At what age is physiological phimosis diagnosed in boys and what is it? Treatment and photo of the disease. Why is phimosis dangerous? Possible consequences and complications for a man if left untreated What is physiological phimosis in a child

The foreskin of the male penis is a fold of skin covering the mucous membrane. This structure is necessary for the free sliding of the skin relative to the head. With the development of phimosis, such sliding is difficult because the fold is narrowed. The degree of narrowing of the skin fold depends on:

Subtypes of phimosis

There are the following subtypes of phimosis:

1. . Normal until three years of age and is associated with underdevelopment of the foreskin. Natural elimination occurs by the age of 5-6 years, when the head begins to open on its own. If this does not happen, phimosis is considered a pathology and requires the intervention of a urologist.
2. Hypertrophic. The epithelium of the foreskin thickens and protrudes beyond the head. A kind of proboscis appears on the penis. Without treatment, hypertrophic phimosis leads to hypogonadism. This disease is a deficiency of the function of the gonads and a violation of the synthesis of sex hormones.
3. Atrophic. The foreskin becomes thinner and gradually completely atrophies.
4. . Scars form on the edges of the foreskin, which leads to pain during sexual intercourse.

Why is phimosis dangerous?

What happens if you don’t have surgery for phimosis?

The narrowing of the foreskin does not always bring discomfort to a man, so most of them do not pay attention to the problem and do not consider it necessary to consult a doctor.

Meanwhile, if phimosis is not treated and neglected, some related problems may develop.

• difficulty in mobility of the skin on the head of the penis leads to a decrease in its sensitivity, which leads to difficulty achieving orgasm;
• during sexual intercourse, a man experiences pain and discomfort;
• sexual desire decreases;
• Premature ejaculation often occurs.

Can phimosis affect a man's sex life? In some cases, fear of pain leads to psychological problems in sexual intercourse. A man ceases to experience sexual desire, and gradually such abstinence leads to complete sexual dysfunction.

An additional incentive for a man is the appearance of the penis after phimosis, which develops real complexes that interfere with normal sexual life.

Phimosis of the fourth stage can cause infertility due to impaired ejaculation.

Don't neglect visiting your doctor! After examination and consultation, a qualified professional may recommend a circumcision procedure. On our website you will find many useful articles on this topic:

• : including, features and;

One of the serious and significant problems for parents of young gentlemen is the question. Serious debates are flaring up regarding hygiene and the nuances of caring for the penis of boys: does the child have phimosis, is it a pathology, or is it a feature of age-related anatomy?

You will find answers to all these questions in this article.

Physiological phimosis in boys

To understand what physiological phimosis is and understand how to properly care for male genitalia, you just need to have a good knowledge of male anatomy and physiology in terms of age. Then this knowledge itself will push you to the right actions in caring for your penis.

The child's penis has three sections:

• root, at the base of the testicles,
• penis body,
• and his head, which ends in a special opening of the urethra, through which the boy urinates, and when he grows up, sperm will also be released from there.

Under normal conditions, at birth, the head of the penis is covered by a special fold of skin called the foreskin (preputial sac). In adults, this area easily moves and brings out the head of the penis, and the foreskin has two sections - the outer (covered with skin) and the inner (formed by mucous membrane).

There is a cavity between the head and the foreskin; in this space, special glands secrete lubricants and antimicrobial substances that help with hygiene and facilitate the sliding of the head from the skin sac. In the lower part, the head is connected to the skin of the foreskin by a special frenulum with blood vessels and nerves.

In children, the skin in the foreskin area usually completely covers the head of the penis and even gathers into a fold of skin at the tip. And also the skin of the head of the penis is usually fused to the area of ​​the head of the penis with special adhesions (synechia), which do not allow the head to be brought out freely. This structure of the baby’s penis is a phenomenon of physiological phimosis (that is, it is a completely normal phenomenon).

This name comes from the Latin word fimosis - compression, tightening, but at this age this phenomenon (unlike older children and adults) is not a pathology. Very few children are born with the head of the penis partially or completely exposed; all others usually have this feature.

Pathological phimosis in boys

Usually, in the absence of any action to open the head, problems with the penis do not arise, but accumulations of smegma may form in the foreskin area, which are difficult to eliminate due to abundant synechiae. In such cases, a kind of tumor forms at the tip of the penis. In these cases, they resort to the help of surgeons or urologists, who carefully separate the synechiae under local anesthesia with a special instrument like a stick probe and remove the accumulated secretion. Then, over the course of several days, it will be necessary to perform hygienic baths for the penis with antiseptic solutions for proper healing.

If we are talking about the fact that pathological phimosis develops directly with strangulation or a sharp difficulty in removing the head of the penis, it will be characterized by a number of features. Typically, such phimosis occurs in the event of injuries or violent actions to remove the head, when injuries to the mucous membrane, microtears occur and an inflammatory process is formed.

Symptoms of pathological phimosis in boys

• In the first stage of phimosis, the head of the penis can be completely withdrawn in a calm state, without an erection. During the erection stage, it is difficult to remove it.
• In the second stage of phimosis, the head of the penis cannot be brought out in any condition, but it is clearly visible through the hole.
• In the third stage, it is not possible to remove the head at all; it is visible only a couple of millimeters in the hole.
• In the extreme, fourth stage, the narrowing is so pronounced that the process of urination occurs with swelling of the foreskin and straining, pain and discomfort, which leads to the child screaming and crying.

Phimosis in boys, treatment

In the first two stages of phimosis, only dynamic active observation by parents is required without any action on their part; in the third stage, strict monitoring of the urination process and strict genital hygiene are required in order to prevent inflammation and pain.

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Any violent actions towards the baby’s penis, removing the head with force and pressure, which will only increase injury to the foreskin, are prohibited.

Pathological phimosis requires the intervention of a doctor, and often this is surgery under anesthesia, especially with cicatricial or atrophic type of phimosis. With an atrophic penis, there is too much excess skin, and it interferes with the removal of the head, but cicatricial phimosis is the result of the actions of the parents.

The causes of cicatricial phimosis are obvious:

• violent manipulation of the penis (stretching or sudden sudden removal of the head)
• inflammation in the foreskin (balanoposthitis), which results in adhesions.

Let's say it again!

