Phimosis and paraphimosis are called narrowing of the foreskin of the penis. With phimosis, it is impossible to expose the head of the genital organ. Paraphimosis, on the contrary, is a complication in which the head is difficult to “close”. Its narrowing occurs due to pinching of the foreskin during sexual intercourse or masturbation.
Author:
- Sorokin Nikolai Ivanovich, head of the urological service of the university clinic of Moscow State University. M. V. Lomonosova
3.00 (Votes: 4)
What is circumcision of the foreskin
Male circumcision is one of the most common urological operations. It is widely believed that circumcision of the foreskin is a very simple, routine procedure. But it is not so! In order to get an excellent aesthetic result after surgery (and not a rough, tugging, asymmetrical scar), it is very important that the procedure is performed by an experienced urologist surgeon.
In our clinic, the operation is performed by a urologist-andrologist, surgeon, Ph.D. BABIKIN Anton Vasilievich. The procedure is carried out according to the standards of aesthetic medicine: after circumcision, an invisible scar is formed.
Male circumcision performed for medical reasons is somewhat different from traditional circumcision and is more effective in treating phimosis, balanoposthitis, rapid ejaculation or eliminating hygiene problems.
Frequently asked questions
- Does circumcision affect penis size? - No. Circumcision does not affect the cavernous bodies and the glans.
- When can you start playing sports? – It all depends on the cutting method and the condition of the seam. As a standard, you can study after 2 weeks.
- When can you shower? – The day after surgery, but with penis protection. The seam can be wetted after 2 days, but do not soap or wipe it.
- How to go to the toilet after circumcision? − In the first days after circumcision, the urethral sponges may stick together, crusts and swelling may appear on them. In such cases, urine splashes and gets everywhere, including on the seam. To avoid this, before urinating, you can apply the cut-off body of a 20 ml syringe to the urethra.
- Is sick leave given after circumcision? – Sick leave will only be given if the circumcision is performed in a public clinic and the hospital stay is at least a week. If the operation is done in one day and without complications, then they do not give it.
- When can you go to the bathhouse or swimming pool? – In 3 weeks, when the stitches are removed and the marks from them have healed.
Reviews from our patients after circumcision of the foreskin
On the medical forum you can read reviews from our patients after circumcision surgery. Reviews are presented in the form of postoperative photo reports, which show how the healing progressed, what problems arose after the operation and how they were resolved.
The forum discusses the treatment of balanoposthitis, phimosis, rapid ejaculation caused by increased sensitivity of the head and foreskin, and other problems that completely disappear after circumcision of the foreskin.
We perform aesthetic circumcision, when the foreskin is not simply removed, but the patient’s wishes regarding this or that type of circumcision are also taken into account, and after the operation an almost invisible scar is formed.
Is it possible to do circumcision at home?
Circumcision on your own is called self-mutilation. Such manipulations are fraught with fainting, bleeding, blood poisoning, and ugly scars. If you can’t get to the doctor’s office with the question of circumcision, then theoretically you can call him to your home. Many religious families practice this, inviting relevant representatives of the community. It is difficult to persuade an ordinary surgeon to perform home circumcision, since if complications arise, he seriously risks his profession. Such manipulations fall under Article 235 of the Criminal Code of the Russian Federation on the illegal implementation of medical activities.
When is male circumcision performed?
Often circumcision of the foreskin is done simply at the request of the man . Circumcision in this case has several goals: it is a solution to problems with penile hygiene, increasing the duration of sexual intercourse with increased sensitivity of the head, and preventing inflammatory processes.
our operating room
The issue of appearance is important: some believe that the penis should look natural, others, on the contrary, are sure that after circumcision the penis looks more aesthetically pleasing.
Circumcision in men for medical reasons is carried out to treat phimosis (narrowing of the foreskin of the penis). Circumcision is also a method of treating chronic balanoposthitis (inflammation of the foreskin and glans) in the absence of effect from conservative therapy.
