Phimosis at 23 years old

Phimosis is actually a very common condition. For men, if the phimosis causes pain and infection, it can be removed surgically. For a 23-year-old male with phimosis, it may have some impact on his sexual life, so going to a regular hospital for surgery will have a certain improvement in his future life. In addition, if surgery is not performed, men must pay attention to the hygiene of the glans penis.

Phimosis refers to a condition where the foreskin opening is narrow and small, and cannot be turned up to expose the glans penis. Phimosis is divided into congenital phimosis and acquired phimosis. The mild epithelial adhesion between the inner plate of the foreskin and the surface of the glans penis is absorbed, the foreskin retracts, and the glans penis is exposed. If the adhesion is not absorbed, congenital phimosis is formed. Acquired phimosis is mostly secondary to phimosis of the glans penis, causing scar contraction of the foreskin opening. If the phimosis is severe, it can cause dysuria or even urinary retention. When smegma accumulates, there may be an itchy feeling on the glans penis. Long-term chronic stimulation can induce infection and cancer, leukoplakia and stones.

Clinical manifestations

The foreskin opening is narrow and pinhole-like, which can cause varying degrees of dysuria, slow and small urine flow, and bulging foreskin during urination. The foreskin cannot be turned up for cleaning, and smegma accumulates in the foreskin sac. The smegma can be discharged from the foreskin opening, or it can remain in the coronal groove of the glans penis in small pieces. The retention of smegma makes urine discharge difficult, and it is easy to develop foreskin and glans inflammation. In foreskin and glans inflammation, the foreskin opening is red and swollen, with purulent secretions. Incarcerated foreskin, the pain is severe, the foreskin is edematous, a narrow ring can be seen on its upper edge, and the glans penis is dark purple. There is dysuria, and long-term incarceration can cause necrosis of the foreskin and glans.

Diagnosis

1. Phimosis refers to the condition where the foreskin is too long, the external opening is narrow, and it cannot be turned up, so that the glans penis cannot be exposed. Secondary phimosis refers to the condition where the foreskin and glans penis cannot be turned up and the glans penis cannot be exposed due to repeated inflammation of the foreskin and glans penis.

2. The foreskin is small, and the foreskin is occasionally turned up to the coronal sulcus area and becomes incarcerated there and cannot be turned down. This is called incarcerated foreskin. Over time, the foreskin at the distal end of the incarceration ring will become obviously swollen or even necrotic, and in severe cases, it may affect urination.

Differential diagnosis

1. Foreskin is too long

Phimosis refers to the foreskin that cannot be turned back, the foreskin opening is narrow and small, and if the foreskin is too long, you can use your hands to turn the foreskin back to expose the glans penis.

2. Hidden penis

The child was obese, the foreskin was beak-shaped, the penile skin was not attached to the penis body, and the penile compression test was positive.