With physiological phimosis, there are no problems with the child’s urination, and then nothing needs to be done. If the child cannot urinate on his own, when urinating, the foreskin swells and urine is released in drops or a weak stream - the help of a doctor is needed. such a problem can lead to acute urinary retention, a child emergency that occurs due to pain or strangulation of the tissues of the head. At the same time, the baby does not urinate for a long time, cries, kicks his legs, and a swollen bladder is felt above the pubis. This requires calling an ambulance immediately and catheterizing the bladder and treating the penile problem with adequate pain relief.

The second danger is the pinching of the head of the penis by the tissues of the foreskin - paraphimosis, when the head is forcibly removed. This condition is extremely painful and dangerous; if help is not provided within the next 30-90 minutes, the head of the penis may die. If the head is pinched against the tissues of the foreskin, and within a minute it does not come back out, immediately call an ambulance and the hospital. If the pinching is not severe and tissue swelling has just begun, doctors will be able to return the head to its place with their hands under anesthesia. If the swelling is severe and the tissues are severely pinched, surgical dissection of the skin compressing the head will be required.

For pathological phimosis, the main treatment method will be circumcision (circumcision), during which the foreskin tissue is removed from the head along with their pathological changes that interfere with the normal removal of the head.

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It is necessary to understand the structure and functioning of the penis in men in order to better understand the mechanism of development and consequences of this disease. The penis consists of three parts: the head, the root, and the body.

The development of phimosis is associated with the anatomical features of the head. Normally, it is hidden by the foreskin, that is, skin, which consists of two sheets. A man's foreskin should be mobile, capable of quickly exposing the head. The leaves of the foreskin differ slightly from each other.

The outer one is the usual skin, which is characteristic of the whole body, and the inner one is more like a mucous membrane. The inner layer of the foreskin of the penis and its head are separated using a special space of the preputial sac. The ducts of the glands open into this cavity, and accumulation of (natural lubrication) occurs there.

Normally, the foreskin has connections with the frenulum along the lower part of the penis, where the main vessels and nerves pass.

Phimosis is a condition of the penis in which the foreskin narrows significantly, making it impossible or difficult to bring the head of the penis out. Phimosis can be both pathological and physiological, that is, it can be a variant of the norm. Physiological phimosis is characteristic of newborn babies and children of primary and secondary school age.

It is a protective reaction of the body when the baby’s defense system against various infections has not yet been formed. An important feature of physiological phimosis is its origin.

The essence of this phenomenon is not that the foreskin is narrowed, but that it fuses with the head with the help of synechiae. Therefore, any attempts by parents or a doctor to expose the head end in the appearance of erosions on the inner layer of the foreskin, into which infection easily penetrates. Due to attempts to expose the head during physiological phimosis, the process can be brought to a pathological state, when inflammation of the foreskin ends in narrowing.

Also, the process of exposure is very painful for the child. With physiological phimosis occurs gradual opening of the head. Statistics show that phimosis goes away on its own with age:

• One year old - half of the children;
• Three years old - 90% of boys;
• Seven years – 92%;
• Teenage – 99%.

In children, synechiae gradually resolve, which is manifested by a gradual opening of the head. The mechanism for the disappearance of synechiae is the gradual desquamation of epithelial cells. And with active sexual development in adolescents, the hormones produced help increase the elasticity of the foreskin, which promotes normal exposure of the head.

In what situations is the disease physiological?

Phimosis in children is not always physiological, so pathology should be differentiated from the normal variant. First of all, the determination criterion is age. However, doctors do not agree on the age at which congenital phimosis does not require medical intervention. In various clinical databases you can find very small numbers, for example, 2 years, and some experts believe that phimosis can remain physiological throughout life.

Due to the fact that doctors do not determine the time of transition of physiology into disease, the clinical picture is important. The appearance of any complaints in a child indicates that it is time to go to the doctor and get treatment.

If a child has a history of physiological phimosis, which resolved on its own, but for some reason reappeared, then we are talking about a secondary pathological process. Such a child will have a pronounced clinical picture of the disease, as well as a different mechanism for the development of phimosis. However, in any case, it is necessary to conduct an examination for more accurate differentiation.

Consequences

Physiological phimosis is rarely accompanied by any complications, and therefore does not require any therapeutic measures. However, parents should closely monitor their child's condition and notice the slightest changes. The most common factors leading to complications:

1. Failure to comply with intimate hygiene rules;
2. Tendency to allergic reactions;
3. Attempts to forcefully expose the head;
4. Overheating;
5. Diabetes;
6. Overweight.

Parents, even if a physiological phimosis that does not require treatment is diagnosed, should immediately show the child to a doctor if such symptoms appear;

• and him;
• Local signs of the inflammatory process (swelling, hyperemia, pain);
• Severe itching;
• General disorder of the child's condition.

The main complications that can occur with physiological phimosis:

1. Allergic reactions;
2. Inflammatory process (or fasting, as well as their combination);
3. Urinary retention (acute or chronic);

Treatment and prevention of complications

Uncomplicated physiological phimosis does not require any treatment, and the doctor prescribes watchful waiting. If mild symptoms of inflammation associated with poor intimate hygiene appear, you can cope with the consequences yourself. For this purpose, special washes with furatsilin are used. This technique is carried out as follows:

• Furacilin is taken into a syringe of 10 milliliters (the solution should be warm);
• The skin of the foreskin is slightly retracted;
• The syringe, from which the needle is first removed, is inserted into the resulting hole;
• The solution is injected into the cavity and thereby washes the space between the head and the foreskin.

This method can be repeated several times, ending with the introduction of special oil solutions into the washed space. The presence of an allergic reaction can be associated both with the external impact of the allergen on the body, and with the consumption and further removal of the aggressor from the body. Measures taken in case of an allergic reaction:

1. Identification and elimination of the allergen (this can be external chemicals, clothing and other external irritants, as well as foods or medications);
2. Minimize the contact of household chemicals on the skin of the foreskin;
3. Increase fluid intake to flush out the irritant from the body.

If the above measures do not have the desired effect or if the child’s condition worsens and the symptoms increase, then self-medication should not be done. Parents should quickly take their child to a specialist. If complications occur, special treatment measures are required:

• Balanoposthitis is treated with antibacterial and anti-inflammatory drugs, as well as local rinses;
• Paraphimosis (that is, pinching of the glans penis) is treated only in a hospital setting and under anesthesia;
• Any difficulty urinating, even if phimosis is considered physiological, requires surgical intervention.

Uncomplicated phimosis upon reaching adolescence, if it does not tend to go away on its own, is treated conservatively and without medication.

