the lymph nodes in the inguinal region, and a decrease in potency. Accumulated smegma elements turn into dense deposits - smegmolites.

    On any phimosis stages of pathological origin, a man needs medical measures. Often, doctors resort to surgical intervention.

    Symptoms and treatment of the first degree of phimosis

    To recognize in a timely manner phimosis of 1 degree and start treatment, you need to know its main symptoms:

    • a change in the sensitivity of the receptors of the head, which causes premature ejaculation,
    • scarring after the healing of microcracks, which further reduces the foreskin,
    • paraphimosis, in which the head is exposed, and a narrow ring of folds is fixed with a coronal rim. The movement of the skin in its normal position is impossible. As a result, the head turns blue due to impaired blood circulation. If you do not provide medical care, then the death of living tissue will begin. Here, doctors resort to an emergency incision of the foreskin.

    Main danger stage 1 phimosis - a sharp release of the head of the penis in an erect state, which leads to pinching. Experts advise not to ignore the problem. If the foreskin does not function as it should, the disease itself will not go away.It’s better to contact a urologist who will tell you what to do if you have phimosis of 1 degree. Treatment with corticosteroid ointments, massage, manual stretching will help. In the future, non-invasive methods of therapy will be ineffective.

    Particular attention should be paid to head hygiene. When washing, the foreskin should be pulled very carefully, as well as during sex / masturbation. It is advisable to use grease to provide better glide.

    Symptoms and treatment of the second degree of phimosis

    If it is impossible to move the foreskin both at rest and during erection (the widest part of the head does not pass into the hole), then this phimosis 2 degrees, photo which can be considered in detail. Also in patients observed:

    • pain when trying to pull off the skin (this can be done with the permission of the doctor, and very carefully)
    • difficulties in conducting hygienic procedures of the genitals. Since the skin does not move in full, it is impossible to remove smegma, the remains of sweat and urine from the head of the penis.

    Is it possible to have sex with phimosis of the 2nd degree, Interested in many patients. Experts answer - it is possible, but a man during intimacy experiences painful sensations and discomfort. In addition, the act of premature ejaculation is not ruled out and the danger of involuntary release of the head remains.

    And at this stage of the pathology, the urologist offers the use of ointments and daily skin stretching. The chances of success of treatment are minimal, so most likely the therapy will have to be done by excision of the foreskin.

    Symptoms and treatment of the third degree of phimosis

    The foreskin can be moved only at rest and slightly expose the tip of the head of the genital organ. As soon as the fingers are removed, the skin folds will return to their place. Treatment of phimosis of 3 degrees at home not carried out. Pathology must be eliminated in an operational way. A man cannot achieve orgasm, the appearance of a member changes, which negatively affects sexual desire. Besides:

    • it becomes very painful to urinate, as the foreskin covers the urethra,
    • with an erection bleeding from injury to stretched skin folds is possible.

    Urine remains on the head and infects the genitourinary tract, which causes prostate and kidney disease. If the flow of urine is disturbed for a long time, then the urethra narrows. This condition is also treated operatively.

    Symptoms and treatment of the fourth degree of phimosis

    If you pay attention to phimosis 4 degrees, photo it is not much different from the pathology in the third stage. The difference in the severity of symptoms:

    • the pain becomes constant and acute,
    • it's impossible to lead a sex life
    • there are no normal conditions for hygiene procedures,
    • body temperature rises
    • inflammatory processes begin, often accompanied by itching, swelling with burning.

    The main danger lies in infection, the problem with the outflow of urine and sperm, impaired blood circulation. There can be no question of any outpatient treatment here. A urologist must be an experienced specialist. Its task is to prevent irreversible consequences and improve the patient's condition in the shortest possible time.

    If a man has discovered phimosis 1, 2 degreesthen home treatment he should be carried out regularly until complete recovery. In other cases, the only salvation is surgical intervention with complete excision of the foreskin.

    It can be carried out in any modern clinic under general or local anesthesia. Recovery after surgery takes about a month. And after two months the patient returns to sexual life and forgets about his problems.

    Watch the video - Types and degrees of phimosis:

    Cicatricial phimosis

    Cicatricial phimosis refers to pathologies of the physical plane, in which the head of the penis cannot be exposed, i.e. it is not removed from the foreskin.

