Difficult uncapping can cause complications in young men and adults. Possible causes with Antoine Faix, urologist and andrologist surgeon.
We call “phimosis” a narrowing of the foreskinthe skin surrounding the glans of the penis, which prevents scaling partial or complete. With the exception of infancy, where phimosis and preputial adhesions are quite naturalphimosis can occur at any age for a variety of reasons.
What are the causes of phimosis?
► The functional phimosis : “An adult or even a teenager can have a foreskin that he manages to retract at rest, but when erect, the elasticity of the foreskin is not enough. We then speak of a functional phimosisresponsible for pain during masturbation or sexual intercourse. It is most often a phimosis existing at least already in childhood but which has not disappeared“, explains the surgeon.
► The secondary phimosis : It is a phimosis which appears when the capping was not a problem before. “Of the skin problems, dermatological pathologies, local infectionsat the level of the foreskin can thus be responsible for difficulties in retracting, at rest, in erection, or both, in adults: eczema, lichen, psoriasis, penis tumor, mycosis, syphilitic chancre and any other local genital infection“, further specifies the professional.
What are the causes in adults?
Phimosis can more rarely appear in adults and be linked to diabetes or sclero-atrophic lichen. the adult man can also suffer from a phimosis which he did not realize as a child and which is revealed during erections.
“Not being able to uncap a newborn, a toddler, is normal and should not be done”
What causes phimosis in older men?
The capping can affect adult men at an advanced age. “We’re talking about elderly man’s phimosis. In the absence of erections and sexual intercourse, the foreskin being a very thin skin, it can become damaged and sclerosed, with an inflammatory reaction. Circumcision may then be indicated. Phimosis can also be the consequence of diabetes, diabetics being more exposed to the risk of balanitis, these inflammations of the glans can be the cause of phimosis. Finally, phimosis can be of traumatic origin.
What are the causes of phimosis in children?
“Almost all children are born with the foreskin glued to the glans, we then speak of physiological preputial adhesions. Not being able to recap a newborn, a toddler, is therefore normal and should not be done. That then gradually peels off, starting at two or three yearsusually at the same time as potty training. It is important that the child has decapped before puberty at least partially. This should therefore be checked by the pediatrician or general practitioner“, develops Antoine Faix. According to figures from Health Insurance, the Complete removal of the glans is possible in only 4% of newborns, 50% of 3-year-old children and 99% of adolescents. “The decalottage without at least local anesthesia is no longer indicated because it is extremely painful and traumatic for a child”says the doctor. the little child, in the shower or while urinating in particular, breaks down on its own and will gradually reach full capping. “If the child is embarrassed, if he feels burning, then at this time we discuss a release of adhesions or possibly a circumcision or a preputial plasty, but never again a resection in consultation”, repeats our expert.
When to worry?
“If at the age of 6 or 7, the little boy still hasn’t taken off his cap at the very least and he has symptoms (difficulty urinating properly, burns, inflammation, etc.) this can be an indication to release the adhesions and in some cases proceed to circumcision or foreskin plasty“, explains Antoine Faix. If the phimosis is acquired, it is essential to consult. Treatment for phimosis will depend on its cause. “Anti-inflammatory, antifungal, healing, antibiotic ointments are indicated for phimosis secondary to a dermatological pathology. If local treatments do not work, then the solution is surgical“, notes the specialist. A circumcision (removal of the foreskin) or sometimes a plasty of the foreskin are then indicated.
“The latter allows to keep the foreskin, the intervention consisting in widening it. Circumcision will however be the only solution. if the skin is too damaged and cannot be kept. These surgeries are performed under local or general anesthesia, in a hospital structure. It is necessary, in my opinion, that they be carried out by a pediatric surgeon or urologist”. Most often, these are not painful procedures. “However, this can be unpleasant for the first few days during nocturnal erections.“, admits Antoine Faix. The stitches are absorbable and healing is complete within a month., even a month and a half. “An ointment may be prescribed to help with healing. Complications are exceptional when the procedure is performed by a competent surgeon in a hospital setting.“, concludes the urologist.
Thanks to Antoine Faix, urologist and andrologist surgeon, former head of the Andrology and Sexual Medicine Committee of the French Association of Urology.