For therapy, a special technique developed relatively recently is used. The treatment consists of daily exercises that take only a quarter of an hour, when the man tries to expose the head through masturbation.

This method requires prior consultation with a doctor and accuracy. A man should not forcefully expose the head, but simply try to stretch the foreskin as far as possible. The method is highly effective, since phimosis is gradually cured in approximately 75% of patients.

To improve the stretching of the foreskin, you can also use drug treatment, which consists of using corticosteroid ointments. These drugs are used topically and only in the absence of contraindications, which include inflammatory processes. Corticosteroid ointments should only be prescribed by a doctor, as their use leads to a variety of side effects.

As an auxiliary treatment, you can use folk remedies, which consist of local washing of the affected area with herbal decoctions. The most effective herbs for phimosis are: chamomile, calendula or string. In case of uncomplicated physiological phimosis, these drugs can be used to prevent complications.

Often, during a preventive appointment with a pediatrician, boys are diagnosed with phimosis. This disease often occurs in infancy and is considered the absolute norm - this is due to the fact that all the baby’s structures are still developing. Therefore, there is no need to worry and take urgent therapeutic measures.

What is phimosis, what are the reasons for its development, how to treat it, and in what case should you consult a doctor? All parents who raise future men should know the answers. Untimely detection of pathology and treatment can lead to complications, problems with urination and sexual life in the future.

What is phimosis and why does it occur in boys?

Phimosis is a pathological condition in which the head of the penis is not completely exposed. This situation does not always indicate that the child has a disease, so there is no need to try to open the head on your own, because your actions can only cause harm.

Before reaching 6 years of age, the reproductive system in boys is still developing. If after this time the condition remains unchanged (the head does not appear, the baby complains of pain when urinating and discomfort in the intimate area), you should seek help from a specialist.

There are several reasons for the development of phimosis:

• congenital pathology resulting from disorders of intrauterine development;
• injury to the penis, causing narrowing of the prepuce or scar formation;
• inflammatory processes in the intimate area, including balanoposthitis;
• improper restoration of tissue structure after surgery on the genital organ;
• a small number of elastic connecting structures.

At what age can this problem occur?

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This condition is observed in the majority of newborn boys (almost 95%): the head of the penis comes out partially, since the foreskin is connected to it by synechiae. Therefore, phimosis in children aged 2-3 years is the absolute norm - this condition is called the term “physiological phimosis in boys.”

By the age of 4, many children return to normal without outside intervention. The skin surrounding the reproductive organ becomes mobile, and the head is completely exposed. It is believed that opening can take up to 6 – 7 years - this depends on the general physiological development.

Some experts do not advise starting treatment for phimosis before the age of 10, unless, in addition to the main symptom, other accompanying symptoms are observed (pain, itching, difficulty urinating, etc.). In any case, it is necessary to consult with a pediatrician to prevent complications from occurring and not to aggravate the child’s condition.

Classification and symptoms of pathology

Phimosis in boys is divided into 3 types - cicatricial, hypertrophic and congenital. Depending on the type of pathology, a treatment regimen is determined. The characteristics of the disease of each type are discussed in the table.

Forms of phimosis

Type of phimosis	Reason for development	Symptoms	Method of treatment
Scarred	the main factor provoking the appearance of cicatricial phimosis is neglect of the rules of personal hygiene; inflammation of the genital/urinary organs; congenital pathology.	With cicatricial phimosis, the foreskin is longer and prevents the free exit of the head. Cracks and scars appear on the skin, swelling appears, resulting in a narrowing of the genital opening. Carrying out hygiene procedures is almost impossible. Often the course of cicatricial phimosis is accompanied by inflammation of the area (paraphimosis).	Drug therapy or surgery.
Hypertrophic	There is only one reason for the occurrence of hypertrophic phimosis - excess weight, including obesity in the intimate area (the surrounding tissues in this condition have an excessive accumulation of fat cells).	The pathology occurs not only in young children, but also in adults. Due to the excess fat layer, the prepuce lengthens and a large amount of moisture accumulates under the skin. The foreskin is tightly wrapped around the head of the penis, which is why it cannot come out. Increased humidity contributes to the development of inflammation, so the child may experience pain.	If the disease is detected early, surgery can be avoided. Therapy can be carried out at home, but it is necessary to adjust the child’s nutrition.
Congenital	may occur for no reason; genetic predisposition; developmental pathologies during pregnancy.	Physiological phimosis manifests itself in a narrowing of the foreskin, due to which the head cannot extend beyond the boundaries of the surrounding skin. In some cases, fusion of the prepuce and the genital organ is observed.	Treatment is carried out after the boy reaches a certain age. Drug therapy is used; if it fails, surgery is indicated.

The main symptom of phimosis is the inability to open the head of the penis (narrow foreskin) or its complete closure (the photo shows what phimosis looks like).

Manifestations of pathology also include:

• problematic urination - small children often cry or are capricious, urine is released in droplets (a thin stream) with slight delays;
• pain during erection;
• radiating pain in the upper region of the penis;
• if phimosis is accompanied by an inflammatory process, then pus may ooze from the opening of the genital organ, body temperature rises, and the head of the penis swells and turns blue.

Diagnostic methods

The pathological condition is easy to detect by visual examination. An experienced urologist determines the degree and form of the disease by the appearance and complaints of the patient. Sometimes additional diagnostic procedures are required - ultrasound, Dopplerography, OAC, OAM. Based on all available information, an accurate diagnosis is established and a treatment plan is drawn up.

A urologist can diagnose phimosis after a visual examination

Features of treatment

Treatment can only be carried out after consultation with a doctor. The initial stage of phimosis is treated with medication and other methods; the specialist gives recommendations on changing the daily diet, if necessary.

If the disease is advanced, then surgical intervention is indispensable. Physiological phimosis, as a rule, goes away on its own, but sometimes it is necessary to eliminate the problem promptly.

Surgery with before and after photos

Surgical intervention is indicated only when conservative therapeutic methods are ineffective. The operation is carried out in several ways:

• traditional - the surgeon makes axial incisions in the foreskin, then stitches it together (thus increasing the diameter of the pulp ring);
• Shkloffer operation - a zigzag dissection is performed, after which the edges of the wound are connected with sutures (local anesthesia is required before the procedure);
• circumcision - complete removal of the skin around the head of the genital organ (the result is in the photo).

Circumcision result

One alternative to surgery is laser removal of the foreskin. This method has a number of advantages - absolute painlessness, absence of blood, quick recovery.

