Urology
WHAT IS A PHIMOSIS?
A phimosis is a defect in the structure of the foreskin, making it difficult or impossible to slide it off the glans penis. The condition can occur at any age and for a variety of reasons.
A narrowed foreskin opening causes pain during intercourse. It also makes hygiene more difficult. Inflammation and diseases caused by bacteria occur. Neglecting the problem of the foreskin can, in extreme cases, lead to kidney disease, bladder disease and penile cancer.
We can distinguish between:
- full-blown phimosis – this is the most advanced state of the condition. The foreskin opening is so narrow that it is not possible to slide it off the glans;
- partial (incomplete) phimosis – a less advanced condition in which it is possible to remove the foreskin from the penis at rest. In some cases of partial stoma, it is also possible to slide the foreskin off the glans when the penis is erect, but this is very painful.
Phimosis Laser Surgery
The most effective form of treatment is foreskin plication. However, it is often the case that the only solution that will resolve the problem of stool is complete circumcision. This is the excision of the foreskin in whole or in part.
Phimosis is a condition in which the foreskin cannot be slid off the glans penis. In the most advanced stage of stools, the glans is not visible at all in both the resting state of the penis and its erection.
Consequently, the penis at the very top takes the shape of an elongated and truncated cone. In less advanced stages, the foreskin can be retracted halfway down the glans or completely. However, due to the pressure of the foreskin on the glans groove, a person with a phimosis feels pain and discomfort.
Once the patient is qualified for the procedure, the doctor informs the patient on how to prepare for the procedure. The procedure for a staple takes about an hour. It is carried out under local anaesthesia. If there is a possibility of preserving the foreskin, a foreskin plication is performed. The surgeon then widens the opening of the foreskin by making longitudinal incisions in one or more places along the penile axis. Once the skin has been properly shaped, it is sutured. Foreskin plication can be performed using a scalpel or a laser. The doctor chooses the appropriate method based on the patient’s indications and preferences.
The most common causes of phimosis include:
- inflammation of the foreskin,
- problems with improper maintenance of intimate area hygiene,
- mechanical damage to the penis (e.g. during sexual intercourse).
Phimosis Laser Surgery
Both in the case of children and adults, surgery to dilate the foreskin may be necessary. The decision on the need for surgery and the surgical method is made by the doctor at the first visit to the clinic. The procedure itself has a low probability of complications: haemorrhages or infections.
Treatment of phimosis includes:
- foreskin plication – dilation,
- partial circumcision – removal of the foreskin up to its narrowing,
- total circumcision – removal of the entire foreskin.
Complete removal of the foreskin is sometimes the only solution to the problem of phimosis. This often raises some doubts in men, although in Poland circumcision is used quite often
The procedure itself for a phimosis is carried out under general or local anaesthesia. It lasts about an hour. If there is a possibility of preserving the foreskin, a foreskin plication is performed. Several incisions are then made at the mouth of the foreskin and sutures are inserted. The latter are usually absorbable, so they do not need to be removed at an additional visit.
The operation of the stool can also be carried out using a CO2 laser. The main advantages of this method include:
- less risk of bleeding (the laser beam cuts tissue while closing blood vessels),
- less post-operative swelling,
- less visible scar after cutting.
The procedure is performed in our Clinic by urologists with many years of experience, Dr Maciej Jarosz and Dr Tomasz Drabarek.
Phimosis Laser Surgery
- inability to maintain proper hygiene
- discomfort
- pain during sexual intercourse, inability to have intercourse
- recurrent inflammation of the glans and foreskin
- difficulty in passing urine, and in extreme cases complete overgrowth of the foreskin resulting in urinary retention
- inability to conceive children (a phimosis is one of the causes of male infertility)
- possibility of developing cancer (a foreskin is one of the most important factors in the development of cancer of the foreskin and penis! )
- cosmetic or religious reasons
- improvement in the quality of sexual life
- reduction of pain
- increase in penis hygiene
- reduction in the risk of infection
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