    A similar pathology arises against the background of congenital intraorganic features and can develop for a sufficiently long time, representing a physiological norm.

    Sometimes such narrowing occurs against the background of an injury or infection, and also forms against the background of previous infections.

    According to ICD-10, cicatricial phimosis is indicated by the code N-47. Physiologically, this condition is a narrowing of the foreskin. Congenital phimoses are quite common and are the physiological norm, and they pass independently by puberty.

    However, cicatricial forms of pathology occur in boys of any age group under the influence of external traumatic or internal pathological causes. Moreover, in the process of phimosis formation, active formation of scar tissue on the foreskin occurs.

    In adolescents and men, phimoses often arise due to microtraumas received during masturbation or sexual intercourse. Physiological phimosis does not differ from a cicatricial clinic or treatment methods. But it is better to carry out prophylaxis in a timely manner than to later treat men's health.

    Caution! In the photo, cicatricial phimosis (click to open)

    Clinical picture

    Diagnosis of phimosis is usually straightforward. You can suspect him yourself, you just need to study a photo of this pathological condition. When the disease is overgrown with more severe symptoms, the patient can already accurately identify the symptoms that concern him. But in this condition, it is almost impossible to cope with pathology in conservative ways.

    The formation of cicatricial structures does not cause any pain, so pain and other severe symptoms indicate the onset of the inflammatory process provoked by the narrowing of the patient's flesh.

    The most common symptom is pain, resulting from constant threats of repeated trauma to the narrowed tissues of the flesh during sexual intercourse or during urination. Also, pain symptoms accompany inflammatory processes in which hyper-swelling provokes compression of the nerve endings on the mucous membranes of the skin of the foreskin and penis.

    In addition to pain, phimosis is accompanied by other symptoms, which include:

    • Hypertension of the tissues of the penis,
    • External changes in the shape of the penis, its size and shape,
    • The urethra is severely impaired, severe pain is experienced during the release of urine from the urethra of the patient, and the pressure of the stream is noticeably weaker,
    • An erection weakens, the quality of sexual life decreases.

    In general, it is not difficult to understand that any pathology has arisen on the foreskin, since the impossibility of exposing the head is a fairly clear and characteristic sign of the disease.


    To diagnose pathology, patients are assigned a list of diagnostic measures:

    1. General laboratory examination of urine and blood,
    2. A blood test for hepatitis, syphilis and HIV, as well as for determining the level of sugar,
    3. Screening for pathologies transmitted through sexual contact, necessary to identify the type of pathogen,
    4. Detection of rhesus and blood type,
    5. Microscopic examination of mucous discharge from the urethra,
    6. Coagulogram
    7. If there is abundant purulent discharge, then bacteriosis on the microflora is carried out and the degree of sensitivity of pathogens to antibiotics is determined.

    As for instrumental diagnostics, with cicatricial phimosis it is rather uninformative, therefore it is carried out only if there are suspicions of inflammatory lesions of the urogenital structures of the man.

    Circular excision of the foreskin

    This intervention is most often performed and involves dissection of the foreskin and removal of narrowed tissues. After the intervention, sutures are applied with self-absorbable material. The recovery period after such an intervention can be one and a half to two weeks, and can stretch for a month - it all depends on the degree of development of phimosis and the success of the operation.

    Adult patients can resume sexual intercourse about a month after the intervention, but only if the circumcision is successful.

    The disadvantage of this intervention is considered to be an increase in the sensitivity of the head, which will now always be naked, hence the early ejaculation.

    But over time, sensitivity, on the contrary, decreases, which leads to an increase in the duration of sexual intercourse.

    Laser correction

    Laser cutting is considered the safest.

    This procedure has many advantages over other methods, because:

    • No stitching required
    • Minimally painful procedure
    • Tissues regenerate quickly enough,
    • The usual postoperative complications are absent,
    • In addition, the child can be operated on an outpatient basis with a laser, hospitalization in this case is optional,
    • The organ after laser correction quickly restores its functions.

    Laser surgery is certainly preferable, but it is performed mainly in paid clinics, and it is indicated only in the early stages of phimosis.