Therapy at home

Phimosis in children is eliminated in several ways, which, as a rule, are combined. During the treatment period, you need to monitor the child’s hygiene; doctors recommend taking baths with the addition of herbal decoctions (chamomile, celandine, calendula, etc.), manganese solution or sea salt.

After bathing, the upper skin of the genital organ is lubricated with cream or a special ointment and stretching movements are made (with two fingers, the tissues are spread apart). You cannot do this too quickly and sharply - manipulations should not cause pain to the child. This method allows you to achieve good results within two months. It takes 10 minutes a day to complete the procedure.

Doctors also often prescribe corticosteroid ointments - Betamethasone, Triderm, Diprosalik, Budesonide, Clobetasol and others. They have antimicrobial and antibacterial effects, promote rapid healing of scars and microcracks.

Triderm corticosteroid ointment

If the use of ointments is contraindicated, you can replace them with Vaseline. Any medications should not be used without a doctor's prescription.

Possible complications

In addition to possible discomfort and difficulties during hygienic procedures, additional problems and pathologies often appear that require immediate treatment. These include diseases:

• Balanoposthitis is an inflammatory process that occurs in the foreskin and the end of the penis. Occurs due to poor hygiene. The patient develops the following symptoms: itching, discharge of purulent accumulations, hyperemia, pain.
• Paraphimosis occurs when parents try to expose the head of the penis on their own. Sudden and incorrect movements lead to forced stretching of the foreskin and subsequent compression of the genital organ. Blood vessels and tissues suffer from this. The patient experiences severe pain, the tip of the penis increases in size and swells. If the disease is not treated in time, necrosis or gangrene of the genital organ may develop. The way out of this situation is amputation of the affected area.
• Fusion of the foreskin and the head occurs if no measures are taken for a long time to eliminate phimosis - synechiae (fusions) gradually form (we recommend reading:). In this condition, it is impossible to fix the problem on your own.

Prevention of phimosis in children

The physiological form of phimosis does not require therapy. To prevent the development of the disease in boys, it is enough to carefully monitor the regular implementation of hygiene procedures and visit a pediatrician for preventive examinations. If a child is prone to obesity, then it is necessary to adhere to a special diet.

Every newborn boy has a congenital feature of the genital organ associated with complete coverage of the head of the penis with a fold of skin. Doctors call it physiological phimosis. Young mothers are often not familiar with this diagnosis, so they try to find out more about phimosis in infants (forum) and medical websites. In fact, phimosis of the physiological type does not pose a danger to the baby and disappears as the boy grows older. There are other situations when physiological phimosis, characteristic of newborn male children, transforms into pathological at an older age. The problem develops in children aged 6-7 years. But here, for correct diagnosis, you need to take into account the individual characteristics of the development of the child’s body. In medicine, there have been cases where congenital phimosis disappeared on its own only in adolescence.

What does physiological and pathological phimosis look like in boys in the photo: before and after elimination, how is it classified in the international classification of diseases, what features does the pathology have at different periods of a boy’s life? This article will tell you about this.

ICD code: Phimosis in children (photo), general characteristics

According to medical statistics, in 95-96% of newborn boys the head of the penis cannot be completely exposed. This feature in medicine is called physiological phimosis. Phimosis in a one-year-old child does not require medical intervention and is considered a normal condition. However, if the baby has difficulty urinating or is capricious when emptying the bladder, parents should take him for a consultation with a pediatric urologist, pediatrician or surgeon.

In the international classification of diseases, childhood phimosis is assigned code N47. The disease is included in the category “Diseases of the genitourinary system” and the subcategory “Diseases of the male genital organs” together with pathologies of excess foreskin and paraphimosis.

Phimosis at 1 year and features of pathology in newborn boys

Congenital phimosis is characterized by complete immobility of the foreskin, which physiologically fuses with the surface of the head. Most boys are born with physiological phimosis. Only 4-5% of male babies have a movable foreskin, which can be easily lifted and expose the head of the genital organ. Pediatricians and andrologists call phimosis in the first year of life a normal physiological phenomenon. This feature of the child’s body goes away on its own after several years of life. At the same time, if inflammation of the head of the penis or foreskin occurs, as well as in the event of problems with urination, a child of any age undergoes surgery for medical reasons or uses medication.

Phimosis at 2 years

In little boys under 2 years of age, problems and pathologies of the foreskin do not arise, since it completely covers the head of the penis and is closed quite tightly. Pathogenic microorganisms simply cannot penetrate under it, and, therefore, the inflammatory process in the genital organ does not threaten the baby. But there are exceptions in which the physiological state of the foreskin turns into a pathological process. Phimosis in boys at 2 years of age develops if parents forcefully try to open the head of the baby’s penis. It is impossible to stretch the foreskin in infancy, because such manipulations lead to the appearance of tears, bruises and microcracks in the delicate tissues. If adults neglect this requirement, the child develops pathological phimosis at the age of 2. It happens:

• atrophic (in a boy, the ring of the foreskin critically shrinks, the pathological development of tissues becomes clearly visible, the skin becomes thinner, and its vulnerability to mechanical influences increases);
• hypertrophic (the problem is associated with pathological elongation of the prepuce sac, more often observed in overweight boys, with the accumulation of a large amount of subcutaneous fat in the pubic area);
• cicatricial (appears as a result of mechanical injuries to the delicate tissues of the foreskin, provokes its swelling, as well as the rapid accumulation and stagnation of urine under it; due to unfavorable processes, connective tissue scar adhesions are formed between the inner part of the head and the prepuce).

Phimosis in a 2-year-old boy does not always require surgery. Surgery is recommended by a doctor only if there are risks to the child’s health.

Phimosis at 4 years old

The inability to retract the foreskin from the head of the penis in boys aged 4 years can also be considered a normal physiological phenomenon. If the child does not experience pain when urinating, he is not capricious and does not show anxiety, treatment of phimosis or surgical intervention is not required. Parents should contact a pediatric urologist only if the child has phimosis and complications have developed (the glans penis is inflamed, problems with urination have arisen). Medical statistics show that at the age of 4-7 years, the manifestations of congenital phimosis disappear in many boys. The head begins to freely emerge from under the foreskin. If this does not happen, you can consult a specialist and, if necessary, undergo a course of medication.