Cases of circumcision of the foreskin in older men and overweight individuals are usually associated with the development of diabetes mellitus and a decrease in local immunity, when chronic inflammation of the foreskin occurs with frequent exacerbations, ending in the formation of a narrowing. The operation is aimed at eliminating the substrate of the inflammatory process - the foreskin.
In some cases, removal of the foreskin is performed when correcting the curvature of the penis, as well as before using an extender to enlarge the penis. In the latter case, the operation is justified from the point of view of ease of use of the extender apparatus (it is easier to fix the head when the frenulum and foreskin do not interfere or are pinched).
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EXCELLENT RESULTS
Look at the results of treatment of our patients: photos before and after circumcision in men
REAL REVIEWS
You can chat with our patients on the forum and find out all the details
EXPERIENCED SPECIALISTS
Circumcision of the foreskin and other operations in the intimate area are performed by Dr. BABIKIN A.V.
REMOTE DIAGNOSTICS
Don't waste time! Get diagnosed remotely. If the diagnosis is confirmed, come immediately for surgery.
LOW PRICES
We have a transparent pricing policy. The cost of the operation includes all stages of treatment until complete healing and does not change!
THE DOCTOR IS ALWAYS IN CONTACT
Our doctors are always in touch: telephone, forum, email. You will not be left alone after the operation, even if you cannot come to the clinic.
What types of phimosis are there?
Men who have had to deal with this disease want to know what types of phimosis there are.
Depending on the characteristics of development, the following types of phimosis are distinguished:
- Hypertrophic . It is characterized by narrowing of the foreskin and thickening of the epithelium, which protrudes beyond the head.
- Atrophic . The foreskin becomes very thin and atrophies.
- Scar . Difficulties in opening the head arise due to scars formed on the foreskin.
If phimosis is diagnosed in men, a photo helps them determine the type of disease. Regardless of how phimosis develops in men, photographs of different stages of the disease help determine the presence of pathology and the need to see a specialist.
Why circumcision: pros and cons
What are the main advantages of a circumcised penis over an uncircumcised one:
- eliminating the risk of developing phimosis
- prevention of inflammatory diseases and sexually transmitted infections
Photos before and after circumcision are presented on our forum.
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In addition, the advantages of circumcision include:
- increasing the duration of sexual intercourse due to a slight decrease in the sensitivity of the head of the penis. At the same time, the fullness of sensations during sex does not decrease, but, on the contrary, increases due to the fact that the head is no longer covered by the foreskin during friction, but is in contact with the entire surface of the vaginal walls.
- a significant reduction in the risk of infection during sexual intercourse in women with the HPV virus, which causes cervical cancer (in men, this virus causes genital warts).
However, whether an adult man needs circumcision surgery in the absence of phimosis and inflammatory changes, only he can decide for himself.
Hygiene of the genital organs Indeed, an open head is more hygienic. The fact is that smegma accumulates between the foreskin and the head of the penis. Like any biological fluid, it is a favorable environment for the development of infection. Moreover, it has been proven that when stagnant smegma gets on the cervix during sexual intercourse, it contributes to the appearance of a tumor there (cervical cancer). To avoid all these troubles, a man has to regularly (at least twice a day) toilet his genitals - retract the foreskin and wash off the smegma. After circumcision, there is no need for such careful care. And rumors about the need for smegma for normal sexual life are greatly exaggerated.
Decreasing sensitivity of the glans and increasing the duration of sexual intercourse After circumcision, the glans of the penis becomes less sensitive, and due to this, sexual intercourse is prolonged.
Sometimes the time of sexual intercourse may not increase at all if a man’s rapid ejaculation was not initially associated with the sensitivity of the head of the penis, but was caused by other reasons.
In order to determine whether the duration of sexual intercourse will increase after circumcision and a decrease in the sensitivity of the glans, it is necessary to do a lidocaine test : treat the glans penis with lidocaine spray or gel, and then, when the drug is absorbed, wash off the residue with water and have sexual intercourse (you can use condom with anesthetic). If ejaculation occurs later than usual, then it is safe to say that circumcision will help prolong sexual intercourse.
