Why does the head of the penis not open and what to do? What to do if the head does not open. What to do if the foreskin does not open.

Phimosis– a condition characterized by narrowness of the foreskin, which leads to limited mobility. Thus, the first, and often the only, sign of phimosis is the inability to expose the head of the penis at rest and/or during erection.

The foreskin or prepuce in men is the fold of skin covering the head of the penis. The preputium is a specialized tissue, the structure of which is in many ways similar to the structure of the eyelids and labia in women.

The foreskin consists of two sheets that are attached to coronal sulcus located at the base of the head of the penis. The outer leaf is lined with thin skin epithelium, and the surface of the inner leaf is a mucous membrane.

Provides additional fixation of the preputium bridle, located on the underside of the glans and limiting the movement of the foreskin towards the base of the penis. The structure of the frenulum of the foreskin is in many ways similar to the structure of the frenulum of the tongue.

Typically, during an erection, the foreskin moves towards the base of the penis and exposes the head of the penis. In its normal state, the prepuce completely covers the head, so that the inner surface of the foreskin forms a preputial cavity (preputial sac) - a narrow gap between the head and the foreskin.
Thus, the foreskin performs a protective function, protecting the mucous membrane of the glans penis from drying out and adverse external influences. It is for this reason that when treating phimosis, doctors try to preserve this anatomical formation and resort to circumcision (removal of the foreskin) only in extreme cases.
How common is phimosis?
It should be noted right away that phimosis is a very common phenomenon and in many cases does not cause much concern to patients.

This is due to the fact that the head and foreskin are formed from the same tissue during intrauterine development. The development of the external genitalia continues until the end of puberty, so congenital physiological phimosis is observed in more than 95% of newborn male infants.

By the beginning of the second year of life, the head of the penis opens in only 20% of infants, and by the beginning of the third - in 50%. As a rule, spontaneous elimination of physiological phimosis occurs in preschool age (3-6 years).

However, it is far from unique that the head of the penis opens for the first time already during puberty, due to an increase in the level of sex hormones that help soften and stretch the skin of the foreskin.

Many peoples of the world have a common gene for predisposition to the persistence of physiological childhood phimosis into adulthood. So, for example, in some countries of Southeast Asia, phimosis in adult men is considered normal, except in cases where narrowing of the foreskin leads to painful symptoms.

And in the culture of Ancient Greece, a long and narrow foreskin was not only not considered a pathology, but was also perceived as a sign of beauty and masculinity. The exposed head of the penis was considered obscene because it was reminiscent of circumcision. Ancient frescoes depict the custom of artificially gradually lengthening the foreskin.
To do this, ancient Greek youths used a special leather tape - kinodesma, one end of which was attached to the foreskin, and the other was tied around the waist. Wearing a kinodesma was seen as a manifestation of special modesty and decency.

Classification of phimosis

Phimosis can be divided into two main classes:

associated with the development of the glans penis and foreskin physiological phimosis in children;
pathological phimosis.

This classification is of utmost importance because it determines medical tactics: for physiological phimosis in children, hygienic measures and medical supervision are recommended, and for pathological phimosis, conservative treatment or surgical elimination of the defect is recommended.

According to the mechanism of development, hypertrophic and atrophic phimosis are distinguished.

Hypertrophic phimosis characterized by significant elongation of the foreskin (due to its very characteristic appearance, it is also called proboscis phimosis).

Statistically, hypertrophic phimosis is more common in obese boys, which is associated both with metabolic disorders and with the accumulation of fatty tissue in the pubic area.

About atrophic form of phimosis they say in cases where the foreskin, on the contrary, is reduced in volume and tightly fits the head of the penis. In this case, the preputial opening is narrowed and does not allow the head to pass through.

Causes of phimosis

Most common congenital phimosis when physiological phimosis does not resolve on its own and the opening of the glans penis never occurs - neither in childhood nor during puberty.

The reasons for this anomaly have not yet been studied. The fact that phimosis occurs more often in some peoples than in others indicates the existence of a genetic predisposition to congenital phimosis.

Clinical studies have shown that congenital phimosis is often combined with other structural abnormalities of the connective tissue and musculoskeletal system, such as flat feet, scoliosis, and heart defects.

In children, a common cause of the development of pathological phimosis is injuries, including those received during grossly violent attempts by parents to “correct” physiological phimosis in little boys.

In such cases, adhesions form between the mucous membranes of the glans penis and the foreskin, leading to a narrowing of the preputial cavity and the development of secondary pathological phimosis.

And finally, a fairly common cause of phimosis in children and adults are infectious and inflammatory processes in the preputial sac, leading to the formation of a characteristic cicatricial phimosis.

Degrees of pathological phimosis

Anatomically, there are four degrees of narrowing of the preputial ring.

For phimosis first degree It is possible to freely remove the head of the penis in a calm state, but during an erection, exposure of the head is difficult or painful.

ABOUT second degree phimosis is said to occur when difficulty exposing the head occurs even at rest. During an erection, the head is either completely hidden under the foreskin, or only a small part of it is exposed, often swelling in the form of a ball.

At third degree phimosis, it is no longer possible to move the head of the penis beyond the preputial ring.

Fourth degree phimosis is characterized by such a sharp narrowing of the foreskin that it causes difficulty urinating.

It should be noted that it is customary to talk about the first to third degrees of pathological phimosis when the patients are adults or adolescents. As for the fourth degree, normally in childhood physiological phimosis the preputial cavity has an opening sufficient for the free passage of urine.

Therefore, signs such as filling of the preputial sac during urination and/or narrowing of the urine stream, even if they occur in early infancy, clearly indicate pathology and require emergency medical intervention.

Symptoms of pathological phimosis in adults

In cases where phimosis does not yet cause problems with urination, the most common complaints of patients are more or less inconvenience during sexual relations, such as:

pain during sexual intercourse (with phimosis of the first or second degree);

premature ejaculation;

decreased intensity of sexual sensations during intercourse;

decrease in potency.

In addition, many men suffering from phimosis complain of purely psychological problems associated with the “wrong” appearance of the penis. They often develop various kinds of complexes, so they have to undergo combined treatment with a urologist and a psychotherapist.

At the same time, it is not uncommon for men with severe phimosis to experience absolutely no problems sexually.

What is the danger of asymptomatic phimosis in adults?

Today you can find opposing points of view regarding medical tactics in cases of phimosis that are not accompanied by the appearance of any unpleasant symptoms. Indeed, is it worth correcting a “defect” that was considered a sign of beauty among many peoples?

Unfortunately, phimosis poses a significant threat to the health of an adult man. The fact is that the cells of the mucous membrane of the inner leaf of the prepuce secrete a special secretion that has a rather complex composition (fats, bactericidal substances, pheromones (exciting substances), etc.). This secretion is the main part of smegma (translated from Greek as “sebum”), which also includes dead epithelial cells and microorganisms.

The activity of cells of the glandular epithelium of the foreskin increases during puberty (maximum smegma formation occurs at the age of 17-25 years) and progressively decreases in older men.
Normally, smegma protects the mucous membranes of the glans penis and the inner surface of the foreskin from drying out, and also acts as a natural lubricant during sexual intercourse.

However, the secretion of the glands of the mucous membrane of the inner layer of the foreskin is an excellent living environment for many pathogens. Therefore, stagnation of smegma in the preputial sac can cause the development of infectious and inflammatory diseases, such as balanitis (inflammation of the mucous membrane of the glans penis) and balanoposthitis (combined inflammation of the mucous membranes of the glans penis and the inner layer of the foreskin).

In addition, according to many studies, with prolonged stagnation of smegma, carcinogenic substances are formed and accumulate in it, which contributes to the development of cancer in men (papillomas of the glans penis, penile cancer) and their sexual partners (cervical cancer).

In childhood, cleansing of the preputial sac occurs independently, since the amount of smegma secreted is small. To prevent the development of complications, adult men must follow the rules of hygiene, that is, perform a daily toilet routine, which consists of washing the foreskin and glans penis with warm water and soap.

With phimosis, this procedure is usually difficult. Thus, the narrowing of the foreskin in adults contributes to the accumulation of smegma in the preputial sac.

Even in cases where phimosis does not manifest itself with any unpleasant symptoms, doctors advise taking care of eliminating the pathology, since, in addition to the danger of developing infectious-inflammatory and oncological diseases, one should also take into account the possibility of developing such a serious complication as paraphimosis.

Paraphimosis as a severe complication of phimosis in adults

Paraphimosis refers to a complication of phimosis when the withdrawn head of the penis is pinched in the shifted foreskin.

The head, caught in a tight ring of narrowed foreskin, swells, and the pressure of the ring increases. Thus, a vicious circle is created: the circulatory disturbance caused by strong compression increases the swelling of the head, and the swelling increases the pressure on the head of the foreskin ring.