Phimosis in adolescents 16 years old

The persistence of congenital phimosis at 5 years and at an older age (up to the 16th birthday, when adolescence begins) may be a sign of physiological processes or a pathological abnormality. To understand what type of phimosis a boy suffers from, parents should carefully look at the symptoms. Redness of the skin on the penis, the inability to remove the head of the penis from under the epithelial fold on the skin, swelling and soreness of the foreskin sac, impaired urine drainage and its accumulation under the preputial sac, malaise, weakness, headaches - all these manifestations are a reason for immediate medical intervention .

Doctors begin to classify phimosis as a disease and pathological deviation of sexual development in a child when the boy turns 7 years old. During the diagnostic process, the doctor looks at the state of the prepuce, the degree of narrowing of its outer edges and, based on this information, determines the degree of pathology and the causes of its occurrence.

Causes

Phimosis in early childhood is dangerous due to the high probability of its transformation into pathology. The mucocutaneous membrane that forms the cap over the head of the penis is tightly closed at the very beginning of a boy’s life. It is impossible to perform hygienic procedures under it, so pathological bacteria can accumulate there, contributing to the development of the inflammatory process. This is the main cause of phimosis in children.

Physiological and pathological phimosis in boys: causes of occurrence

Factors in the development of phimosis in childhood in boys depend on the type of deviation. For example, doctors cannot accurately determine why physiological phimosis develops in newborn babies. Most often, its causes are associated with genetic predisposition.

The pathological causes of phimosis in boys are as follows:

• insufficient, poor-quality hygiene of the external genitalia in boys, due to which the infection gets under the prepuce and provokes the development of inflammation;
• wounds, injuries, microscopic tears in the skin on the head or foreskin;
• past diseases and inflammatory processes in the genitourinary organs (balanitis, balanoposthitis).

Phimosis: causes in children

Phimosis in boys of different ages can also appear due to the following factors:

• deficiency of connective tissue in the child’s body;
• overly uncomfortable clothing that squeezes and rubs the boy’s genitals;
• injuries to the penis associated with inept actions of parents in the process of bathing a newborn baby.

Often in young boys, the penis and the fold of skin around it grow unevenly. The foreskin develops more slowly and therefore wraps too tightly around the head of the penis, making it impossible to expose it and perform the necessary hygienic procedures. The initial stages of childhood pathological phimosis are accompanied by progressive narrowing of the foreskin, injuries and scarring of its internal part. The situation is aggravated by further narrowing of the skin fold. An acute condition of head entrapment may develop, requiring immediate surgical intervention.

The symptoms of phimosis always help the doctor determine the causes of the pathology. The severity of signs, their number and characteristics contribute to the detection of the causative agent of the disease and the development of an effective treatment regimen.

Symptoms

The question of how to determine whether a boy has phimosis or not worries many parents. Note that the symptoms of this deviation vary depending on the age of the baby and the complexity of the course. If phimosis is diagnosed in boys, the signs and treatment of the disease are determined in accordance with external manifestations, the presence of complaints and acute conditions.

Phimosis in newborn boys: symptoms and features of the disease

Parents who want to know how to determine phimosis in boys (photo) who have just been born should know the physiological features of the structure of the genital organ in infants. For most boys, immediately after birth, the penis has one anatomical feature. His foreskin fuses with the head of the penis, so the latter cannot be exposed. This form of phimosis is not considered a problem; with it, the baby feels good and does not bother him with unpleasant sensations.

The situation is completely different with pathological phimosis of newborns. The disease develops already during the baby’s life and can take on various degrees and types. Signs of phimosis in a child under 1 year of age associated with pathological changes in the foreskin are represented by the following manifestations:

• exposure of the head of the penis is difficult (a symptom of cicatricial phimosis);
• hypertrophy of the foreskin, which is characterized by its excessive thickening and elongation (the skin protrudes beyond the boundaries of the genital organ, hangs from it like a proboscis, the head of the penis does not open because of this, some children have slight problems with urination);
• thinning of the foreskin, accompanied by maximum manifestations of phimosis in newborns (it is impossible to release the head of the penis, the baby has difficulty emptying the bladder, urine comes out in droplets or in a weak stream, its remains accumulate under the skin fold and provoke infection);
• blueness and swelling of the tip of the penis is a dangerous complication of phimosis (paraphimosis), in which the head of the genital organ is pinched by a narrowed fold of skin;
• increased temperature (a symptom of an inflammatory process, balanitis, balanoposthitis or diseases of the urinary system resulting from the penetration of infection from the foreskin into the urethra, ureters, bladder).

All the signs listed above require medical intervention.

Phimosis: symptoms in adolescents

The degree of phimosis in boys, symptoms and treatment of the disease are interrelated with each other. When doctors diagnose “phimosis” in teenage boys, they already call the inflammatory process a disease and pathology that needs to be eliminated with medication. Often in such situations it is impossible to do without surgery.

Phimosis in adolescents is often associated with the onset of puberty. The external genitalia develop intensively, as a result of which the size of the foreskin may not correspond to the parameters of the penis. During this period, the skin fold does not have time to grow behind the head of the penis, strongly tightens it and injures it. Phimosis and symptoms in children manifest themselves in the form of the following deviations:

• the head of the penis does not open well at rest, sometimes it is not exposed at all;
• an inflammatory process develops, the foreskin swells and becomes red;
• the teenager has difficulty urinating;
• sexual desire decreases;
• the size of the genital organ changes, its swelling is observed;
• pus accumulates under the foreskin, which can come out through a narrowed opening;
• pain and discomfort when trying to expose the head of the penis or during urination;
• hanging of the foreskin from the penis, pinching the head with it.

Symptomatic manifestations of pathological phimosis in adolescents can appear complexly or individually. In any case, if there are alarming signs, you should consult an andrologist.

What does Komarovsky say about phimosis (signs of inflammation of the foreskin in children)

Dr. Komarovsky identifies the following signs of phimosis in boys (photo):

• difficulties in exposing the head of the organ;
• pain when urinating;
• the head of the penis does not close completely;
• the color of the head changes;
• the foreskin becomes so inflamed that the pathological process becomes clearly visible;
• the fold of skin hypertrophies and hangs from the penis.

Komarovsky draws parents' attention to the fact that the symptoms of physiological phimosis in newborns look somewhat different. A small child cannot yet say what hurts. However, parents will be able to understand that something is wrong with the baby’s health, because he is constantly capricious, crying and refusing to eat. The list of pathological symptoms is supplemented by external signs in the penis area. The intimate organ swells, becomes edematous, and acquires a bluish tint. Older boys, due to discomfort in the penis, constantly adjust their underwear and try to scratch the area near the pubis.

