PHIMOSIS AND PARAPHIMOSIS :-
Phimosis is condition in which the foreskin (prepue) cannot be retracted over the glans in uncircumcised males.
It occurs when the penile foreskin is constricted at the opening making retraction difficult or impossible.
Etiology
1.Congenital
2.Infection and inflammation
3.Poor hygiene
4. Local trauma
Types
1.Physiological phimosis(congenital) :-most common condition and is present from birth
2.Secondary phimosis (aquire) :- may occur at any stage of life, after repeated infection and trauma.
Clinical manifestations
1.Ballooning of foreskin during voiding
2.Penile pain
3.Dysuria
4.Urinary infections
5. Redness and scarring of foreskin
6.Retraction of the foreskin is not possible
7. Scrotal tenderness
Diagnostic evaluation
1. History taking and physical examination
2.Blood test
3.Urine test
4.Penile swab test :- To check foreskin for bacteria
5.Urinalysis :- To asses the urinary tract infections
Treatment
1.Controlling infection with local treatment and broad spectrum anti microbial drugs
2.Effective genital hygiene is essential to prevent acquired penile disorders
3.Routine circumcision -surgical removal of the foreskin
Complication
1. Obstructive uropathy
2. Chronic inflammation and irritation that leads to penile cancer
PARAPHIMOSIS
Paraphimosis is a condition in which the foreskin, once retracted over the glans, cannot be returned to it's usual position.
Causes
1.Vigorous cleaning
2. Masturbation
3.Sexual intercourse
4.Catheterization
5.Cystoscopy
Clinical manifestation
1. Glans penis swelling
2. Edema
3. Pain
Management
1.The foreskin can be gently compressed either manually or with an elastic wrap
2. Manually reduction by gently pulling the foreskin.
3. Surgical incision of the fire skin with local anesthesia may be necessary to solve problems
0 Comments