In adult men and adolescents, paraphimosis most often occurs during sexual intercourse or masturbation. It should be noted that this complication is typical only for phimosis of the first or second degree, since more severe forms of phimosis simply do not allow the possibility of exposing the glans penis.

Clinically, paraphimosis is manifested by acute pain, the head of the penis swells and becomes bluish. Over time, the intensity of the pain syndrome decreases due to severe circulatory disorders. In advanced cases, the strangulated head becomes purple or black.

Severe and prolonged circulatory disorders can lead to deep necrosis (death) of the tissues of the foreskin and glans penis. Therefore, paraphimosis is an extremely dangerous complication that requires immediate help.

First aid for paraphimosis in men is to immediately seek specialized medical help. In the early stages of the development of paraphimosis, doctors can perform manual reposition of the glans penis (this manipulation is very painful, so it is performed after the administration of narcotic analgesics). In more severe cases, they resort to cutting the foreskin ring.

Physiological phimosis in children

First of all, it should be noted an essential feature of physiological phimosis in infants: the lack of mobility of the foreskin is not at all due to the narrowness of its opening.

At such a tender age, for most boys, the inner layer of the foreskin is fused to the head of the penis. It is for this reason that you should never try to forcibly expose the head - this will lead to erosion of the inner surface of the preputial cavity, the development of an inflammatory process and the occurrence of secondary pathological phimosis.

The well-known children's doctor Komarovsky rightly asserts that in 99 cases out of 100, complications of physiological phimosis in children are associated with rude and illiterate intervention carried out by the parents themselves on the advice of relatives, neighbors and even, sadly, doctors.

If nothing bothers the boy (no problems with urination, pain, itching, etc.), no additional measures should be taken to correct phimosis. It is only necessary to perform a regular toilet every day, washing the perineum and genitals with water. It is best to use soap no more than once every three to four days, avoiding it getting into the preputial sac.

Separation of the mucous membranes of the glans penis and the inner layer of the foreskin occurs due to the gradual desquamation of epithelial cells. This is a fairly slow process that should not be artificially stimulated.

The exfoliated epithelial cells form the basis of the so-called children's smegma, which, accumulating, slowly moves towards the exit and is excreted in the form of grains along with urine. Unlike adult smegma, children's smegma does not pose a risk for the development of infections and cancer.

Physiological phimosis itself performs an important protective function; it protects the delicate, unformed epithelium of the glans penis and the inner layer of the foreskin from external aggressive agents.

Until what age can phimosis in a boy be considered a physiological phenomenon?

To date, doctors have not agreed on the age at which phimosis in a boy should be considered a pathology, and when it is necessary to take special measures to eliminate it. Therefore, in the articles of specialists you can see different figures - 2-3 years, 5-7 years, 7-10 years and even 14-17 years.

If we focus on clinical data, then the probability of self-elimination of physiological phimosis in a five-year-old boy is 90%, at the age of 10 years - 83%, and by the age of thirteen it decreases to 33%.

Many pediatricians advise parents to take a wait-and-see attitude before reaching puberty: if there are no alarming symptoms, it is best to wait, since phimosis can be treated at an older age.

It should be noted that the persistence of phimosis by the age of 11-13 may be associated with a low level of male sex hormones in the blood, which have a beneficial effect on the process of softening and stretching of the foreskin.

In addition, it is necessary to distinguish congenital physiological phimosis from secondary phimosis resulting from any infectious and inflammatory diseases.

Of course, only a specialist can make such a diagnosis. But in cases where the child has already experienced an opening of the head of the penis, and then a narrowing of the foreskin occurs, we are most likely talking about pathological phimosis.

Can physiological phimosis cause problems in boys and what to do in such cases

Physiological phimosis in children rarely causes complications. Problems most often arise when basic hygiene rules are violated, as well as from overheating and an increased tendency to allergic reactions.

In cases where the severity of unpleasant symptoms is insignificant (itching, slight redness, restlessness of the child), you can try to eliminate the problem yourself. Many pediatricians recommend washing the preputial cavity with a warm solution of furatsilin using a regular ten-millimeter syringe.

The procedure is as follows:

Draw a warm solution of furatsilin or ectericide into the syringe;

Pull the skin up without exposing the head;

Insert a syringe without a needle into the resulting gap (it is more convenient to carry out this manipulation together, so that one person retracts the foreskin, and the other performs actions with the syringe);

Release the solution from the syringe under pressure, flushing out any accumulated secretions.

If necessary, repeat the rinsing several times and complete the procedure by instilling oily solutions into the gap (2-3 drops of Vaseline, olive oil or vitamin A oil solution).

If a child has an increased tendency to allergic reactions (exudative diathesis, atopic dermatitis, etc.), unpleasant symptoms may be associated with exposure to allergen substances excreted in the urine or with their contact effect on the skin.

if possible, eliminate the suspected agent (review the menu, medications taken, antibiotics, vitamins, diapers used, household chemicals, etc.);
avoid exposure to chemicals on the skin;
increase the amount of fluid consumed to quickly “wash out” allergens from the body.

However, treatment at home should never be abused. If, despite all efforts, unpleasant symptoms persist, you should seek specialized medical help (your attending pediatrician or pediatric urologist).

Even in cases where phimosis in a boy was unconditionally recognized as physiological, you should immediately consult a doctor if the following alarming symptoms appear:

problems arise with urination (difficulty urinating, pain, etc.);

there are pronounced signs of inflammation (swelling and redness in the foreskin, pain).

Complications of phimosis in children requiring specialized medical care

Complications of phimosis in children requiring specialized medical care include the following pathological conditions:

balanoposthitis;
paraphimosis;
urinary retention.

Balanitis, posthitis and balanoposthitis in children

Balanitis called inflammation of the glans penis, postitom- inflammation of the foreskin.

Balanoposthitis– combined infectious and inflammatory lesion of the glans penis and foreskin.

These diseases occur several times more often in boys than in adult men. The latter circumstance is connected precisely with the physiological characteristics of the structure of the child’s male genital organ.

In addition to physiological phimosis, important predisposing factors to the development of inflammatory processes in the area of the glans penis in children are:

diabetes mellitus (high sugar content in the urine contributes to the development of infection in the preputial cavity);
obesity (metabolic disorders, deterioration of conditions for personal hygiene);
vitamin deficiency (decreased overall body resistance).

As a rule, acute balanitis, posthitis or balanoposthitis begins unexpectedly against the background of complete health. In most cases, it is possible to determine the exposure that triggered the development of the disease. It could be:

injury received during a crude attempt to expose the head of the penis;
acute allergic reaction (excretion of food or drug allergens in the urine or direct contact with the allergen (diapers, cosmetics, soap, washing powder, etc.));
overheating;
severe hypothermia, which can cause a sharp decrease in immunity;
external injury, including from uncomfortable clothing (panties that are too tight with a seam in the middle, injury from a snake, etc.).

In children, the most common condition is a combined inflammatory lesion of the glans penis and foreskin.

The symptoms of the disease are quite characteristic:

redness and swelling in the foreskin (posthitis);
through the hole you can see the hyperemic area of the head (balanitis);
pain that increases with urination (irritant effect of urine on the inflamed tissue of the head and foreskin);
itching and discomfort;
serous or serous-purulent discharge.

The severity of these symptoms, as well as enlarged lymph nodes, increased body temperature, and the appearance of symptoms of intoxication (weakness, lethargy, headache, loss of appetite) serve as an indicator of the severity of the disease.

If you suspect an infectious inflammation of the glans penis and/or foreskin, you should immediately consult a doctor who will prescribe the necessary treatment.

With relapses of the disease, as well as in the case of secondary phimosis, the question of surgical treatment may arise.

Paraphimosis in children

In young boys, this pathology most often occurs as a result of a violent attempt to expose the head of the penis, made by inept parents in the course of “correcting” physiological phimosis.

The clinical picture and complications of phimosis in boys are the same as in adult men. Characterized by very severe pain, redness and rapidly progressing swelling of the glans penis. Untimely or inadequate medical care can lead to irreparable consequences in the form of necrosis of areas of the foreskin and penis.

First aid for paraphimosis in children. There are a lot of tips online for how to straighten the head on your own (applying cold to reduce swelling, using oil, etc.). Of course, a lot depends on the severity of paraphimosis (severity of swelling and pain) and the child’s mental state.

But it is wiser not to follow such advice. Reduction of the glans penis in case of paraphimosis is a very painful procedure, which in medical institutions is performed under anesthesia (in pediatric practice, intravenous anesthesia is used, which implies a short-term but complete loss of consciousness).

So it is best not to waste precious time and not to abuse the child, but to seek medical help as soon as possible. In such cases, patients are transported in a supine position with legs apart.