Evgeniy Komarovsky gives parents of children useful tips to help reduce the severity of symptoms of phimosis, as well as to properly prevent this disorder.

1. Signs of phimosis can always be prevented. The boy's parents simply must carefully monitor the hygiene of his external genitalia.
2. You need to bathe your child every day, paying special attention to the cleansing of the genitals. In the evenings, the genitals should be washed with clean warm water without using soap.
3. Under no circumstances should you forcibly expose the head of your penis. Some parents make a big mistake by trying to pour soap suds under the child’s foreskin to better clean the internal cavity of the “pouch.” This cannot be done, because the chemical components included in the soap can cause irritation, and the water remaining inside will become a favorable environment for the life of pathological bacteria. As a result of such improper actions, an inflammatory process develops under the foreskin, and suppuration may occur.
4. A newborn baby needs to change diapers often. This will help avoid prolonged contact of the glans and foreskin with excrement (feces and urine).

Adults should pay due attention to suspicious symptoms so as not to miss the moment and show the baby to a highly specialized doctor in time. The specialist will not only detect the symptoms and causes of pathological phimosis, but will also prescribe an effective course of treatment.

Treatment

How to treat phimosis in boys, what to do when diagnosing such a pathology? This question is relevant for many parents, who were informed by a pediatrician about this peculiarity of the development of the foreskin in a newborn. Physiological phimosis does not require correction, since it is asymptomatic and goes away a few years after the birth of a boy. Treatment of phimosis in childhood is necessary if the deviation takes on a pathological form.

How is phimosis treated in boys? Basic methods and techniques

Therapy for pathological phimosis in boys is carried out using a variety of methods. The choice of treatment method depends on the following factors:

• severity of the disease;
• degree of disease;
• boy's age;
• presence of complications;
• diagnosing concomitant diseases.

After detecting phimosis in boys (photo), treatment is carried out using 2 methods:

• surgical;
• conservative.

If a child is not yet 6-7 years old, his phimosis most often has a physiological nature. It is not worth eliminating it with surgical methods. Pediatricians recommend that parents observe the dynamics of the development of phimosis and prevent its complications using conservative methods at home.

How to cure phimosis in a child using conservative methods?

Caring parents often ask pediatricians what to do if their child has phimosis. When answering questions, specialists take into account the stage of the disease. If the pathology has just begun to develop, there is every chance of getting rid of it without surgery. In general, doctors in many cases try to avoid surgical intervention for phimosis in boys. Radical manipulations are associated with risks, so preference is given to conservative methods of eliminating defects of the foreskin.

The main non-surgical methods of combating phimosis in children:

• gently sliding the foreskin by hand;
• the use of hormonal ointments, which are based on the component cortisone (Betamethasone, Clobetasol);
• using a finger or instrumental method of stretching the foreskin.

Conservative treatment options for childhood phimosis are used to eliminate stages 1 and 2 of the disease. In more severe cases, they are not effective and are replaced by surgery.

Treatment of phimosis in children with surgery

Surgical removal of phimosis in children is a radical method of correcting pathology, which is used in cases of ineffective conservative treatment. The surgical method of eliminating phimosis is considered the most effective, because it is guaranteed to help eliminate the problem and prevent relapses.

Surgical treatment of phimosis in children is mandatory if the disease is complicated by pinching of the head of the penis (paraphimosis). Without surgical intervention, the tissue of the head of the penis will quickly die, and eventually gangrene will develop. In this situation, the genital organ must be amputated.

Surgical treatment of the foreskin involves its complete or partial excision. Surgeons use various surgical techniques, but in most cases circumcision (cutting of the foreskin) is used. Circumcision of the foreskin involves partial or complete excision of the skin fold above the head of the penis. Sometimes, under local anesthesia, a specialist will make a small incision in the foreskin to surgically stretch it. This method includes the following techniques:

• dorsal incision (an incision in the skin of the foreskin, including transverse locks, running along the back of the inflamed ring of the hindpuce; the surgeon subsequently stitches it together using transverse sutures);
• triple dissection of the skin fold (the method helps to expand the foreskin and is based on the surgeon creating 3 longitudinal incisions of small length, expanding the foreskin to the required parameters and suturing the created incisions; the operation is performed using general anesthesia; adolescents can be given local anesthesia);
• lateral incision (analogous to the dorsal incision, but with a small addition in the form of 2 longitudinal notches on the sides, subsequently sutured with transverse sutures).

The above techniques belong to a surgical procedure called preputioplasty (foreskin surgery) and are used to treat phimosis in adolescents. Sometimes, to expand the foreskin, the surgeon makes a zigzag incision on its surface and then sutures it. The effectiveness of this method is quite high. In 99% of cases, surgery is successful and does not cause any complications.

If surgical treatment turns out to be ineffective, the boy develops complications in the form of long-term chronic processes. Against this background, the risks of infectious diseases or cancer of the head of the penis increase. For cicatricial phimosis, conservative treatment methods are ineffective, so with this diagnosis in boys, the doctor advises surgery. Treatment of phimosis after surgery should be effective and correct - this will help avoid complications.

Phimosis in boys: treatment after surgery

Postoperative therapy for phimosis in boys of different ages is aimed at eliminating infection, relieving swelling and inflammation. The task of parents is to provide the baby with quality care after the surgical procedure. If the baby complains of pain during urination in the postoperative period, you can dip his penis in warm water for a few minutes. This method helps relieve tension in damaged muscles. After using it, the boy will no longer be in so much pain. The surgeon who removed the phimosis must prescribe an antibacterial ointment for applying bandages. The need for dressings continues for the 1st week, then they are canceled. Recurrence of phimosis is possible only if the foreskin is not completely excised. With complete removal of the skin fold, the likelihood of complications during the rehabilitation period is minimal.

How to treat phimosis in a child at home

It is possible to treat childhood phimosis at home if the pathology has a hypertrophic form. The therapeutic course takes a long time (up to several months without a break), and treatment procedures are recommended to be performed at least 3 times a week.

The essence of home treatment is to perform certain manipulations when bathing the boy. Parents should gently move the foreskin upward until the child begins to complain of pain. You also need to pour a little Vaseline oil (3-4 drops) inside the preputial sac. But it is worth remembering that treatment procedures performed at home will not help eliminate cicatricial phimosis.