On average after 1-3 months. after the operation, the head becomes less sensitive, and the duration of sexual intercourse increases by 2-3 times.
However, a decrease in sensitivity can also be considered as a “minus” of circumcision. According to our observations, problems arise in 0.5-1% of patients if the man had problems completing sexual intercourse before surgery.
Reducing the risk of contracting HIV infection
According to statistics, the majority of men who contracted HIV through sexual contact had uncircumcised foreskin. The increased risk of infection is explained by the fact that this part of the head of the penis is most susceptible to microtrauma, through which infection occurs more easily.
The cells of the foreskin mucosa are most vulnerable to HIV. Therefore, circumcision was recognized as a method of preventing infection with this infection. Although there is an opinion that this advantage only applies to residents of Africa, since countries on other continents have free access to condoms that are more effective in protecting against HIV.
Male circumcision surgery
Circumcision in men is performed under local anesthesia. Anesthesia is used for circumcision in children, or at the urgent request of the patient. The operation is performed to treat phimosis and balanoposthitis (for medical reasons), as well as when performing circumcision of the foreskin for religious reasons or the man’s own desire.
In the vast majority of cases, circumcision surgery is performed on an outpatient basis in a day hospital. Hospitalization is required in rare cases in the presence of severe concomitant pathology.
Reviews from men
Judging by the reviews on the forums, everyone is happy with the result of circumcision, but most have a rather difficult time with the first 2 weeks of recovery . After 2 months, men are already living full lives. Examples of reviews are below.
Circumcision of the foreskin in men: the cost of the operation
The price of the operation is circumcision of the foreskin with frenuloplasty - aesthetic circumcision is performed with the formation of a neat, inconspicuous postoperative scar! - 48 thousand rubles (The cost of tests is 2.5 thousand rubles. They can not be taken from us).
The price includes all expenses associated with the operation: preparation for the operation, the operation itself, local anesthesia, stay in the ward.
In our clinic, it is possible to perform circumcision of the foreskin on the day of treatment. The time spent in the clinic is only 2-3 hours!
Interesting article: “What determines the price of a circumcision operation - how much the operation should cost and how not to overpay”
Reducing the risk of contracting STDs and developing urinary tract infections
The first advantage of circumcision is that it reduces the risk of contracting sexually transmitted diseases. During the procedure, tissues that are most sensitive to infectious agents are removed. According to statistics, the risk of becoming infected with the human papillomavirus is reduced by 32-35%, and genital herpes – by 28-34%. According to other data, in Israel, where circumcision is very popular, syphilis is less common among men.
Circumcised men suffer from genitourinary infections 10 times less often. This is due to the fact that they do not have a foreskin, under which harmful bacteria can accumulate.
HOW IS THE TREATMENT PRODUCED IN OUR CLINIC?
In order to undergo treatment with us, please study this small section. You will have all the information, and it will be easier for us to conduct a dialogue.
- Check out this information:
- The price of the operation and what is included in the price
- What you need to know about the operation and how to prepare for it
- If you are having surgery to increase the duration of sexual intercourse, do a test with an anesthetic
- Look at the results and reviews from our patients to get an idea of how the healing is progressing and what the post-operative scar will look like.
- Contact us by email. email [email protected]
- Provide information about yourself and what you want to do. We will respond as soon as possible (usually within 1 day).
- In correspondence we will resolve the necessary issues.
- If there are many questions or it is difficult to discuss them by mail, we will invite you to an in-person meeting. But, as a rule, this is not required.
- Of course, we are always glad to see you! So, if you want, come for a consultation, let’s talk (indicate this in the correspondence).
- Together we will choose the date of the operation! We will send all the instructions: what you can and cannot do, how to prepare.
