A tight foreskin is also medically known as phimosis if it cannot be retracted to fall behind the glans penis. This condition is a common observation among infants and toddlers. For a long time, the main form of treatment has been through circumcision. This is, however, changing and parents are opting for other forms of management. We will have a look at some of the ways used to relieve tight foreskin without circumcision.
A proper diagnosis is essential before a decision to intervene can be made. It is worth noting that up to 96% of all male infants may exhibit some form of non-retractability of the prepuce. The presence of natural adhesions between the prepuce and the glans penis is responsible for most of these cases and thus the condition is termed physiological phimosis. This is different from pathological phimosis which is caused by abnormal conditions such infections and trauma.
The physician needs to determine which of the two types they are dealing with because this will have a bearing on the method of management to be used. The physiological type is often managed conservatively while the pathological type will more often than not require circumcision. Left untreated, the pathological type may persist for months and lead to problems in the entire urinary system.
There are a number of reasons as to why circumcision may not be preferred by a number of parents. One of them is cultural practices where the parents are against the practice as a cultural belief and would only have it if there were no other options available. Some patients may have genital malformations such as epispadias and hypospadias for which the foreskin is used in surgical correction. The foreskin cannot, therefore, be removed before this operation.
Circumcision is at times the right procedure to be undertaken but may not be carried out for one reason or the other. For instance, the parents may decline it on cultural grounds which means that an alternative must be sought. Circumcision is also considered inappropriate when the foreskin is to be preserved for future operations such as the corrective of urethral abnormalities (hypospadias and epispadias).
Conservative surgery also has its place. This is a procedure in which only part of the skin is incised while the rest is left intact. An example is prepu-tioplasty which involves the creation of a small incision on the upper part. Others include frenulotomy and meatoplasty. The main benefits include, quicker recover, less cost and simplicity. The downside is that phimosis may recur.
Topical steroids are another effective option. The success rates associated with steroid use tend to range between 65 and 95 per cent. The mechanism involved is quite unclear but a substance referred to as lipocortin is believed to be involved in mediating local anti immunity and anti-inflammatory actions. The main downside is that the steroids may result in skin thinning.
Phimosis has been treated through circumcision for many years. This has been changing recently for a number of reasons. Some of these reasons include the fact that circumcision is quite costly and is associated with surgical risks. A number of alternatives to circumcision now exist and these offer some advantages. All the alternatives should be considered before a final decision on what is most appropriate is made.
A proper diagnosis is essential before a decision to intervene can be made. It is worth noting that up to 96% of all male infants may exhibit some form of non-retractability of the prepuce. The presence of natural adhesions between the prepuce and the glans penis is responsible for most of these cases and thus the condition is termed physiological phimosis. This is different from pathological phimosis which is caused by abnormal conditions such infections and trauma.
The physician needs to determine which of the two types they are dealing with because this will have a bearing on the method of management to be used. The physiological type is often managed conservatively while the pathological type will more often than not require circumcision. Left untreated, the pathological type may persist for months and lead to problems in the entire urinary system.
There are a number of reasons as to why circumcision may not be preferred by a number of parents. One of them is cultural practices where the parents are against the practice as a cultural belief and would only have it if there were no other options available. Some patients may have genital malformations such as epispadias and hypospadias for which the foreskin is used in surgical correction. The foreskin cannot, therefore, be removed before this operation.
Circumcision is at times the right procedure to be undertaken but may not be carried out for one reason or the other. For instance, the parents may decline it on cultural grounds which means that an alternative must be sought. Circumcision is also considered inappropriate when the foreskin is to be preserved for future operations such as the corrective of urethral abnormalities (hypospadias and epispadias).
Conservative surgery also has its place. This is a procedure in which only part of the skin is incised while the rest is left intact. An example is prepu-tioplasty which involves the creation of a small incision on the upper part. Others include frenulotomy and meatoplasty. The main benefits include, quicker recover, less cost and simplicity. The downside is that phimosis may recur.
Topical steroids are another effective option. The success rates associated with steroid use tend to range between 65 and 95 per cent. The mechanism involved is quite unclear but a substance referred to as lipocortin is believed to be involved in mediating local anti immunity and anti-inflammatory actions. The main downside is that the steroids may result in skin thinning.
Phimosis has been treated through circumcision for many years. This has been changing recently for a number of reasons. Some of these reasons include the fact that circumcision is quite costly and is associated with surgical risks. A number of alternatives to circumcision now exist and these offer some advantages. All the alternatives should be considered before a final decision on what is most appropriate is made.
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