Introduction
In the case of phimosis, it can happen that the narrowing of the foreskin does not recede by itself. Also the treatment with oils etc. is sometimes not promising.
In such cases, surgery is always necessary. Since the constriction often recedes of its own accord by the time the child reaches pre-school age, this is also the time when a possible surgical procedure is most likely to be considered. In this case, the narrowing is removed by means of circumcision or circumcision. This procedure can be performed quickly and usually on an outpatient basis.
Indication for surgery
Until the age of 2 years, phimosis is considered normal. An operation is usually recommended when the tightness causes inflammation, irritation or pain. Possible pain during urination can also be a reason for surgery.
Furthermore, an operation should be performed if the phimosis has not regressed by itself even up to pre-school age. In total, however, the patient should not wait longer than 8 years of age. At this age phimosis often becomes a psychological burden for the affected boys.
If the operation is performed at an early age, the chances that the child will retain very few memories and thus psychological stress of the phimosis are much higher. An operation at around the age of 6 is considered advantageous, because at this age the child can understand the purpose of the operation, but should not yet feel the intervention in the genital area as too stressful. At least in the case of existing complaints, however, the procedure should not be delayed too long.
Difficulties in urination, in connection with a possible inflammation of the foreskin, can greatly increase the risk of urinary tract infections. Also the usually poorer hygiene due to the fact that the foreskin cannot be completely pulled back favors the formation of inflammatory reactions and thus ultimately the risk of penis cancer. Last but not least, difficulties during sexual intercourse can also occur in the later course, for example so-called paraphimosis.
In this case, the foreskin, which is too tight, pushes back over the glans, but then forms a kind of lacing ring there, which hinders the blood flow and causes the glans to swell. Since the foreskin cannot be pushed back any other way, an acute surgical intervention is necessary. In general, an intervention should not be performed into an existing inflammation. In principle, a regression of the phimosis by the end of puberty is also possible on its own. However, the psychological stress described above should be weighed here.
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