    With advanced forms of pathology, traditional circumcision is prescribed.

    Consequences and Complications

    If you start the disease, it will soon lead to the development of balanitis or balanoposthitis, in which there is inflammation of the head, and then the foreskin on the patient’s penis.

    If the narrowing of the flesh progresses, then accumulation and stagnation of smegma occur, which further provokes the development of bacterial and infectious processes under the flesh. With the development of such a combination, surgery becomes inevitable.

    Inflammation of the genitals gradually spreads to the genitourinary and reproductive structures, negatively affects the sexual life of the patient.

    With phimosis, it is impossible to fully conduct hygiene of the genitals, which only increases the likelihood of infection and provokes additional inflammatory lesions.

    As a result, there is the formation of purulent-inflammatory processes on the mucous tissues of the head and the inner side of the foreskin.

    In the video about the causes, symptoms and treatment of cicatricial phimosis:

    Symptoms and degrees of phimosis

    There are four degrees of phimosis in adults and children:

    • The first degree is to open the head of the penis only at rest. If you try to expose the head of the penis during an erection, then the man feels pain, it's quite difficult to do,
    • The second degree - the head is difficult to withdraw at rest, with an erection it does not open at all,
    • The third degree - the head of the penis does not open or opens only partially at rest,
    • The fourth degree - the head of the penis does not open at all, while the process of urination is difficult.

    In addition to these degrees of phimosis in adults and children, another relative phimosis is isolated, which is characterized by a noticeable narrowing of the foreskin only with an erection.

    For the first and second degrees of phimosis, pain is characteristic, manifested during an erection when the foreskin is pulled on the head of the penis.

    With phimosis in boys, after the onset of active sexual life, a deterioration may occur, which after a certain time will lead to the fact that the head of the penis will not be able to open at all.

    This is due to the fact that during intercourse or masturbation, trauma to the mucous membrane occurs and micro bursts occur, in place of which scars form, which leads to a decrease in tissue elasticity and increased phimosis.

    Thus, the main symptom of phimosis in boys is the inability to expose the glans penis.

    Sometimes this condition does not cause any complaints in boys, but most often with phimosis in children there are problems with the process of urination, which can occur with noticeable straining, which causes the child some anxiety.

    In this case, urine begins to enter the preputial cavity, and the process of emptying the bladder occurs in a thin stream or drip through a small hole.

    In some cases, inflammation can join the phimosis, which manifests itself as pain in the head of the penis and foreskin, purulent discharge.

    Lymph nodes may increase, temperature may rise. In the case of paraphimosis (infringement of the head by the narrow foreskin), acute pain occurs in the glans penis, the head enlarges and turns blue.

    In this situation, the patient needs emergency medical care.

    With phimosis in adults, problems with potency can occur, which is due to soreness that occurs during intercourse.

    With severe phimosis in adult men, stagnation of smegma can occur - a secret secreted by the glands of the foreskin, which becomes a favorable environment for the multiplication of many bacteria and the development of inflammation.

    With the fourth degree of phimosis, the maximum narrowing of the foreskin occurs, which complicates the normal outflow of urine. The result can be infectious processes in the urethra.

    Another complication of phimosis is paraphimosis, which is an infringement of the head by a narrowed foreskin. In such cases, the head is manually adjusted or an operation is performed.

    1. The accumulation of smegma and trauma can cause the development of balanoposthitis - inflammation of the foreskin and head.
    2. With 3-4 degrees of phimosis, the foreskin can grow to the head of the penis.
    3. The most serious complication of phimosis is penile cancer due to stagnation of smegma in the preputial sac.

    Modern phimosis treatment - without surgery and surgery

    Pathological phimosis is dangerous for the development of complications: paraphimosis and balanoposthitis.

    Paraphimosis - This is an infringement of the foreskin of the glans penis. This condition occurs during intercourse or masturbation and, as a rule, occurs during phimosis of the first and second severity, because with phimosis of the third and fourth degree, head exposure is impossible.

    At the same time, the head swells, which creates even more pressure on it.

    Acute pain in the penis is noted, the head of the penis acquires a bluish tint. This condition requires urgent medical attention, because with prolonged circulatory disturbance in the plov penis, tissue necrosis (necrosis) can occur.