Difficulty urinating

Difficulty urinating occurs when the opening of the foreskin is very narrow. In such cases, a very characteristic symptom is observed: swelling of the preputial sac with urine during urination. The stream of urine becomes thin and intermittent, and sometimes urine is released in drops.

In addition, in such cases, children often complain of pain and discomfort during urination. They begin to avoid going to the toilet, which leads to the development of secondary enuresis (daytime and nighttime).
Difficulty urinating in infants is manifested by restlessness, crying and severe straining when urinating.

This pathology leads to increased pressure in the urinary tract, which is fraught with serious complications. Therefore, difficulty urinating is an indication for emergency elimination of phimosis.

Medical tactics in the treatment of pathological phimosis

Today, along with surgical methods of treating pathological phimosis, conservative methods are widely used, such as:

gradual daily manual stretching of the foreskin;

the use of special devices that stretch the foreskin;

drug treatment of phimosis (use of steroid ointments that help soften and stretch the tissue of the foreskin).

The attitude of medical specialists to the above methods of treating phimosis is far from unambiguous. Some professionals consider conservative treatment a dubious way to “put off until tomorrow” an inevitable operation.

This disdainful attitude was greatly facilitated by the fact that many patients self-medicate without consultation with professionals and often make gross mistakes leading to serious complications (paraphimosis, infectious and inflammatory diseases of the foreskin).

In addition, it is often not taken into account that cicatricial forms of phimosis are an absolute contraindication to the use of conservative methods. The fact is that scar tissue does not stretch, so all attempts to eliminate phimosis are doomed to failure.

Meanwhile, there is evidence of the effectiveness of conservative methods in many patients, even with the second or third degree of congenital phimosis.

An important positive aspect of all non-surgical methods of treating phimosis is the “naturalness” of their effects, since they actually repeat the mechanism of physiological self-elimination of age-related phimosis.

In addition, conservative methods of treating phimosis make it possible to fully preserve the absolutely important functions of the foreskin and avoid unpleasant side effects and complications.

Thus, in the absence of contraindications, conservative methods may well be used as a useful alternative. Of course, treatment should be carried out after consultation with a specialist and under the supervision of a doctor.

However, in cases where it is necessary to achieve rapid and radical elimination of phimosis for medical reasons (for example, with phimosis of the fourth degree) or for personal reasons, it is better to give preference to surgical intervention.

Non-drug conservative treatment of phimosis. Tension methods.

Tension methods came into practice in the last years of the last century, when original statistical studies were conducted showing that the risk of developing congenital phimosis depends on the method of masturbation.

As a result, a hypothesis was put forward about the possibility of eliminating congenital phimosis by gradually stretching the foreskin and special methods for conservatively eliminating the pathology were developed.

The general rules of these techniques are:

mandatory preliminary consultation with a professional and subsequent medical supervision;
gradual stretching (in no case should pain be allowed);
regularity of manipulations.

Method exposing the head during masturbation became one of the first developed conservative methods of treating congenital phimosis. This method consists of daily exercises to expose the head of the penis, which should be performed for at least 10-15 minutes a day.

There is evidence that it is possible to eliminate phimosis of the first or second degree with the help of exercises to expose the head in just three to four weeks.

Method foreskin stretching consists of daily pulling the foreskin onto the head of the penis during the morning shower, as well as after urination until pain appears.

This method is often used when the self-elimination of phimosis in childhood is delayed. In such cases, it is quite effective, but the duration of treatment largely depends on the type of phimosis and can reach 3-4 months for hypertrophic (proboscis) phimosis.

Method finger sprain consists of carefully inserting the fingers into the preputial cavity and gradually spreading them apart.

According to some data, the effectiveness of the methods described above for congenital phimosis reaches 75%.

Treatment of phimosis with ointments (drug treatment of phimosis)

Drug treatment of phimosis is a combination of the tension methods described above with the use of ointments containing corticosteroid drugs.

softening and increasing the elasticity of the foreskin;

reducing the severity of inflammatory reactions (drugs in this group are called steroidal anti-inflammatory drugs).

It has been proven that the combination of the use of corticosteroid ointments with tension methods allows for a faster effect, promotes rapid healing of microcracks and protects against unpleasant pain.

Drug therapy is especially indicated for children and adolescents (recommended by the American Association of Pediatrics), since it is at this age that there is the greatest chance of eliminating congenital phimosis using conservative methods.

However, it should be borne in mind that such ointments are not suitable for everyone. So, for example, a contraindication to the local use of corticosteroid drugs is the presence of a bacterial, viral or fungal infection - both acute and chronic.

Long-term use of drugs can cause unpleasant side effects (thinning of the skin, hyperpigmentation, disruption of the structure of superficial vessels), and with uncontrolled use, the systemic effect of corticosteroids may occur, which is fraught with dangerous complications.

Therefore, ointments with corticosteroids can be used only after a thorough examination and consultation with a specialist who has sufficient experience in treating congenital phimosis with this method.

Of course, individual selection of the drug and dose of the drug is necessary, as well as constant medical monitoring of the results of therapy.

Traditional methods of treating phimosis

It should be noted right away that traditional medicine, like homeopathy, is absolutely powerless in the fight against narrowing of the foreskin.

However, some favorite remedies of traditional healers are widely used as an aid. We are talking about herbal decoctions that have anti-inflammatory, bactericidal and softening effects, such as:

chamomile;
calendula;
series.

Decoctions are prepared according to a standard recipe, which can be read on the packaging of medical raw materials purchased at a pharmacy, and are used for baths carried out before the manipulation of stretching the foreskin.

Steaming the skin of the foreskin in a bath with a decoction of medicinal herbs for 15-20 minutes promotes effective, painless and safe stretching.

This kind of preliminary procedures is especially recommended for children and adolescents.
During the treatment of phimosis, you can alternate decoctions of various medicinal herbs or use a collection of medicinal plants for decoction.

The only contraindication to the use of traditional medicine as an adjuvant in the treatment of phimosis may be individual intolerance or allergies (which are extremely rare).

Surgical treatment of phimosis

Elimination of phimosis using a bloodless method

This surgical procedure is most often used in children; its undeniable advantage is minimal intervention and preservation of the functions of the foreskin.

First, a special probe is inserted into the prepuce cavity, which is used to separate the synechiae (adhesions) formed between the head of the penis and the inner layer of the foreskin. To do this, carefully move the probe inward to the coronary sulcus and make slow movements clockwise.

Then the opening of the foreskin is expanded using a Pean clamp: the ends of the clamp are inserted into the hole and the jaws are separated.

Often two or three such manipulations are enough to completely eliminate phimosis. In cases where no positive dynamics are observed, more invasive surgical intervention is indicated.
After sessions of bloodless elimination of phimosis, it is necessary to follow all the surgeon’s recommendations in order to prevent fusion of the mucous membranes of the foreskin and the head of the penis.

Anti-relapse measures are indicated for a month: daily manual opening of the foreskin and washing of the preputial cavity with a weak solution of potassium permanganate. If this manipulation is too painful or unpleasant for the child, it can be performed once every two to three days, but not less often.

Surgical interventions for phimosis

To date, a fairly large number of methods for surgical correction of pathological phimosis have been developed. The choice of surgical method depends on the patient’s age, the type of phimosis (atrophic or hypertrophic, congenital or cicatricial), the severity of the pathology, as well as the qualifications of the operating surgeon and the capabilities of the clinic where they turned for help.

Surgical interventions for phimosis are most often performed under local anesthesia; indications for the use of general anesthesia may be:

the patient’s age is too young;
increased emotional lability;
individual intolerance to drugs used for local anesthesia;
personal desire of the patient.

All surgical procedures performed for phimosis are one-day operations and do not require a long hospital stay for the patient. Complications are extremely rare.

After surgery, you may experience discomfort in the area of the surgical wound for several days, but, as a rule, you can manage without taking additional painkillers.

In cases where there is a need to remove sutures, this manipulation is performed 7-10 days after surgery. Before removing the sutures, it is necessary to change the dressings every other day and ensure that urine does not come into contact with the postoperative wound.

As a rule, the patient can have sex within two weeks after the operation. Until this time, it is advisable to wear tight underwear that provides additional support for the penis.

Circular excision of the foreskin

Circular excision of the foreskin, which in medicine is more often called circumcision, and “in the world” - circumcision, is the most common operation to eliminate pathological phimosis.

Important positive aspects of this surgical intervention are the speed of elimination of all unpleasant symptoms and the absence of relapses (this is the only surgical intervention for phimosis that provides 100% effectiveness).

The only but significant drawback of the method is the complete elimination of the foreskin, and, consequently, the irreversible loss of all the functions it performs. However, it should be taken into account that millions of men in the world undergo circumcision every year for religious reasons and do not suffer at all.

