Ointments and creams
If the phimosis is uncomplicated, i.e. there are no persistent or recurring infections and the urine flow is unimpeded, a conservative therapy can be tried first. Initially this means that it is possible to wait until the age of 3 years to see how it develops. In addition, ointments containing estrogen or cortisone can be used on an experimental basis.
Such ointments could be, for example, Ovestin (Estriol) or Dermoxin (Clobetasol) or Ecural (Mometason). These creams should be applied 2x daily under the foreskin and rubbed in. The whole is used for about 4 weeks. In about 80% of cases, this application leads to an improvement of the narrowing.
Stretching
In the case of phimosis, it is also possible to first try to stretch it gradually. In this case, ointments containing cortisone should also be used. During the daily application of the cream, the foreskin is always carefully moved. However, it should be noted that this should only be possible with no pain and without resistance! This procedure should be carried out over a longer period of time and can achieve results that do not require further surgical therapy.
Complications
In about 1% of the cases, phimosis causes secondary bleeding, wound healing disorders, secondary scarring and irregular wound edges are very rare (0.05% of cases). Another complication of phimosis is penis cancer. Phimosis and the resulting lack of hygiene leads to the development of foreskin sebum, the so-called smegma. This smegma is a risk factor for the development of penis cancer.
Other forms of phimosis
Infant phimosis: This is a fusion of the epithelium of the glans penis with the inner foreskin epithelium. This fusion usually resolves in the 3rd year of life, is considered physiological and therefore not an indication for surgery. Paraphimosis: Paraphimosis is an acute emergency situation and must be treated adequately and immediately.
The cause of paraphimosis is a retraction of a too tight foreskin behind the glans into the sulcus coronarius. The penis becomes swollen because the blood supply and the outflow of blood are interrupted. In the worst case, paraphimosis can lead to necrotizations (death) of the glans.
However, due to the very strong pain, paraphimosis is usually treated in time. Therapy is first of all manual repositioning by compressing the edematous tissue to such an extent that the foreskin can be pushed forward. If such a maneuver is not possible, the lacing ring is incised from dorsally (at the back) under anesthesia to avoid necrotizing the penis. After the swelling of the penis is reduced, the circumcision is performed.