- You need to arrive at the clinic at the appointed time and tell the receptionist your name and that you are booked for an operation with Dr. Babykin.
- It is necessary to fill out the contract and pay for the operation. (The administrator will already have all the information about you and your operation)
- You will be taken to your room and told what to change into. Everything will be given out, you don’t need to take anything with you!
- Before the operation we will talk, I will answer your questions and ask mine.
- We will come to the operating room together, I will help you lie down on the operating table.
- It will take some time to prepare and treat the operation area.
- We will begin the operation and immediately administer anesthesia. It won't hurt!
- You can talk to us during the operation, but you must not disturb us.
- We will take you to the ward, where you will need to lie down for a while.
- We'll give you all the instructions and send you home.
- Observation, as a rule, takes place remotely - through a forum or by e-mail. Of course, you can come and show yourself - all this is included in the cost of treatment.
- The most important thing is to follow our recommendations and inform us about your condition every few days (just write a few words and attach a photo so that we understand that you are doing well).
- The sutures are absorbable and do not need to be removed. But if you really want to, you can come to the clinic or remove them yourself.
Symptoms
Parents often treat phimosis in boys very calmly, because There are practically no complaints from children, and doctors assure that by the age of seven this situation will normalize. In some cases, phimosis in boys may be indicated not only by difficulty exposing the foreskin, but also by the inability to urinate normally. The baby may worry, cry, urine does not always flow out in a stream, sometimes only in a drop.
Phimosis in men is accompanied by other symptoms, the degree of manifestation of which increases in proportion to the stage of the disease. If the disease progresses, inflammation appears, which accompanies pain in the tissues of the foreskin. Purulent discharge, high body temperature, general malaise and weakness, difficulty urinating, pain during erection are symptoms characteristic of phimosis.
How is circumcision performed?
After treating the skin of the penis with a disinfectant solution, local anesthesia of the surgical area is performed. To do this, a rubber tourniquet is temporarily placed at the base of the penis and an anesthetic is injected into the penis. Skin puncture is the only unpleasant moment of the operation for the patient. After injection of the anesthetic, pain sensitivity is completely disabled for the time necessary for circumcision.
Below is a diagram of the “standard” version of the circumcision operation using the two-incision method:
ATTENTION: this page contains only schematic images of what the penis will look like after circumcision. You can view PHOTOS of our patients AFTER FORESKIN CIRCUMSTANCE on our forum
Through a circular incision around the head of the penis, the layers of the foreskin are mobilized and excised with simultaneous plastic surgery of the frenulum (red dotted lines are the incision sites).
Dr. Babykin A.V.
In the case of “incomplete” circumcision, a second circular incision is made in such a way as to preserve more of the skin of the penis, which will subsequently fold over the head of the penis and imitate the foreskin. The foreskin itself (inner layer) and scar tissue (with phimosis) are removed in any case, so that there is no recurrence of phimosis or the formation of a constriction ring (if circumcision is performed incorrectly).
At the final stage of the circumcision operation, absorbable sutures are placed along the length of the skin incision, as well as sutures in the frenulum area. This concludes the operation. The patient is bandaged. And after 1-2 hours you can go home.
What will the penis look like after circumcision?
After healing of the surgical wound, an invisible scar remains (up to 1 mm wide), located circularly at a distance of 3-5 mm from the coronal groove of the head of the penis.
At the request of the patient, incomplete or partial circumcision is performed (when a large part of the skin of the penis remains, simulating the foreskin and partially covering the head), a standard version (the head is open when the penis is at rest), as well as tight circumcision (after which not only the foreskin is removed , but also most of the skin of the penis).
Look at examples of our work on the forum in the section before and after circumcision surgery
Why is phimosis dangerous?
Some men are in no hurry to see a doctor for examination and treatment because they do not know how dangerous phimosis is. If the disease is ignored, there is a high risk of developing serious consequences.