    • Balanoposthitis - The inflammatory process of the skin of the glans penis and foreskin.
    • The disease develops due to the ingress of pathogenic bacteria into the prepuntial sac (cavity of the foreskin) and stagnation of its contents (smegma, discharge from the urethra).
    • This condition develops in violation of penile hygiene due to the inability to expose the glans penis during phimosis.
    • Treatment of phimosis begins with the correct diagnosis and study of the symptoms of phimosis.
    • The basis of non-drug treatment of phimosis is the gradual manual stretching of the foreskin.
    • With phimosis of the first and second degree, the effectiveness of the methods reaches 75%.
    • Drug treatment of phimosis
    • Drug therapy consists in applying to the glans penis and foreskin corticosteroid ointments.

    Medicines increase the elasticity of the foreskin. In addition, glucocorticoids reduce swelling, accelerate the healing of microcracks.

    1. The method also requires medical advice, may combine with tension method.
    2. There are several surgical methods for the treatment of phimosis, the main ones:
    3. Surgical treatment of phimosis, like any other surgical operation, can cause complications:

    To prevent inflammation after surgery, it is recommended to wash the postoperative area daily antiseptic solutions or ointments. If necessary, a course is assigned antibiotic therapy.

    The cost usually includes anesthesia, surgery, dressings, sutures, consultations.

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    Paraphimosis treatment methods photo and video

    A condition in which the glans penis is compressed by its foreskin is called paraphimosis. The disease is extremely painful, because the resulting infringement leads to the appearance of severe edema and disrupts the blood flow of the penis.

    Paraphimosis in men is dangerous because in the absence of medical care, the tissues of the penis die without proper nutrition, and in order to save the patient's life, it is necessary to remove the penis almost completely.

    What leads to the appearance of pathology

    The main reason for the formation of this process is the existing phimosis in a man or a child.

    In the presence of a condition where the foreskin ring is narrowed more than is required for the healthy functioning of the body, the vessels of the penis are compressed, the urethra is narrowed, and pain occurs.

    Also, pathology does not allow you to fully open the glans penis, which prevents a full sexual intercourse in men.

    Also, the causes of the formation of paraphimosis include forced exposure of the head of the penis and damage to the frenum during intimacy. The latter occurs when:

    • too active sexual intercourse,
    • uncomfortable sexual position
    • active masturbation
    • the presence of diabetes
    • existing scars on the bridle,
    • low elasticity of the foreskin,
    • diseases of a dermatological nature affecting the genital organ.

    Often, paraphimosis in boys arises as a result of the first masturbation: not yet knowing how to properly handle a delicate organ, adolescents make sharp and active movements that traumatize the foreskin. If the child has congenital phimosis, the appearance of its complications is almost inevitable.

    Special care should be taken by the parents of young boys. Many mothers or fathers try to forcefully open the head: they open the foreskin when washing, steam out the skin in a bath or hot bath, etc. All this injures the bridle, forming wounds and inflammations.

    A closed head is a natural state for a baby, its opening occurs independently, as the boy grows up and develops.

    This condition is called physiological phimosis, it is not a pathology and does not require treatment in childhood. Opening of the head occurs without assistance at the age of 3 to 7 years. And only if the disclosure does not happen, the child is shown to the doctor and they solve this problem surgically.

    Doctors can also damage the delicate part of the body if certain medical procedures (catheter placement, cystoscopy) are performed carelessly or without sterility, especially if the baby performs these actions, which requires the premature opening of the head of the penis.

    Less commonly, paraphimosis can result from allergic reactions and the installation of piercings on intimate parts of the body.

    Manifestations of the disease

    The disease is characterized by a sudden manifestation: an ailment arises sharply, characterized by bright and intense manifestations. First, the penis swells, and the swelling is localized on its trunk.

    At the same time, the head remains in its previous state, only its color changes: it turns red, then acquires a bluish tint. All this is accompanied by severe pain that occurs when squeezing the enlarged penis with the narrow foreskin.

    Pain with paraphimosis is greatly enhanced when you try to touch the penis or urinate. If the pain disappears, this is a sign of the death of the tissues of the penis.