Circumcision is the only method for cicatricial phimosis, as well as for the fourth degree of phimosis, paraphimosis and recurrent balanoposthitis (the operation is performed after the elimination of the acute process).

Foreskin plastic surgery for pathological phimosis

An alternative to circumcision is plastic surgery aimed at eliminating phimosis in combination with partial preservation of the foreskin.

So, with prepucioplasty, unlike circular excision of the foreskin, the foreskin is not completely removed, since a much smaller incision is made.

Another common method of foreskin plastic surgery is called the Schloffer method. During the operation, the surgeon makes not a straight, but a zigzag incision, and then stitches the edges in such a way as to significantly widen the hole while preserving the foreskin.

In addition, methods of foreskin plastic surgery according to Roser, spiral foreskin plastic surgery, etc. are quite widely used.

The general disadvantages of this type of operation include a longer recovery period, the possibility of relapses and a relatively short list of indications. So, for example, operations with partial preservation of the foreskin cannot be performed on patients with severe cicatricial forms of phimosis.

Laser treatment of phimosis

Laser treatment of phimosis is a surgical procedure in which the energy of a laser beam is used instead of a surgeon’s scalpel.

With the help of a laser, it is possible to perform both operations for circular excision of the foreskin (laser circumcision) and plastic surgeries that preserve the foreskin.

Laser surgery is characterized by high precision incisions, so that damage to surrounding tissue is minimal.

In addition, laser beams cut tissue, simultaneously cauterizing blood vessels, and have a bactericidal effect.
Thus, laser surgery has the following advantages:

safety (there is no risk of bleeding or infection of the surgical wound);
less severe pain syndrome;
short recovery period.

Surgeries for laser correction of pathological phimosis are usually performed under local anesthesia.

Compared to conventional surgery, the postoperative period with laser correction of phimosis is more comfortable (there is virtually no tissue swelling, there is no need for dressings, suture removal, etc.) and lasts only three to four days. However, doctors do not advise starting sexual activity earlier than two weeks after the operation.

The inability to open the head of the penis is a common male pathology that affects people of all ages.

In newborn children, this is not a deviation, since in most cases, dilatation begins only after 1 year. In addition, the inability to expose the head of the penis in boys under 12 years of age does not require treatment.

Full opening may not be observed until the age of 16 - and this is the norm, and is an indicator of slow opening (fast opening - complete exposure of the head of the penis by 3 years).

The covering of the glans penis by the foreskin is a structural feature of the male body, which changes as it grows older. If changes do not occur, then, starting from 13-17 years old, this can be considered a pathology requiring drug treatment. Moreover, the inability to open the head of the penis over time can begin to cause constant discomfort and quite severe pain.

In some cases, this can lead to the development of psychological problems and difficulties in a teenager, so it is important for parents to monitor this point and promptly refer their son to see a specialist.

Why does the head of the penis not open?

The reasons for the inability to open the head of the penis can be completely different. The most common among them include:

Previous injuries to the genital organs. Even minor wounds and blows, to which a young man may not attach much importance, can cause serious complications. In particular, we are talking about the development of phimosis, the absence of treatment of which may subsequently require surgical intervention.
Infectious diseases of various nature. Often boys develop pathologies of the genitourinary system due to non-compliance with basic rules of personal hygiene. This is also an issue that, first of all, should be controlled by parents. In particular, it is important that the penis is thoroughly washed with warm water every day. Soap and shower gels are not necessary in this case - they can lead to deterioration of the skin in the genital area, but rinsing with plain water should be carried out even with the head closed - this will help avoid the accumulation of harmful microorganisms under the foreskin and prevent inflammation and various diseases .
Genetic characteristics and congenital pathologies. There are a number of nationalities in which pathology associated with the inability to open the head is more common than in others. Moreover, in most cases, this genetic deviation is passed on through generations.

Main symptoms of pathology development

Symptoms of the inability to open the head of the penis can be either active or passive. That is why the boy’s parents must constantly monitor this process independently and with the help of specialists. If at the same time you observe redness or slight swelling of the genital organs, this is usually a sign of incipient inflammation, and immediate action must be taken.

Other characteristic signs of the presence of pathology are:

disturbance of the urination process: the appearance of pain, urinary retention, depletion of the urine stream, etc. This is due to the fact that insufficient opening of the head of the penis makes it difficult for urine to exit normally from the bladder;
the presence of constant pain in the genital area, aggravated by touch. This is due to the natural increased sensitivity of the skin tissue in the groin area. Ejaculation also causes severe pain;
decreased libido and complete reluctance to engage in sexual intercourse (often occurs as a consequence of psychological problems). It is associated with constant discomfort in the genital area, which a man experiences throughout the day, including during sex. However, it is important to understand that correct and timely treatment of this pathology can completely restore “men’s health” and the patient’s ability to return to a normal, fulfilling life.

Treatment of pathology

There are various methods for treating the inability to open the glans penis, which depend on the age of the patient and the causes of the development of the pathology.

Treatment with chamomile and oak bark

This method of treatment is suitable if the pathology is diagnosed at the very initial stage and the head opens - but this process is difficult and causes discomfort.

Chamomile and oak bark are used in the form of baths every day before bed. This procedure helps relieve inflammation and pain.

Drug treatment

This method of treatment is an indication for those patients whose pathology is diagnosed at stage 2. In this case, treatment with natural remedies is not enough and active drug therapy is required.

The doctor must select a specific list of medications, but usually it includes anti-inflammatory drugs and muscle relaxants - they help relieve acute pain and increased tension on the foreskin of the penis.

In some cases, treatment with antibacterial drugs is also required, aimed at destroying the specific bacterium that caused the development of the pathology.

The doctor prescribes a specific antibiotic after the patient submits a seed culture for analysis.

Surgery

This more radical method of treatment is prescribed if the pathology is diagnosed at stages 3 or 4. Taking medication alone is not enough for such patients.

Phimosis in adult men is a pathology.

If he has the disease, he cannot have a full sex life due to pain and discomfort.

If the disease is advanced, it is difficult for a man to go to the toilet and carry out hygiene procedures, since the foreskin does not allow the head to be properly released.

The accumulation of smegma causes infectious and inflammatory processes, since its presence is a favorable environment for many pathogenic microorganisms.

Exacerbation of relative phimosis begins to manifest itself strongly with active sexual life. During an erection and during sexual intercourse, a man experiences severe pain.

And if the patient does not pay attention to redness and inflammation for a long time, then the inability to live a sexual life makes men depressed. For this reason, the long course of the disease negatively affects mental health.

In an adult, it is almost impossible to expose the head, since in most cases adhesions form, which make the flesh completely immobile.

If phimosis is detected, a man should consult a doctor to prevent the pathological course of the disease.

Starting from the first and minor manifestations of the disease to pathologies, when it is not possible to even slightly expose the head, a couple of months pass. Initially, relative phimosis occurs with redness of the tissues.

As the disease progresses, the narrowing of the flesh progresses more and more, as a result, the number of scars begins to increase and the head ceases to open at all.

Urination becomes problematic. Urine begins to come out in drops or a thin stream. At the same time, the man begins to experience severe pain.

Causes

There are several reasons causing this pathology:

The most common is injury to the genital organ, as a result of which scar tissue of the organ begins to form. Because of this, the foreskin narrows.
With intensive development of the body during puberty, the size of the penis itself ceases to correspond to the size of the foreskin.
Genetic predisposition.
Phimosis that did not go away during puberty.
Diabetes mellitus can also cause the disease.
Low immunity can also become an impetus for the development of the disease.

Symptoms

The main symptom is the inability to even slightly expose the head of the penis. There are also urinary problems that cause pain or discharge of pus.

And it is because of these symptoms that a man visits a urologist or surgeon. And then experts diagnose relative phimosis, explaining the cause of the unpleasant consequences.

There are also a number of symptoms, upon detection of which the patient should visit a doctor.

Enlarged lymph nodes in the groin area.

Temperature increase.
Increasing head size.
Due to compression, the man's head may acquire a bluish tint.
Decreased potency.

IMPORTANT: Having discovered such symptoms, the patient must visit a doctor.

Relative phimosis is observed only in men, since it appears only when the penis is erect. It can also be observed in young men who have experienced puberty.

How dangerous is the disease?

If the patient does not treat relative phimosis, the greater the likelihood of complications that can lead to negative consequences.

Complications during the disease can lead to necrosis of the penis.

During the first stage, the head can open in a calm state, but it is quite difficult to do this during an erection.
In a calm state it is difficult to expose the head, and with an erection it is no longer possible.
The head, even in a calm state, opens only partially.
It is not possible to expose the head even in a calm state. This stage is characterized by urinary retention, pain and inflammation of the urethra.

If you start the course of the disease, you can get the following complications.

