The glans is covered when not erect

The layer that often covers the glans is called foreskin, which is also a kind of phimosis. It refers to the foreskin that exceeds the glans due to development after birth, so the foreskin appears. The other is caused by acquired development, which is prone to bacterial infection and can be treated surgically if necessary.

Phimosis refers to the narrowness of the foreskin opening, which prevents the foreskin from being turned upward to reveal the glans penis. Phimosis can be divided into congenital and acquired, and can also be called physiological phimosis and pathological phimosis.

Congenital phimosis: Every normal boy is born with congenital phimosis. There is physiological adhesion between the foreskin and the glans penis. In addition, the foreskin opening is narrow and small, so the foreskin cannot be turned up to expose the glans penis. Strictly speaking, congenital phimosis is not a disease, but a physiological phenomenon. If a boy is not born with phimosis, it is abnormal to expose the glans penis. It may be a congenital malformation, such as hypospadias, epispadias, etc. Physiological phimosis will separate from the glans penis and the foreskin opening will gradually expand and heal itself as the adhesion is absorbed a few months after birth. After the age of 3, 90% of children have phimosis. After the age of 17, less than 1% have phimosis. Most physiological phimosis can heal itself.

Acquired phimosis: Congenital phimosis can lead to infection and cause glans phimosis. If glans phimosis recurs and becomes chronic inflammation, the foreskin loses its skin elasticity and expansion ability, forming scar contraction, and the foreskin cannot be turned up. This type of phimosis is acquired phimosis, often accompanied by urethral stenosis. Scar contraction after foreskin trauma can also lead to acquired phimosis.

Treatment principles. Phimosis does not need to be treated for children under 5 years old who do not have difficulty urinating, are not infected, and have mild smegma. For symptomatic phimosis, you can first try to dilate the foreskin opening. You can go to the hospital for treatment, repeatedly try to turn the foreskin up to dilate the foreskin opening, expose the glans penis, remove the smegma, apply antibiotic ointment or liquid wax to lubricate it, and then restore the foreskin. Parents continue to use this method to treat at home, and most children can be cured as they grow older.

Circumcision is suitable for:

① Acquired phimosis with a narrow fibrous ring at the foreskin opening;

②Recurrent episodes of penile balanitis;

③ After 5-6 years old, the foreskin opening is severely narrow, the foreskin cannot be retracted and the glans penis is exposed, and conservative treatment is unsatisfactory. The first two are absolute indications for surgery.