    If this pathology occurs in babies, then pain during urination makes them restrain their natural urge, which leads to acute urinary retention. Another sign of pathology is the pose of the representative of the stronger sex at the time of going to the toilet: the man tries to spread his lower limbs as wide as possible, while the body instinctively leans forward.

    With tissue necrosis, the blue color of the head changes to darker, shades such as lilac and black begin to appear. Dying is very dangerous, since the only way to cure is to amputate the male organ.

    Complications and diagnosis of the disease

    The consequences of the disease rarely occur, leading to this neglect of their own health. If a man ignores the symptoms that have arisen or tries to resolve the problem on his own, time is running out and it becomes impossible to help him cope with the pathology.

    If tissue death has begun, then such a treatment as reduction of paraphimosis becomes impossible. Ulcers and erosion may also occur at the site of the injury to the skin of the penis.

    Through them, pathogenic microflora enters the patient’s body, inflammation begins, which can be very difficult to eliminate.

    The result of this complication is often the removal of the part of the penis where the wound was formed.

    It is very easy to make a correct diagnosis with this pathology, even a novice surgeon or urologist can do it. Its external manifestations are very characteristic and do not raise doubts about the correctness of the diagnosis.

    In addition to visual examination and palpation, the doctor will necessarily ask the patient about the reasons that could provoke the development of pathology, about his other complaints about well-being, the presence of chronic diseases, etc.

    Very important information is the exact time the first symptoms of the pathology appeared, their brightness and strength. This will allow you to determine how long the head tissue remained without nutrition, and choose the type of solution to the problem - reduction of paraphimosis or amputation of the penis.

    Paraphimosis Prevention

    It is very simple to prevent the development of pathology: it is enough to handle the genital organ gently and carefully. It is important to take care of your health and treat all diseases of the genitourinary system: treat infectious diseases, eliminate phimosis, and relieve inflammation.

    • It is also important to observe the rules of personal hygiene and instill a love of cleanliness for children, monitor the condition of the small penis.
    • It is necessary to avoid injuries not only to the penis, but also to other areas of the pelvis, to avoid too active sexual contacts, especially after drinking alcohol or drugs: they dull not only a sense of security, but also pain, which makes it difficult to detect the manifestations of the disease in a timely manner.
    • With existing pathologies of the endocrine system, it is important to undergo a medical examination regularly, if the patient is healthy, then to visit a urologist once a year for prevention.
    • Children from three years of age should also be regularly examined by a pediatric surgeon or urologist who will monitor physiological phimosis and, if necessary, open the head to the child.

    What does phimosis look like in boys: photo

    Does your child need surgical treatment for phimosis, or do you need a consultation from a competent and experienced pediatric urologist? Nikitsky Mikhail Nikolaevich will be able to help you. Here are some examples from his practice (how phimosis in children looks in the photo, the results of surgical treatment).

    In the photo: what does phimosis look like in a boy. The condition of the penis after surgery: plastic frenulum is performed (sutures on the head along the frenum of the penis).

    In the photo: phimosis in a child. Stenting of the urethral opening.

    The child was consulted by a urologist with a diagnosis of phimosis. Surgical treatment recommended - circumcision. The child was hospitalized in a one-day surgical hospital Medicamente for surgery.

    During the operation, narrowing of the urethral opening was revealed - meatal stenosis, short frenum of the penis. Performed circumcision, plastic frenum of the penis.

    The plastic of the meatal opening and stenting of the urethral opening were performed (so that the opening does not narrow again after the operation). A stent is placed for 5-7 days until the tissue heals completely.

    In the photo: phimosis in a teenager 12 years old. The condition of the penis after surgery. On the head there are seams along the frenum of the penis - plastic frenum is made.

    The boy’s parents turned to the Medicamente medical center with complaints of phimosis. Recommended - surgical treatment for circumcision. The child passed the tests on the same day in our clinic. After 3 days, the child was operated on for phimosis. Circumcised. During the operation, a complication was revealed - a short frenulum of the penis.

    This problem is also resolved in one operation. To prevent complications after circumcision in the form of meat stenosis, hormonal therapy for meat has been prescribed. In the postoperative period, a pressure bandage was applied for the period of adaptation of the child to new sensations.