When trying to expose the head, it may be pinched by the foreskin, which can cause paraphimosis. This is a dangerous disease that requires immediate medical attention.
If measures are not taken to free the head within 30 minutes, tissue necrosis will begin, which can lead to further amputation of the penis.
The disease can lead to serious inflammatory processes. Due to the accumulation of smegma, the inflammatory process begins, since it is a breeding ground for pathogens. The patient is diagnosed with balanoposthitis.
In the presence of stage 3 or 4 of the disease, fusion of the flesh with the penis occurs. The formation of synechea in this case is removed only through surgery.

IMPORTANT: Self-medication is prohibited.

Treatment Options

There are several treatment options for relative phimosis.

Foreskin stretching method

Any man can use this technique independently at home.

This does not require any tools.

The only rule is that the process must be periodically monitored by a surgeon to avoid complications. This is a kind of masturbation in which it is necessary to move the foreskin as carefully as possible to the maximum possible length. Pain should not be allowed to occur.

If you use the technique correctly, the head will be exposed within 20 days. The procedure is as follows.

Two fingers are inserted into the prepuce and slowly begin to spread the flesh, lightly pressing on the head. This procedure must be done regularly every day for 2 months or more.

This method is only suitable for those with stages 1 and 2 of the disease. The effectiveness of the method is about 75%.

IMPORTANT: When stretching, avoid acute pain.

Another option is to tighten the foreskin. Stretching should be done 3-5 times a day for 5-10 minutes.

There should be no pain during the procedure. The method is especially effective for those who have stages 3 and 4 of the disease. As soon as the lumen increases, you can proceed to the method described above.

Drug treatment

To treat relative phimosis, the doctor prescribes it to the patient.

They must be applied to the head and flesh. They help increase skin elasticity, and also relieve swelling, inflammation and heal microcracks.

The most effective and safe is clobetasol. It is used once a day for 1-3 months. In order for the treatment to give a positive result, it is necessary to expand the flesh using ointment.

Surgical methods

The most effective method is circumcision.

During the operation, the surgeon removes the foreskin, thereby freeing the patient from the formation of phimosis forever.

The operation lasts approximately 40 minutes. Anesthesia is not used. The patient is given penopubical blockade or intracavernous anesthesia.

They do not provoke risks compared to anesthesia. The patient is not hospitalized. After surgery, he is observed for 2 hours, and then he is sent home.

In some situations, a shloffer operation is performed, the essence of which is to make a zigzag incision in the foreskin. Then a seam is made.

The operation is performed under anesthesia. The essence of this technique is that the foreskin is preserved, but the hole becomes wider, which allows the head to be released.

The only downside is the possibility of relapse. There is no guarantee that the flesh will not scar again over time.

Relative phimosis in adults is treatable. It is very important to consult a doctor at the first symptoms of the disease in order to avoid further negative consequences.

Watch the video: phimosis in men.

When the head of the penis does not open well in adult men, it is called problematic phimosis. Only three percent of the stronger sex experience this condition. This is a rather serious problem, as it comes with a number of consequences.

Basically, this problem occurs in adult men, since boys are born with a closed head, and after a while it opens. Although few men suffer from such a symptom, they still wonder what to do in such a situation.

Why does the head not open all the way or not open at all?

The male genital organ changes its structure with age. In a newborn baby, the foreskin covers the entire head of the penis. As the child grows, the foreskin gradually separates from the penis and, upon reaching 12 years of age, the head becomes completely open.

There are many reasons why a man’s head does not open. Scientists have identified three main factors:

Past groin injuries
Introduced and developing infection,
The influence of genetics.

Injuries vary in severity, ranging from bruises to deep wounds. Although severe injuries heal, they leave scars on the tissue. Few men like to go to the hospital and therefore try to endure or heal intimate wounds themselves. Incorrect and untimely treatment leads to the appearance of hidden pathology. Unfortunately, it must be removed through surgery.

Advice! If a man has had any injuries related to the genital organ, he should urgently seek help from a doctor. He will prescribe an examination and if any damage appears, he will help cure it without resorting to surgery.

An infection can also cause the head of the penis to not fully open. Most often, the infection occurs in those who poorly observe the rules of intimate hygiene. Mothers who have not taught their children to wash their penis properly, under running water, without using soap or other detergents, doom them to acquire this pathology.

Under the foreskin of a poorly washed penis, microorganisms accumulate, causing inflammatory processes. The infection affects the genital organ, in particular, the head does not open completely.

Genetic predisposition is associated with nationality. Therefore, if in all generations male representatives from the same family had phimosis, then the parents decide to have surgery on the baby.

Types and stages of phimosis

Experts have identified two types of this pathology:

Hypertrophic phimosis. If you are overweight or have a special body constitution, adult men have excess foreskin.
Cicatricial phimosis. Occurs due to injuries to the genital organ.

In addition to the types of disease, there are four stages of the disease. Depending on the identified stage, your own course of treatment is prescribed, so you should always be under the supervision of a doctor.

1st degree. A mild degree of expression of the pathology, which occurs without much discomfort. Problems arise during erection, when the penis becomes large.
2nd degree. Painful sensations, even in an inactive position of the penis. During an erection, the foreskin separates very poorly and terrible pain occurs.
3rd degree. Associated with the inability to expose the head. If this degree of the disease is not treated, problems will arise in a man’s sexual life.
4th degree. The extreme stage, in which it is very difficult to go to the toilet and seminal fluid accumulates.

Each degree is accompanied by different symptoms. However, in an excited state, men will always notice the presence of an illness, since pain and discomfort will manifest themselves sooner or later. As the disease worsens, it causes severe pain in the penis area and sexual desire in men begins to disappear.

Why is this dangerous?

Some men know that they have a narrowed foreskin, but because they do not see any symptoms of the disease, they refuse treatment. However, over time, they begin to notice severe problems in their sex life. For example:

Premature ejaculation.
Lack of orgasm.
Poor sexual attraction to the opposite sex.
Little sensitivity of the penis.
Severe pain during intercourse.

Due to the frequent manifestations listed above, men develop a psychological barrier, which is why potency decreases or disappears altogether. Complexes and self-doubt develop, so sex becomes an enemy for them.

Interesting! The fourth degree of the disease can cause infertility.

Due to the narrowed foreskin, an infection appears, and as a result, an inflammatory process that needs to be treated in addition to phimosis. However, the most dangerous complication is the formation of paraphimosis. In such cases, surgery is inevitable.

What to do: methods for solving the problem

The very first thing you need to do is go to an appointment with an experienced specialist. A urologist or andrologist can help solve your problem.

Phimosis can be cured in several ways:

Taking baths made from herbal infusions.
Drug treatment will help relieve pain and reduce inflammation.
Use of antibiotics.
Surgery is only effective in extreme cases and is known as circumcision.

Men also practice stretching the foreskin at home. Such procedures can only be done with the permission of a doctor.

Advice! Monitor your level of personal hygiene, wash the genital organ thoroughly so that an inflammatory process does not develop.

Which treatment method should I choose?

Depending on the degree and complexity of the disease, different treatment methods are chosen. However, circumcision is the most effective. Of course, this is a rather expensive procedure and after it you need to undergo rehabilitation, but after a couple of months, you will forget about this illness forever.

Circumcision helps a man improve his sex life and experience pleasure from it. It has been noticed that after removal of the foreskin, men satisfy their sexual partner better.

This is a rather serious problem, as it comes with a number of consequences.

Why does the head not open all the way or not open at all?

There are many reasons why a man’s head does not open. Scientists have identified three main factors:

Past groin injuries
Introduced and developing infection,
The influence of genetics.

Injuries vary in severity, ranging from bruises to deep wounds. Although severe injuries heal, they leave scars on the tissue. Few men like to go to the hospital and therefore try to endure or heal intimate wounds themselves. Incorrect and untimely treatment leads to the appearance of hidden pathology. Unfortunately, it must be removed through surgery.

Under the foreskin of a poorly washed penis, microorganisms accumulate, causing inflammatory processes. The infection affects the genital organ, in particular, the head does not open completely.

Genetic predisposition is associated with nationality. Therefore, if in all generations male representatives from the same family had phimosis, then the parents decide to have surgery on the baby.

Types and stages of phimosis

Experts have identified two types of this pathology:

Hypertrophic phimosis. If you are overweight or have a special body constitution, adult men have excess foreskin.
Cicatricial phimosis. Occurs due to injuries to the genital organ.

1st degree. A mild degree of expression of the pathology, which occurs without much discomfort. Problems arise during erection, when the penis becomes large.
2nd degree. Painful sensations, even in an inactive position of the penis. During an erection, the foreskin separates very poorly and terrible pain occurs.
3rd degree. Associated with the inability to expose the head. If this degree of the disease is not treated, problems will arise in a man’s sexual life.
4th degree. The extreme stage, in which it is very difficult to go to the toilet and seminal fluid accumulates.

