Phimosis

　　The foreskin is a layer of skin covering the glans penis. When the foreskin is flipped back, the annular constricted area behind the glans is called the corona sulcus. There are many sebaceous glands in the skin near the corona sulcus, which secrete a smelly secretion that is yellowish-white and泥状 in texture, known as 'foreskin垢'.

　　In the first year of life, the foreskin of male infants is usually difficult to retract from above the glans. Most boys can retract the foreskin by the age of 2, but some boys may have to wait until they are 4 years old for the foreskin to retract behind the glans. After the age of 4, if the foreskin is still difficult to retract behind the glans, it is considered an abnormal condition.

　　The phimosis may be due to the residual tissue bundle connecting the foreskin and the glans at birth. It may also be caused by phimosis resulting from a small prepuce opening. Phimosis can be congenital, but it may also be due to recurrent balanitis or scarring caused by trying to forcibly pull back the foreskin. Boys with phimosis are more prone to urinary tract infections.

　　Phimosis and balanitis can easily lead to phimosis adhesions. Phimosis adhesions generally refer to the prepuce and glans sticking together, which is difficult to flip. Most phimosis adhesions are the adhesion of the inner plate of the prepuce skin to the corona and the glans. Adhesions often cause recurrent balanitis and balanitis because inflammation causes a large amount of fluid to seep out, and after absorption, adhesions occur. Although most adhesions do not affect sexual life or cause lesions, if adhesions cause pain during penile erection, it will affect sexual life. Therefore, it is better to undergo surgical treatment for phimosis adhesions as soon as possible to avoid more difficult treatment in the future.

　　Phimosis adhesions are extremely harmful and can easily accumulate smegma under the prepuce. Generally, it is white with a foul smell. Phimosis and long prepuce are prone to the accumulation of smegma under the skin. The accumulation of smegma is easy to cause bacterial infection, leading to balanoposthitis. Inflammatory adhesions can affect the relaxation of the prepuce, forming secondary phimosis, and even leading to narrowing of the urethral opening. Experts point out that phimosis and phimosis can lead to many diseases, in addition to being prone to phimosis adhesions and prepuce entrapment, they are also prone to various diseases such as male sexual dysfunction, prostatitis, and urinary tract infection. They harm themselves and their sexual partners. Therefore, phimosis and phimosis must be operated on in time.

　　Phimosis adhesions can be divided into partial and complete adhesions. Some phimosis adhesions are very tight and require surgical separation; some are loose or partial adhesions, and the prepuce can be flipped over without inflammation. If the adhesions gradually separate from the glans, the prepuce can usually be flipped to the level of the corona. For phimosis with narrow prepuce opening, if manual flipping of the prepuce and dilation are ineffective, surgery should be performed to separate the adhesions and remove the prepuce.

　　If parents find that their children have symptoms of phimosis and prepuce adhesions, they can adopt non-surgical methods of treatment. By using appropriate drugs to expand and invert the prepuce of the child, repeated treatment can alleviate the困扰 caused by phimosis adhesions. This therapy is bloodless, free from infection, and does not require suture removal, so it is easy for children and their families to accept. Experts point out that if phimosis adhesions are severe, circumcision surgery should be used for treatment because the inner plate of the prepuce skin is adhered to the corona and the glans. Therefore, different treatment measures should be given to phimosis adhesions according to the degree of adhesion.

　　To avoid adhesions of the prepuce, parents should pay attention to the following:

　　One, pay attention to observe the development of the child's small penis. If you cannot judge whether it is normal or not, it is necessary to go to the hospital for a check-up as soon as possible to avoid adhesions of the prepuce.

　　When parents find that their child has phimosis, to avoid adhesions of the prepuce, they should rinse the dirt inside the prepuce with clean water during each bath or before bedtime, to keep the prepuce clean and prevent the accumulation of dirt inside, which can breed bacteria.

　　Three, for children with phimosis, to avoid adhesions of the prepuce, it is necessary to deliberately turn the prepuce outward with the hands, as much as possible to expose the glans, which can help to dilate the opening of the prepuce. It is necessary to persist for a long time until the tight opening of the prepuce is relaxed and the glans can be exposed smoothly.

　　Congenital phimosis and elongated prepuce are present from birth. When children start normal metabolism and secretion after birth, phimosis or elongated prepuce can have some impact on urination, especially when phimosis is present. During urination, the prepuce of the child may swell like a balloon, and there may be some residual urine in the prepuce cavity after urination. In addition to the accumulated sebaceous substances and desquamated epithelium, these will gradually form a mass of prepuce calculus, which is a good culture medium for bacterial growth. Chronic stimulation over a long period can cause inflammation of the prepuce and prepuce and glans inflammation, and recurrent attacks can lead to prepuce cavity adhesions. Due to the presence of prepuce calculus, the urine often appears in a whorl-like shape, excreted slowly and thin like hair. With age, it often causes poor urination.

  Phimosis is caused by long prepuce, due to the narrow prepuce opening or adhesions between the prepuce and the glans after inflammation, which cannot be flipped over to expose the glans. Diet and Health Care: 1. There are no special health care requirements in diet before the circumcision. 2. Within one week after circumcision, it is advisable to eat nutritious foods such as meat, fish, eggs, which are helpful for the incision to heal..

　　If the adhesion is severe, prepuce circumcision can be used for treatment, which is often due to adhesions between the inner plate of the prepuce skin and the corona groove and glans. This is the result of recurrent prepuce and glans inflammation, and the inflammatory adhesions cause a large amount of exudate. After absorption, adhesions occur. The operation requires careful separation, otherwise, it may cause changes in the glans shape. Some patients may have uneven pigmentation of the glans skin after separation, resulting in a speckled appearance.

　　If there are no adhesions, they can be treated by manual manipulation. After disinfection, 2% dicaine anesthetic is used to dilate the prepuce opening to the point where the prepuce can be flipped over. There may be prepuce edema for a few days after separation, which can be dissolved by soaking in warm salt water. If the adhesions have not been significantly relieved, the same method can be used for slight treatment again. This non-surgical treatment of prepuce adhesions does not cause bleeding, infection, or the need for suture removal, so both children and their families are more willing to accept it.

　　The treatment for phimosis and adhesions can be performed at various ages of children, such as neonatal and infant period (0-1 year), toddler period (1-3 years), preschool period (3-7 years), and school age (7-15 years).