    After the operation, the child was ready to go home after 3 hours.

    On the photo: meatal stenosis in a boy of 3 years. The condition of the penis after surgery. Stenting of the urethral opening.

    In boys suffering from meatal stenosis, urine comes out in a too thin stream and in an abnormal direction. It can develop in children of any age, but more often from 3 to 7 years, especially in boys with excised foreskin.

    Parents complained of a thin stream of urine. The child underwent circumcision 8 months ago. After diagnostic bougieurage (determination of the diameter of the urethra), the child was diagnosed with meatic stenosis. In a planned manner, the child is hospitalized.

    The dissection of the meatal opening was performed, the urethral stent was installed for 7 days. The stent is fixed to the glans penis. The stent exceeds the diameter of the physiological opening by several units. The child was discharged home 2 hours after surgery. The stent was removed on an outpatient basis without anesthesia.

    3 months after surgery in a child, the diameter of the urethra corresponded to the physiological diameter.

    Find out how phimosis surgery goes

    Causes of phimosis

    For the development of phimosis in an initially healthy boy there are the following reasons:

    • genetic predisposition
    • flat feet
    • varicocele
    • heart disease, including heart valves,
    • uneven development of the penis and foreskin during puberty.

    Later, the main causes of narrowing of the flesh are phimosis itself: due to the fact that the foreskin is narrow, the leaf inside it is injured. In this case, scars appear on the tissues, which contributes to an additional narrowing of the flesh.

    In adolescence, the risk of wounds and fissures increases, the causes of which are associated with an erection or the onset of sexual activity.

    Symptoms of pathological phimosis

    The first symptoms of phimosis in an initially healthy man are discomfort during sexual intercourse. It can be:

    • pain during sexual contact. These are symptoms of phimosis of 1-2 degrees.
    • early ejaculation
    • decreased potency.

    Often, men have psychological problems. This is due to the abnormal appearance of the penis. As a result, a man has various complexes, therefore, not only urological treatment is prescribed, but also psychotherapeutic.

    Phimosis Complications

    Genital phimosis can lead to the following complications:

    1. The development of balanoposthitis, inflammation spreading to the head of the penis and foreskin. The causes of the complication are the appearance of wounds and cracks on the petals of the foreskin due to tight stretching. At the same time, microcracks do not bleed and do not cause discomfort. But when the wounds are healed, scars form. The skin in these places is not so elastic. Because of this, a narrowing of the flesh occurs, which is accompanied by the progression of the disease.
    2. The growth of the skin of the foreskin to the head of the penis. In the normal state, this does not cause men any problems. But if you try to open the head, pain and bleeding occur.
    3. Pinching of the glans penis with foreskin tissue. This happens during sexual contact. This anomaly is called paraphimosis. When these signs appear, you must immediately visit a doctor in order to avoid complications.
    4. Necrosis of the tissues of the head of the penis. This happens when the opened head of the penis is compressed by the skin of the foreskin. Normal blood flow to the organ stops, which causes tissue necrosis.

    Rarely, but still there are complications after the operation to remove the foreskin. They are of two types:

    1. Sharpduring which the patient feels a retention of urine, bleeding or suppuration of the wound formed after surgery appears. This complication occurs when the operation is performed incorrectly or of poor quality, and the seams are applied. Acute symptoms also appear due to damage to blood vessels during surgery.
    2. Chronic: meatitis or inflammation in the external opening of the urethra. With this disease, painful urination appears, redness appears in the channel itself. For treatment, antibiotic therapy, ointments and creams are used. There may also be inflammation in the external channel of the urethra. As a result, cicatricial narrowing may occur. This complication is called meatostenosis. The man experiences difficulty urinating: long, sometimes painful. With this disease, repeated surgical intervention is required, in which the correct channel shape is formed.

    The presence of phimosis in young boys is not a cause for panic, but a serious reason to see a doctor for examination. The onset of symptoms of the disease after 6 years is a serious reason for a thorough examination and the appointment of appropriate treatment. In order to cure phimosis and avoid complications, you need to contact specialized doctors - andrologists and surgeons.

    Watch the video: What is Phimosis. Foreskin Problems in Men. Essential Phimosis Information (February 2020).

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