Phimosis should be treated at an early age. Separate materials on our website are devoted to this:

Why is this dangerous?

It's just elementary! To restore and enhance potency, you need it every evening.

Premature ejaculation.
Lack of orgasm.
Poor sexual attraction to the opposite sex.
Little sensitivity of the penis.
Severe pain during intercourse.

What to do: methods for solving the problem

The very first thing you need to do is go to an appointment with an experienced specialist. A urologist or andrologist can help solve your problem.

Phimosis can be cured in several ways:

Taking baths made from herbal infusions.
Drug treatment will help relieve pain and reduce inflammation.
Use of antibiotics.
Surgery is only effective in extreme cases and is known as circumcision.

Men also practice stretching the foreskin at home. Such procedures can only be done with the permission of a doctor.

Which treatment method should I choose?

Circumcision helps a man improve his sex life and experience pleasure from it. It has been noticed that after removal of the foreskin, men satisfy their sexual partner better.

1 comment Why does a man’s head not open and what to do?

My head doesn't come out during sex. It's difficult

Poor dilatation of the penis

The head does not open in men for various reasons. Pathology occurs in both adult men and young children. If the problem arose before the age of 12, then there is no need to sound the alarm. The average duration of dilation is 14–16 years. In newborns, opening begins at 1 year of age. By the age of three, most boys have an open head. If the foreskin does not come off well, then the opening occurs more slowly.

How does pathology occur?

The structure of a man's penis changes over time. In the first years of life, the foreskin completely covers the head. The tissues of the foreskin fit tightly to its surface. With age, the penis grows. This affects the partial separation of the flesh from the head of the penis. By the age of 12, in 95% of boys, the foreskin completely frees the glans tissue.

For various reasons, this process does not occur in some boys. The pathology causes unpleasant symptoms and has a detrimental effect on the mental state of a man. Parents should supervise the disclosure. If the process is slow or does not occur, then you need to contact a specialist.

Reasons for the development of the disease

Problems with dilatation occur in men for various reasons. Experts identify several main factors:

Groin injuries;
Development of infection;
Genetic predisposition.

Injury occurs through no fault of the person. Tears and wounds lead to the formation of scar tissue on the annulus fibrosus of the penis. The foreskin cannot come away on its own. Such injuries must be treated promptly. After a short period of time, a hidden pathology is revealed in the man, which requires surgical intervention.

Infection of the soft tissues of the penis is a common cause of the problem. Many mothers of boys do not pay enough attention to personal hygiene. Even an unopened head should be thoroughly washed under warm running water. The use of soap is kept to a minimum. The alkali included in its composition dries the skin of the intimate area. To wash the child, you must use a special foam or gel. Superficial washing leads to the accumulation of pathogenic microorganisms under the foreskin. Microbes cause an inflammatory process, which leads to difficulty opening.

Genetic predisposition depends on nationality. Some peoples have a congenital problem that is corrected surgically. If such nationalities are found in a person’s family, then pathology can occur in children born after several generations.

Symptoms of the problem

If the head does not open, then the man will develop accompanying symptoms. Symptoms may be severe or develop slowly. In childhood, boys need to have their genitals examined daily. The presence of swelling or redness on the penis indicates the development of an infection. The mother should immediately visit a pediatric urologist with the child. Experts also identify a number of signs indicating pathology:

Problems with urination;
Pain when touching the foreskin;
Decreased sexual desire;
Development of psychological discomfort.

The foreskin, which does not move away from the head, significantly impairs the process of emptying the bladder. The stream of liquid becomes uneven, urine comes out intermittently. When touching the head, a man experiences severe pain. This symptom prevents sexually mature young people from leading a full sex life. The tissues of the foreskin are very sensitive, they are penetrated by a large number of nerve endings. During sexual intercourse, a man may experience early ejaculation, the process is accompanied by pain.

Pain syndrome leads to decreased interest in sexual activity. The man avoids the process of arousal. With severe pathology, excitement leads to increased pain and bleeding. General symptoms lead to the development of psychological trauma in men. The doctor needs to explain to the patient that the pathology can and should be treated. With proper therapy, a man completely restores his health.

Treatment of the disease

Therapy is carried out based on the stages of the disease. The pathology occurs in four stages. The first stage is characterized by the development of a small fibrous ring, which makes it difficult to open the head. Treatment at this stage is carried out using conservative methods. It is necessary to strengthen the implementation of personal hygiene rules. To reduce inflammation, you can use baths with plant extracts. An infusion of chamomile and oak bark will help reduce inflammation and reduce discomfort.

At the second stage of the pathology, a man has problems with sex life and urination. At this stage, the disease requires drug treatment. Specialists prescribe anti-inflammatory drugs and muscle relaxants. Anti-inflammatory drugs relieve swelling from the tissues of the head and reduce inflammation. Muscle relaxants are necessary to relax the smooth muscles of the penis. This will help relieve tension on the foreskin and reduce pain.

Some patients require additional antibiotics. These drugs are prescribed to patients whose opening is difficult due to a pathogenic microorganism. A harmful microbe causes disease not only of the head, but also of the entire genitourinary system. The bacteria can be destroyed by exposure to antibiotics. The drug must be selected in the laboratory using culture. It is prohibited to take such substances on your own.

In the third and fourth stages, the problem can be eliminated surgically. The most famous operation is circumcision. With this method, the foreskin tissue is completely removed. After surgery, a man must wash himself in a timely manner.

If the boy’s head does not dilate, then it is necessary to visit a specialist. He will help identify the causes and prescribe the necessary treatment.

and prescriptions must be prescribed by an experienced specialist.

Phimosis in men: causes, symptoms and treatment regimen

Phimosis is a fairly serious pathology characterized by a disruption of the normal physiological structure of the male genital organ.

general information

Phimosis in men is a pathological condition in which it is not possible to fully expose the head of the genital organ. The disease is usually extremely painful.

This pathology requires treatment. Otherwise, the likelihood of developing an inflammatory process in the preputial sac and urine retention in it increases. Phimosis in men adds a lot of problems to everyday and even intimate life. The inability to fully expose the head of the penis leads to loss of sexual desire, erectile dysfunction and the development of various types of infections.

What happens if phimosis is not treated?

This pathology can provoke many negative consequences. First of all, patients begin to develop inflammatory processes under the foreskin, provoked by stagnation of secretions. In addition, due to improper excretion of urine and its backflow into the urinary canal, the urethra becomes infected.

The most dangerous complication of this condition is the so-called paraphimosis. This is a sharp infringement of the head of the organ. This pathology usually occurs as a result of repeated attempts to expose the head during direct sexual intercourse. In this case, the foreskin itself blocks the blood flow of the penis, which leads to its swelling and blueness. Independent attempts to return it to normal usually end in failure. In this kind of situation, it is impossible to do without emergency surgical intervention.

Why does phimosis develop in men?

The causes of this pathological condition are varied. These include the following:

Genetic predisposition. In the male body, there is a deficiency of the elastic element of connective tissue.
Mechanical damage to the genital organ.
Inflammatory processes (balanoposthitis, syphilis).

Despite the fact that the causes of phimosis are very commonplace and with their timely elimination it is possible to avoid the development of the disease, specialists are still forced to diagnose it. The thing is that men are not inclined to closely monitor their health and consult doctors when necessary.

Clinical manifestations

Difficulties in carrying out hygiene procedures. It becomes impossible to completely retract the prepuce, which leads to the gradual accumulation of smegma. It is known to be an excellent environment for the activity of pathogenic bacteria.
Swelling of the genital organ, disruption of normal blood circulation, pain when touched.
Phimosis in men can manifest as problems with urination.

Classification of the disease

Depending on the degree of opening of the head, the following stages of the disease are distinguished:

The first stage is characterized by slight difficulties in releasing the head of the penis during an erection; in a calm state, such problems are not observed.
The second stage is the inability to open the head in an excited state, even with effort.
Third stage. Every time you try to retract the foreskin, bleeding and severe pain appear.
The fourth stage is characterized by painful urination, since the head of the penis is completely covered by the skin.

There are also several subtypes of this pathology:

Physiological. Occurs in children under three years of age. In essence, the disease implies incomplete development of the foreskin. After some time (by 5-6 years), the head opens. If this does not happen, you need to consult a specialist.
Hypertrophic. In this case, there is a thickening of the epithelium of the foreskin and its protrusion beyond the head.
Atrophic. The foreskin initially thins and then completely atrophies.
Scar. Scars of various sizes form on the edges of the foreskin.

Establishing diagnosis

First of all, at the appointment, the doctor collects a complete medical history of the patient and listens to complaints. In addition, the specialist can ask a number of clarifying questions (when did problems with urination begin, whether mechanical damage preceded the symptoms, etc.).