To make the skin with hypertrophic phimosis more elastic and pliable, hormonal ointments (for example, hydrocortisone or prednisolone) must be applied to it. They will soften the foreskin, give it elasticity and facilitate the stretching procedure. Ointments are applied inside the preputial cavity regularly until recovery occurs. The boy’s parents must agree with the doctor on the use of hormonal ointments for home treatment of pathological phimosis.

So, let's summarize. Childhood phimosis, which is physiological in nature and does not cause discomfort to the child, is considered normal. It is not treated until complications occur. If any appear, the boy should be shown to a urologist or andrologist. A visit to a specialist should also be made if the head of the penis has not opened by the age of 13-16. If a child has undergone surgery to eliminate phimosis, parents should definitely ask the surgeon about the specifics of the postoperative period.

Postoperative period

Phimosis in a child after the operation continues for some time with painful sensations. The boy feels discomfort because of the applied bandage with ointments that heal the wounds. The stitches also get in the way and hurt a lot. The process of urination becomes painful and uncomfortable and completely unpleasant. Usually painkillers are not used during this period.

Postoperative period after phimosis in children - what you need to know about its features

After removal of phimosis, the postoperative period in children is associated with regular and frequent changes of protective dressings soaked in antibacterial ointments. It is recommended to change them daily or at least once every 2 days. You should also take the following tips into account.

1. Do not get the bandage wet. If it gets wet from urine, the alkaline environment of this biological fluid will irritate and corrode the postoperative wound. Because of this, the healing and recovery process will take a long time.
2. Surgical sutures may be removed no earlier than 1 week after surgical procedures.

After phimosis is removed from the child, drug antibacterial therapy is carried out using corticosteroid ointments. Normalization of temperature usually occurs on the 2-3rd day after surgery.

Ointment for phimosis in boys

The use of ointments to treat phimosis in boys is permitted only after a preliminary examination of the child and consultation with a doctor. During the examination, the specialist confirms the diagnosis and determines whether the baby has any contraindications to glucocorticosteroid medications. It should be noted that with pathological changes in tissue in the penis area (the appearance of scars and adhesions), the use of ointments is not effective.

Ointment for phimosis in children and its advantages

Ointments against childhood phimosis have the following important advantages:

• help maintain the integrity of the foreskin;
• increase the elasticity of the skin fold over the head of the penis;
• become doubly effective when combined with exercises to stretch the foreskin;
• prevent the development of inflammatory diseases, promote rapid healing of microcracks that appear after stretching of the prepuce.

The list of effective conservative medications for eliminating childhood phimosis includes not only ointments, but also hypoallergenic creams with antiseptic gels.

Ointments for phimosis in boys: list of the best drugs

To successfully cope with phimosis in a child, parents should listen to the recommendations of doctors and give preference to corticosteroid ointments with antibacterial and hormonal components in the composition. The following list presents the best of them.

1. Hydrocortisone. Glucocorticosteroid ointment, which has a suppressive effect on the formation of connective tissues. The product affects the metabolic processes of carbohydrates and proteins.
2. Betamethasone. Effective ointment on a synthetic basis. It is most often prescribed for the treatment of phimosis in boys and men.
3. Budesonide. An ointment from a series of prednisolone drugs, approved for long-term use.
4. Clobetasol. A white ointment that has a mild systemic effect on the affected areas of the genital organ.
5. Diprosalik. Combined ointment against phimosis, which includes salicylic acid and betamethasone dipropionate.
6. Prednisolone. A synthetic-based medicine in the form of an ointment, which is 3-4 times more effective than hydrocortisone and 4-5 times more effective than cortisone drugs.

The listed glucocorticosteroids suppress the formation of connective tissue and prevent the movement of leukocytes to the site of inflammation. Their systemic use helps relieve swelling, eliminate inflammation and allergic reactions.

Levomekol for phimosis in boys, principle of action and tips for application

Levomekol ointment contains the immunostimulating substance methyluracil, as well as the antibiotic chloramphenicol. Doctors recommend using it after operations to remove phimosis. The product perfectly heals microtraumas of the skin, restores damaged tissues of the head, and removes wounds. It is better to use Levomekol 2 times a day, in the morning and evening hours. 2 weeks after regular use of the ointment, wounds in young patients heal completely, the functions of the foreskin are restored, and the inflammation under it disappears. In order for the drug to be as effective as possible, the skin fold above the head of the child’s penis is lubricated with it after bathing. Allergy tests are required before starting treatment with Levomekol. High hypersensitivity to the components of the hormonal drug is the main contraindication to its use for therapeutic purposes.

The hydrocortisone drug Levomekol is widely used to treat constricted foreskin in children. This ointment is a combination preparation and allows you to achieve a pronounced anti-inflammatory effect. Therapy using the product promotes good tissue regeneration.

Diprosalik: ointment for phimosis in a child, its properties and characteristics

Reviews on medical forums about Diprosalik ointment for phimosis in a child are mostly positive. The child’s parents are satisfied with the results of using the medicinal composition. The drug eliminates burning and itching and effectively fights the developed inflammatory process. The active components of Diprosalik quickly eliminate pathogenic bacteria and leave no trace of severe redness around the genitals. The use of this ointment helps to stretch the connective tissue and speed up recovery. The active ingredients of Diprosalik medicinal ointment are salicylic acid and betamethasone dipropionate. Due to them, its effectiveness in the fight against infectious diseases and inflammation increases. To achieve the desired effect from using the drug, the boy’s parents should know how to apply Diprosalik to a child with phimosis. Manipulation involves following such advice.

1. The drug is used only after bathing, when the skin of the foreskin is well softened.
2. Diprosalik is used to treat only damaged areas of skin in the penis area.
3. When the ointment is applied, the prepuce is carefully pulled back, fingers are placed under the foreskin and pushed apart.
4. The procedure is performed for 10 minutes.
5. It is recommended to use the ointment 2 times a day.
6. The duration of therapy is determined individually at a consultation with a doctor. Most often, the course of treatment for phimosis in children using Diprosalic varies from 1 week to 1 month.

Celestoderm for phimosis in children

Ointments for the treatment of phimosis in children, made on the basis of hydrocortisone, provide a good therapeutic effect in a short time. Among such drugs is the drug Celestoderm. This ointment has pronounced antiallergic and anti-inflammatory properties, eliminates itching in the external genital area. Celestoderm constricts blood vessels well and therefore ensures the fastest possible treatment. The ointment is completely odorless and small patients do not complain of an unpleasant aroma when applying the composition. The presence of hydrocortisone in the composition determines the presence of excellent antimicrobial properties. Celestoderm softens the foreskin well, but manufacturers do not recommend using the drug if there are wounds and ulcers on the skin of the penis. Contact of the ointment with the damaged dermis can cause a burning sensation.

