Natural Treatment Is The Best Possible Way To Cure Phimosis

Phimosis and Paraphimosis

Phimosis (inability to retract foreskin over glans) and paraphimosis (inability to return retracted foreskin over glans) are possible complications seen in the uncircumcised male (Fig. 40-11). About 50 of boys typically are able to retract their foreskin by 1 year of age and 80 by age 3 (Anderson and Anderson, 1999). Topical estrogen therapy has been reported as successful, but no randomized trials support its use (Yanagisawa et al., 2000). However, low-potency topical corticosteroid therapy combined with daily prepuce retraction appears effective for phimosis (Zampieri et al., 2005).

Cutaneous Penile Horn

This is a rare exophytic, conical, keratotic mass, which arises in areas of chronic inflammation (Fig. 5.7) . Little is known about its pathogenesis, but longstanding preputial inflammation and phimosis are known to play an important role.48,49 Histological examination can reveal areas of keratoacanthoma, and even intraepithelial carcinoma. They have a risk of malignant transformation into low-grade verrucous or keratinizing SCC, reported in approximately 30 of cases.50,51

Neonatal Circumcision

Circumcision Uti

Circumcision has been used in religious rites for centuries and was used in ancient Egypt as a method for hygiene. Modern data in the United States is conflicting as to the benefits versus risks. By age 5 years, 90 of boys have a spontaneously retractable foreskin. The incidence of phimosis decreases with age and may be treated with a steroid cream. The medical approach to phimosis is initially successful in about 80 of cases and a year later 60 had no phimosis (Ku and Huen, 2007). Many parents still elect to have their male infants circumcised.

Genital Lichen Sclerosus Et Atrophicus LS

Condyloma Acuminata Papule

Balanitis Xerotica Obliterans (BXO) is now better defined as the male genital variant of lichen sclerosus et atrophicus (LS). It was initially described as a chronic, progressive, scleroatrophic inflammatory process of unknown etiology affecting the glans penis, prepuce, and in advanced cases, the anterior urethra and meatus, either individually or in any combination. It occurs almost exclusively in uncircumcised men. Lesions classically appear as pale, atrophic plaques, which may coalesce and sclerose, causing phimosis and meatal stenosis (Fig. 5.6). It presents most commonly in men in their third and fourth decades. Its exact etiology remains unclear theories have hypothesized a possible autoimmune element,34 or even a genetic basis based on HLA antigens,35 although the true pathogenesis is likely to be multifactorial.

Malignant Epithelial Tumors with Clear Cell Features 3461 Clear Cell Carcinoma

Penile Cancer

Clear cell papulosis is a rare clinicopathological entity which preferentially affects the pubic area of young Asian individuals.82-84 Clinically, multiple small white papules are seen along the milky line and lower abdomen. Histologically it is characterized by the presence of round cells with ample clear cytoplasm and bland cytology preferentially located in the bottom layers of the epithelium. The immunophenotype of these cells is similar to that presented by Paget cells but morphology is distinctive.82,84,85 Pagetoid dyskeratosis is frequently found in the inner foreskin of patients with phimosis.86-88 Histologically it is characterized by round pale cells interspersed between normal keratinocytes, predominantly located in the upper layers of the epithelium.88 Cytology remains bland and intercellular bridges are observed between the clear cells and the surrounding keratinocytes. Nuclei are centrally located and are small and pyknotic, occasionally pale, with a perinuclear halo....

Noncircumcision

The positive effect of circumcision is mainly explained by preventing conditions such as poor penile hygiene, smegma retention, and phimosis, which have been reported as risk factors for penile cancer.71011 Phimosis (or narrowness of the opening of the foreskin) leads invariably to retention of the normally desquamated epidermal cells and urinary products (smegma) resulting in conditions of chronic irritation with or without bacterial inflammation of the prepuce and the glans. The frequency of phimosis in men with penile carcinoma is between 44 and 85 and in case-control studies a 65-fold increased relative risk for penile cancer was recorded among males with phimosis.1011 When performing statistical analyses after exclusion of phimosis as a risk factor, the presence of a foreskin did not increase the risk of penile cancer.11 Although carcinogenesis has been attributed to chronic inflammation due to the irritating effects of smegma, to date a carcinogenic agent has not been identified...

Conclusion

Although rare, penile cancer is a disease with a high morbidity and mortality. Insight into its precursor lesions and risk factors offers measures for prevention. Careful monitoring of men with both HPV-related genital Bowen's disease, erythroplasia of Queyrat and Bowenoid papulosis and non-HPV related lichen sclerosus seems useful either to prevent penile cancer or to recognize penile cancer at an early stage, thereby offering conservative therapeutic options. Special attention is given to flat penile lesions, which contain high numbers of HPV and are highly prevalent in the male population. Their role in HPV transmission to sexual partners is highlighted, but their potential to transform as a precursor lesion into penile cancer has been explored unsatisfactorily. To date, the etiology of penile cancers is not completely understood and additional research is necessary to fully delineate the sequence of molecular events involved in HPV, non-HPV, and common (both HPV and non-HPV)...

Inspect the Penis

Phimosis is the condition in which the foreskin cannot be retracted, and it prevents adequate examination of the glans. Because the glans also cannot be cleaned, smegma builds up, leading to possible inflammation of the glans and prepuce (balanoposthitis). This chronic irritation may be a causative factor in cancer of the penis.

Penile Block

The indication for penile block is surgery on the foreskin (phimosis, paraphimosis, circumcision).112 122 The anatomic landmark is the pubic symphysis. The puncture is performed with a 22-G needle, which is 30 mm long. After gently pulling the penis downward and repered the pubic symphysis, the two points are marked just below each of the pubic rami, about 0.5 to 1.0 cm on either side of the pubic symphysis. The needle is introduced at the puncture site, perpendicular to the skin. The penetration is stopped in the subpubic space after a distinct elastic recoil is felt, corresponding to the crossing of the deep membranous layer of the superficial fascia. The depth of insertion depends on the patient's age (8 mm for a newborn 30 mm for a young adult). The same procedure is repeated on the opposite side. A volume of 0.1 mL kg is used for each side with 0.5 bupivacaine and no epinephrine. Epinephrine is absolutely contraindicated because it can lead to spasm of the dorsal arteries of the...

Genitalia

The foreskin is not fully retractable until 3 years of age or later. If you do manage to retract it, be sure you return it to its original location otherwise you may cause paraphimosis, a situation in which the retracted foreskin impedes venous drainage of the glans and results in progressive edema and pain. Diaper rash can cause balanitis, which is an acute inflammation of the glans penis. In boys who are uncircumcised, phimosis, the pathologic inability to retract the foreskin, may develop after balanitis. Observe the position of the urethral meatus.