Diagnosis of this pathology, as a rule, does not cause difficulties and is based on an external examination of the genital organ. The doctor also evaluates the degree of exposure of the head and the presence of pus under the foreskin. In some cases, an additional consultation with a surgeon may be required.

How to treat phimosis in men?

In most cases, this pathology can only be eliminated through surgery. However, there are also conservative methods. One such treatment option is gradual stretching of the foreskin.

Consistent stretching is recommended until moderate pain begins and repeated several times a day for 10 minutes. In the process of directly expanding the passage, you can gradually increase the amplitude of translational movements until the head is completely exposed. For greater effectiveness, it is recommended to take a hot bath before the procedure.

Phimosis in men can sometimes be treated with medication. It involves applying ointments with corticosteroids to the head of the organ. Such drugs are aimed at improving the elasticity of the epithelium, reducing the inflammatory process and swelling. Among these drugs, the drugs Betamethasone and Clobetasol have proven themselves to be excellent. They should be rubbed into the head of the organ every day for two months.

Surgery

How else can you overcome phimosis in men? Treatment through surgery is considered the most effective option for getting rid of this pathology. The operation usually involves the formation of three zigzag incisions in the foreskin and their subsequent stitching. According to experts, such treatment achieves the desired results in almost 100 percent of cases.

Postoperative period

Despite the fairly high effectiveness of surgical treatment, many doctors note the occurrence of various types of complications in some patients. Most often, minor bleeding occurs caused by inaccurate suturing, as well as meatitis (inflammatory processes in the outer part of the urethra).

How to prevent the development of such complications in patients diagnosed with phimosis? In men after surgery, such problems can be avoided if you strictly follow all the doctor’s recommendations. It is necessary to take baths with potassium permanganate and use special antibacterial creams. In some cases, additional surgery may be required to correct defects in the appearance of the foreskin and restore the proper contours of the urethra.

Conclusion

In this article, we talked about what such a pathology as phimosis in men is. The operation, the price of which can vary from 15 to 25 thousand rubles, is the most effective method of treatment. When primary symptoms appear, you should not put off visiting a doctor. It is better to cure this disease at an early stage and not think about its consequences. Be healthy!

I am 16 years old, my glans penis does not open, they say it is phimosis, can I solve this problem without surgery?

With grade 4 phimosis, maximum narrowing of the foreskin occurs and the formation of an obstruction to the outflow of urine. The swelling of the foreskin in the form of a bag and the release of urine drop by drop is only an external manifestation of the narrowing. At this stage of phimosis, serious disturbances occur in the mechanism of urine outflow from the bladder, which leads to the development of infectious complications in the urethra.

Inflammatory complications with phimosis develop as a result of injury to the foreskin and the inability to provide hygienic care, which leads to the accumulation of smegma in the preputial sac, which is a good breeding ground for the proliferation of bacteria. Most often, this leads to the development of balanoposthitis (inflammation of the glans and foreskin of the penis). Pain, redness, and itching appear in the area of the head of the penis. The diagnosis is made based on complaints and examination.

Increment of the foreskin to the head of the penis most often occurs with phimosis grade 3-4. , but can also occur with less significant narrowing. Prolonged close contact of the head and the inner layer of the foreskin leads to epithelial gluing of the contacting surfaces and the formation of adhesions (synechia). The longer such fusions exist, the wider the area of fusion becomes and the stronger the connection between the head and the foreskin. Treatment of synechiae is only surgical.

The head of the penis does not open - is it dangerous?

Many parents, if the head does not come out of the foreskin of a small child, begin to sound the alarm, others do not pay attention to it, hoping that the problem will be solved by itself.

Phimosis, a narrowing of the foreskin, is experienced not only by parents of young children, but also by teenagers and adults. Not everyone is ready to discuss sensitive issues even with a doctor, although the problem causes huge troubles - diseases of the genitourinary system often develop, sexual life becomes difficult... It is considered normal when the head opens by 6-7 years, it is acceptable if complete opening occurs after a year. If this does not happen in time, or for some reason in an adult man the crown of the penis is not exposed, then symptoms of discomfort appear: itching, soreness and burning, difficulty urinating.

If the foreskin does not open completely, this is a good reason to consult a doctor. In this case, the help of official medicine is necessary.

Causes of phimosis and its symptoms

The structure of the male genital organs changes depending on age. In a newborn boy, the foreskin completely covers the end of the penis - this is facilitated by multiple adhesions and synechiae. The preputial sac is almost inaccessible - this reduces the possibility of pathogenic flora entering the body and the development of an inflammatory process in the reproductive system.

In the first year of life, the head of the penis is exposed in 20% of children, and by 3 years - in 60%. The norm is considered to be the condition when physiological phimosis ends by the age of 12. If this does not happen, you need to contact a urologist.

Reasons why the head of the penis does not dilate:

groin injuries;
introduction of an infectious agent;
hereditary predisposition;
genital (nonspecific) infections.

The condition in which the head does not come out of the foreskin gets worse. Attempts to remove it lead to injury to the delicate skin. At the site of scars, collagen fibers are replaced by connective scar tissue, which increases the density of the ring. If multiple scars form, it is impossible to solve the problem without surgery.

Violation of personal hygiene rules also aggravates the condition. It is impossible to allow infection of the child’s penis and accumulation of smegma under the foreskin. Wash the baby with warm running water, without using soap - it causes the delicate skin to dry out. Special detergents are made for children. If they are not there, then you first need to foam the baby soap, and only then wash the boys’ intimate area.

How can you understand that the head of the penis does not open?

Symptoms of phimosis in young children and adult men are similar:

pain when urinating and when trying to retract the foreskin;
swelling and redness of the head;
swelling of the flesh on the edge of the penis so that it begins to resemble a fly agaric.

Men complain of decreased libido.

One of the signs of congenital phimosis is deviation of the stream of urine when urinating to the side or inward, crying of the child during urination, redness of the face during reflex emptying of the bladder.

Based on this behavior of the baby, one can already assume that not everything is in order with his genitals, and notify the pediatrician.

If the foreskin is firmly attached to the end of the penis and does not separate even partially, the operation is performed without waiting for the child to be 2-3 years old.

Many nations solve the problem radically - they circumcise children within the first year after birth.

If the inflammatory process occurs constantly, surgery may be recommended, regardless of nationality and religious preferences.

Difficulties with urination lead to the fact that the bladder does not empty completely - urine stagnates in it, which increases the risk of infectious diseases of the urinary system. Pathogenic microorganisms from the bladder invade the kidneys and prostate, and serious diseases develop - pyelonephritis and glomerulonephritis, prostatitis.

If you try to open the baby’s head on your own, you can provoke bleeding, and subsequently the appearance of adhesions and scars on the foreskin. Complications of childhood phimosis are paraphimosis. During this disease, the foreskin compresses the head of the penis, causing severe pain, swelling, and necrosis of the corolla. Treatment of paraphimosis is only surgical.

What to do if the head of the penis does not open?

One of the methods of conservative treatment when the head of the penis does not fully open is corticosteroid ointments. They are applied to the head, the skin is pulled back a little so as not to injure it, and they ensure that the ointment gets inside. (At the same time, healing of microtraumas takes place). Thanks to medications, the adhesions soften, and gradually the penis opens completely.

Sometimes parents are advised to “help nature.” To do this, during bathing, when the skin is well steamed, you should gradually move the “hood” away from the crown of the penis without making significant effort. Gradually the head will be completely exposed.

Phimosis in adults can be classified as follows.

Level 1 is the easiest. At this stage, difficulties with the removal of the head appear only during an erection; in a calm state, it is completely exposed without much effort. The disease does not cause discomfort; treatment is required only for complications.
2nd degree - in this case, it is difficult to expose the crown of the penis even in a relaxed state; during an erection it is completely impossible to do this. If pain occurs, you should consult a urologist. Treatment is carried out by conservative methods using the method already described above - the use of ointments with corticosteroids or gradual stretching of the foreskin ring. Before stretching, it must be well steamed in a bath of decoctions of medicinal herbs that have anti-inflammatory properties. Stretching takes a minute a day. If the “exercise” is performed regularly, then it is possible to get rid of the problem within 1-2 months.
3rd degree. It is impossible to remove the end of the penis from the preputial cavity on your own. If treatment is not done on time, the condition affects sexual function and becomes the cause of the development of inflammatory diseases of the genitourinary system.
4th degree – the disease manifests itself acutely, the accumulation of smegma in the preputial sac contributes to the development of a general inflammatory process, urination is difficult.

Phimosis of degrees 3 and 4 is treated only surgically - the decision on the type of operation and form of anesthesia is made by a urologist surgeon.

Surgeries to eliminate pathology due to which the head of the penis does not open can be recommended for children and adults.