Cream for phimosis in boys

Special creams are often used to treat phimosis in boys of different ages. Andrologists recommend paying attention to the composition of Akriderm. Its main component, betamethasone dipropionate, quickly eliminates infection, promotes the healing of wounds, cuts and a speedy recovery of the child. According to the manufacturer's instructions, Akriderm should be used 3 times a day. The thick composition of the cream is applied to the inflamed area of ​​the genital organ and lightly rubbed into the skin. The course of treatment is 3 weeks.

Another good anti-phimosis cream for children is called Lokoid. Its action is aimed at stretching the foreskin, fighting infection and restoring the healthy state of the boy’s genital organ. The ointment is based on hydrocortisone 17-butyrate. It is its active action that helps eliminate infection, inflammation and itching. Akriderm is recommended to be used 1-3 times a day for 2 weeks. Usually this time is enough for the head of the penis to fully recover and the sexual organ itself to return to normal.

The effectiveness of ointments against childhood phimosis depends on the correctness of their selection and application. To eliminate the disease in a boy, his parents should select an ointment in accordance with the instructions presented below.

The application of ointment for phimosis is carried out carefully and taking into account the following notes.

1. It is necessary to wash the head of the penis along with the foreskin with chamomile decoction, furatsilin or a weak solution of potassium manganese before applying the ointment to the pathological area.
2. The wet skin of the penis should be dried with a towel, and then a little medicinal ointment should be applied to the head of the penis (if it opens even a little) and the inside of the foreskin.
3. It is forbidden to forcefully open the head of the genital organ in order to apply ointment over it. Due to such actions, the delicate epithelial tissue is injured and scars form on it.
4. Therapy of phimosis with corticosteroid ointments can be supplemented with baths of herbal decoctions, which will soften the skin of the foreskin well. Also, the inflamed skin fold over the head of the penis can be washed with barley decoction or an infusion of chamomile flowers and leaves.

Ointments against phimosis cannot be used if the boy has concomitant diseases (chicken pox, skin tuberculosis or herpes). Contraindications to the use of ointments are also diseases of the cardiovascular system, diabetes mellitus, and poor functioning of the kidneys or liver. Treatment of pathology in case of detection of concomitant diseases is carried out according to an individual scheme developed by the doctor. If there is no therapy for phimosis, the disease will progress, complications and adverse consequences will appear.

Consequences

A narrowed foreskin does not always cause discomfort to a small child, so parents do not bring him to a doctor for consultation. However, adults should remember that phimosis without medical supervision and treatment often leads to the development of associated health problems. For example, the skin above the head of the penis loses mobility and sensitivity, the penis takes on an ugly appearance, and more serious diseases appear that pose a danger to the general and reproductive health of a man. This article will tell you why phimosis is dangerous in boys and what can happen if this pathology is not treated in a timely manner.

Consequences of phimosis in a child

Childhood phimosis is dangerous, primarily due to its complications. If therapy for this disease is not carried out, the child develops the following pathological conditions.

• Paraphimosis. The most dangerous complication of childhood phimosis is associated with pinching of the head of the penis. A dangerous situation is often associated with forced opening of the head of the penis. The narrow foreskin cannot return to its original position, strongly compresses the head and impairs blood circulation in it. The head of the penis acquires a bluish tint and becomes sharply painful. In this case, the boy is indicated for emergency surgical care. Delay is dangerous due to necrosis of the tissues of the head and its amputation.
• Inflammatory diseases, balanoposthitis, balanitis. Inflammation of the foreskin or head of the genital organ is one of the unfavorable consequences of phimosis, which develops with systematic non-compliance with the rules of intimate hygiene. The area under the foreskin is more often infected in boys with reduced immunity or children suffering from any infectious disease. Characteristic signs of inflammation of the foreskin or head of the penis in a child are swelling of this skin fold, redness of the organ, the appearance of purulent discharge from under the prepuce, and severe pain. If the inflammation is not treated in a timely manner, phimosis progresses, and scars form on the skin of the foreskin. Boys with balanitis or balanoposthitis definitely need emergency medical attention. The separation of scar tumors on the inner part of the prepuce is carried out by a surgeon. He carefully inserts a probe into the space between the skin fold and the head of the penis and uses it to separate existing scars. The procedure allows you to create the necessary conditions for the outflow of accumulated pus.
• Acute urinary retention. This condition is often a reflex and is observed in young children. The child tries to avoid the pain that occurs with each urination, so he delays the process of urine flow. A boy who cannot empty his bladder for a long time experiences anxiety and complains of pain over the groin area and in the tummy. When palpating the area above the pubis, a distended bladder is felt.
• Formation of smegmolites. Pebbles inside the foreskin sac (smegmoliths) are formed due to inflammation caused by stagnation of sperm. The seminal fluid does not completely come out due to the narrowed foreskin, it stagnates and becomes a favorable environment for pathogenic bacteria.
• Fusion of the foreskin and the head of the penis. The fold of skin above the head of the boy's penis moves with difficulty. Constantly being in one position, it fuses with the epithelial tissues of the head. If the genital organ is not touched, such adhesions do not create discomfort. But any attempts to expose the head and move the prepuce upward lead to sharp pain and bleeding from the penis.
• Oncological pathologies. Cancerous tumors in the penis are formed due to stagnation of smegma. Secretory fluid in large quantities becomes a fertile environment for the appearance of carcinogenic substances. It is carcinogens that give impetus to the formation of papillomas and malignant tumors.

So, with phimosis in children, the consequences can be dangerous. Therefore, an experienced urologist should treat this disease. All medical procedures and home therapy must be carried out under his strict supervision.

Does phimosis affect conceiving a child?

The boy's parents must understand that phimosis must be treated on time. The disease, which has reached its highest, category 4, is dangerous due to impaired reproductive functions in adulthood. Men who have had to deal with inflammation of the foreskin often ask their doctor the following question about phimosis: is it possible to have children with this disease? It also worries parents whose children have suffered pathology. Experts say that only the last stages of phimosis (3rd and 4th) pose a danger to full conception. Advanced phimosis provokes impaired ejaculation and leads to infertility.