The most common complications of phimosis:
- Balanoposthitis . This is an inflammation of the head of the penis and the foreskin. With a narrowed prepuce, it is impossible to carry out proper hygienic procedures and remove the released smegma. It serves as a breeding ground for bacteria, which contributes to the development of inflammation. With pathology, severe pain, swelling and other unpleasant symptoms occur.
- Infectious lesions of the urethra and other organs of the urinary system . If you have difficulty urinating, there is a high risk of infection of the urethra. In addition, stagnation of urine can provoke the development of inflammatory processes in the bladder, urinary tract and other organs.
- Head pinching . If you try to open the head, it may become pinched. In this case, the foreskin compresses the head, resulting in impaired blood flow. As a result, the head swells, becomes bluish and very painful. Often in such situations, urgent surgical intervention is required, since there is a high risk of developing tissue necrosis.
At an advanced stage of the pathology, fusion of the foreskin with the head may occur due to constant close contact. Intimate intimacy and, accordingly, procreation are impossible in this case. In addition, with advanced phimosis, the production of sex hormones may be disrupted.
Knowing that pathology can cause complications, the question of whether phimosis is dangerous disappears. Any of its manifestations is a reason to immediately consult a doctor. To prevent complications of phimosis, do not delay treatment.
Hypertrophic and phimosis
The pathology is caused by improper development of the prepuce, when its tissue is excessively long and hangs from the penis like a “proboscis”. As a result, smegma accumulates under the foreskin and inflammation occurs, leading to balanitis and balanoposthitis. Without treatment, the situation can result in serious sexual dysfunction.
This disease is especially difficult against the background of diabetes mellitus. Excessive blood sugar provokes the growth of yeast and the development of thrush, which is difficult to treat. Impaired blood microcirculation in the vessels, characteristic of this disease, leads to impaired blood supply and the appearance of dense scars on the foreskin.
Sometimes the situation arises due to a physiologically small penis (hypogonadism). With this pathology, there is underdevelopment of the entire reproductive system (sexual infantilism), caused by a lack of sex hormones.
How does phimosis develop?
The mechanism of development of the pathology becomes clear when studying the structure of the male genital organ. The penis consists of a root, a body and a head, covered by the foreskin.
Inside the trunk there are two cavernous bodies and one spongy body, forming a kind of bulb at the bottom. When blood flows to them, an erection occurs. On top of the penis is covered with thin skin with a huge number of nerve endings, which allow you to receive pleasant sensations during sexual intercourse.
The head has two parts - a wider crown and a narrowed neck. At its end, the urethra, passing through the corpus spongiosum, is torn off.
Below the head there is a narrow coronal groove. Here the skin of the penis forms a movable foreskin (prepuce), which normally moves easily, held in place by a frenulum. The space between the inner layer of the foreskin and the glans is called the preputial sac.
The tissue of the prepuce is delicate and soft, since it consists of two stretchable sheets - the outer one, which does not differ from the rest of the skin of the penis, and the thin inner one.
The foreskin performs many functions:
- closes the sensitive head
, protecting it from irritation and hardening; - covers the urethra
; - its glands produce lubricant (smegma)
, which facilitates gliding during sexual intercourse; - Thanks to the nerve endings located, this skin, together with the frenulum attached to it, enhances the sensations
of sexual intercourse.
But sometimes the foreskin is not properly developed, has scarring or too rough, poorly stretchable tissue. In this case, the head is not exposed and phimosis occurs.
The reasons for this condition are:
- Congenital
, caused by improper intrauterine development of the boy’s genital organs. - Traumatic
, occurring when the foreskin is damaged during hard sex or unsuccessful intimate piercing. - Inflammatory
, appearing as a result of chronic inflammation of the head of the penis - balanitis, or an inflammatory process involving the head and prepuce - balanoposthitis.
Due to inflammation, the foreskin becomes dense, loses elasticity and mobility. Sometimes connective tissue adhesions - synechiae - form between it and the head, making movement of the prepuce impossible.