If the doctor decides to perform circumcision, then during the operation a circular incision is made, cutting out the edges of the skin covering the corolla of the genital organ.

If the condition is not complicated, surgery takes no more than 20 minutes. The patient is discharged home for 2-3 days. There is no relapse of the disease.

During plastic surgery, incisions are made in the tissue of the preputial sac, widening the opening. This operation takes longer, but it is possible to eliminate phimosis and get rid of the foreskin.

The main prevention of phimosis is following the rules of personal hygiene. No other ways to avoid narrowing of the foreskin have yet been invented.

How to treat phimosis in adult men?

Phimosis in men is a condition of the penis in which the foreskin narrows (pathologically, physiologically). Subsequently, the head of the penis does not move beyond its limits or it happens very difficult. Phimosis in newborn boys is a normal condition, while symptoms in adults and adolescents are pathological.

In addition to the many inconveniences that may accompany the disease, stagnation of urine or the development of an infectious process with the further appearance of severe complications is possible.

The infection can form as a result of stagnation of smegma (lubricant), which contains a rich opportunistic microflora. Therefore, if a man notices signs of phimosis, he should immediately consult a urologist for consultation and, if necessary, treatment.

According to statistics in the world, every twenty-fifth representative of the stronger sex suffers from this pathology. Considering the risk of complications that threaten life and reproductive function, phimosis is one of the most important problems of modern medicine.

Causes of the disease

Based on the causative factor that caused the disease, we can distinguish:

Congenital phimosis is observed more often in children and is basically a normal condition of the penis. As for what was acquired, the reasons for it may be:

Hereditary predisposition in which the tissues contain little elastin;
Diseases of the blood and circulatory system;
Sclerosis of the skin, which is more typical for older men;
Diabetes;
Varicocele;
Balanitis;
Penile scars.

Classification

The question of treating phimosis in adults should begin with a correct diagnosis. Considering the large number of phimoses, different in origin and course, treatment is also different. Therefore, to more accurately detail the disease and select appropriate therapy, there are several classifications of this disease. First of all, there is normal physiological and pathological phimosis that is not normal.

The stages are divided into the following types:

The ability of the head to open exclusively in an erect state is impaired. In other states, she calmly exposes herself.
In an erect state, the foreskin does not allow the opening of the head of the penis. In other cases this is difficult to do.
Even at rest, the head of the penis is not exposed. It can be done if you put in the effort. Urination remains normal.
There is no way to open the head, even if you use force. When a man tries to retract the foreskin, a serious complication will arise - paraphimosis. Urination is difficult, urine comes out in a very thin stream or drops from the swollen preputial sac.

Phimoses are also distinguished:

Relative. It corresponds to the first three stages of phimosis development.
Expressed. It is characterized by the same symptoms as the fourth stage of the disease.

Symptoms

The main symptoms that can help identify the disease are:

There is a narrowing of the foreskin and difficulty opening the head of the penis;
Urination is impaired;
During trips to the toilet, the preputial sac begins to swell due to the accumulation of urine in it;
Urine flows in a small stream or drips;
Difficulty erection with painful sensations in the penis.

Complications

Phimosis is a very dangerous disease and if you treat phimosis at home, you can get a number of serious complications. If the pathology has progressed to one of the last stages and urination becomes difficult, then the following may occur:

Their occurrence is associated with increased tension in the abdominal muscles due to difficulty in excreting urine. In later stages, there is the possibility of developing vesicoureteral or vesicoureteral reflux of urine. All this can lead to further disorders of the urinary system:

Atony (decreased tone) of the urinary tract;
Hydronephrosis;
Pyelonephritis, which occurs when urine contains pathogenic microorganisms.

At the same time, a condition may develop in which urine will not be released at all. With phimosis, there is a risk of a condition in which the foreskin and glans penis will be irritated by the contents of the preputial sac. The mechanism for the development of such a complication is very simple.

In the preputial sac, due to the fact that it is impossible to adequately carry out hygienic procedures, epithelial cells begin to accumulate along with smegma. Combined with the urine that remains after each urination, this pasty mass can irritate the head of the penis and foreskin. In the future, if the issue of treating phimosis is left unattended, the formation of preputial stones - stones from smegma - is possible.

When a man tries to open the glans penis on his own in the later stages of the disease, this may be complicated by the development of a serious urological emergency - paraphimosis, in which the glans penis is pinched by the foreskin.

In this condition, if you do not seek medical help in time, there is a possibility of developing necrosis of the glans penis or sepsis (when dead cells enter the bloodstream) and disease of the entire urinary system due to the inability to urinate. Another serious complication can be a disease in which the foreskin becomes inflamed. It is a consequence of insufficient hygiene procedures and the accumulation of a large number of pathogenic microbes.

If you independently deal with the question of how to treat phimosis at home, there is a chance that the process will start.

The consequence of this is complete or partial accretion of the foreskin to the head of the penis. Treatment of phimosis without surgery in adults in this case is impossible - only the intervention of experienced surgeons will help eliminate this complication.

Treatment

Treatment of phimosis with ointments or any other means is completely contraindicated due to the fact that ointments for phimosis in adults do not eliminate the cause, but, on the contrary, intensify the course of the disease due to even greater proliferation of microbes, and such therapy will only worsen the process. For phimosis, surgery is the most adequate treatment method.

To do this, perform one of three possible operations:

Circumcision surgery;
Plastic surgery on the foreskin;
Dissection of the constrictive ring of the foreskin.

These surgical interventions should be performed by an experienced urologist and exclusively in a specialized hospital. If phimosis in men is treated at home and you try to perform similar operations on your own, this is fraught with the emergence of new complications that will aggravate the pathological process.

Therefore, you should never wonder how to cure the disease at home, and when the first signs appear, you should immediately go to a specialist.

Forecast

If the diagnosis was made at an early stage and treatment was started in a timely manner, the prognosis for a man’s life, health and reproductive function is favorable. If the patient applies at a late stage, there is a risk of developing complications that subsequently lead to diseases not only of the urinary system, but also of other organs.

Prevention

First of all, to prevent this disease, it is necessary to perform all hygiene procedures.

In cases where a man has a genetic predisposition, regular examinations by a urologist should become a habit.

This is necessary to prevent the development of the disease and detect symptoms at an early stage. And when the first symptoms appear, in order to avoid the development of complications, you should immediately consult a doctor.

Why does the head of the penis not open and what to do? What to do if the head does not open. What to do if the foreskin does not open.

Classification of phimosis

Causes of phimosis

Degrees of pathological phimosis

Symptoms of pathological phimosis in adults

What is the danger of asymptomatic phimosis in adults?

Paraphimosis as a severe complication of phimosis in adults

Physiological phimosis in children

Until what age can phimosis in a boy be considered a physiological phenomenon?

Can physiological phimosis cause problems in boys and what to do in such cases

Complications of phimosis in children requiring specialized medical care

Balanitis, posthitis and balanoposthitis in children

Paraphimosis in children

Difficulty urinating

Medical tactics in the treatment of pathological phimosis

Non-drug conservative treatment of phimosis. Tension methods.

Treatment of phimosis with ointments (drug treatment of phimosis)

Traditional methods of treating phimosis

Surgical treatment of phimosis

Elimination of phimosis using a bloodless method

Surgical interventions for phimosis

Circular excision of the foreskin

Foreskin plastic surgery for pathological phimosis

Laser treatment of phimosis

Why does the head of the penis not open?

Main symptoms of pathology development

Other characteristic signs of the presence of pathology are:

Treatment of pathology

Treatment with chamomile and oak bark

Drug treatment

Surgery

Causes

Symptoms

How dangerous is the disease?

Treatment Options

Foreskin stretching method

Drug treatment

Surgical methods

Why does the head not open all the way or not open at all?

Types and stages of phimosis

Why is this dangerous?

What to do: methods for solving the problem

Which treatment method should I choose?

Why does the head not open all the way or not open at all?

Types and stages of phimosis

Why is this dangerous?

What to do: methods for solving the problem

Which treatment method should I choose?

Poor dilatation of the penis

How does pathology occur?

Reasons for the development of the disease

Symptoms of the problem

Treatment of the disease

Phimosis in men: causes, symptoms and treatment regimen

general information

What happens if phimosis is not treated?

Why does phimosis develop in men?

Clinical manifestations

Classification of the disease

Establishing diagnosis

How to treat phimosis in men?

Surgery

Postoperative period

Conclusion

I am 16 years old, my glans penis does not open, they say it is phimosis, can I solve this problem without surgery?

The head of the penis does not open - is it dangerous?

Causes of phimosis and its symptoms

What to do if the head of the penis does not open?

How to treat phimosis in adult men?

Causes of the disease

Classification

Symptoms

Complications

Treatment

Forecast

Prevention

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