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Phimosis in children
Hi
My son is 8 years old, and 2 weeks ago he came to show me that his foreskin does not retract (it always used to, with ease). I'm not sure how long this has been a problem as he simply says "since last week". I could see that he has not been cleaning his penis well as the foreskin was swollen and red.
I have treated him with an anti fungal and anti bacterial cream 3x day, so the infection has gone, but the foreskin still does not retract without effort, and then only in a warm bath does it retract a little.
With research I see that a steroid cream is suggested and I have found this research here: http://www.cirp.org/library/treatment/phimosis/orsola1/
Unfortunately seeing a Urologist is out of the question for us, as medical care in South Africa is very expensive and finances are really at an all time low at the moment.
Please could you advise if I am going in the right direction?
Many thanks
Jenni
South Africa
My son is 8 years old, and 2 weeks ago he came to show me that his foreskin does not retract (it always used to, with ease). I'm not sure how long this has been a problem as he simply says "since last week". I could see that he has not been cleaning his penis well as the foreskin was swollen and red.
I have treated him with an anti fungal and anti bacterial cream 3x day, so the infection has gone, but the foreskin still does not retract without effort, and then only in a warm bath does it retract a little.
With research I see that a steroid cream is suggested and I have found this research here: http://www.cirp.org/library/treatment/phimosis/orsola1/
Unfortunately seeing a Urologist is out of the question for us, as medical care in South Africa is very expensive and finances are really at an all time low at the moment.
Please could you advise if I am going in the right direction?
Many thanks
Jenni
South Africa
there is no reason to be embarassed. This is a common condition and doctors/nurses are professionals. I am a nurse and nothing I have seen has made me want to criticize the patient for any reason or judge them. Please see a doctor. The easiest way to tell your parents is probably that you have a problem "below" and you would like to see a doctor. I'm sure they will be concerned and take you to see one.
Hey I'm 13 an I found out I had phimosis when I was about 10. I am to embaressed to tell my parents and to young to seek medical help by my self. Is there a way to cure it without telling anyone?
Hi Dr Mathews,
After a year of posting this question, I happy to give a positive report with regards to my now 9year son and phimosis.
We were starting to panic when no change was observed, and I finally started using a cream called Betnovate Cream, using an earbud and only spreading a tiny amount to the edge of the foreskin. I was advised to teach him that rather than retracting the foreskin, rather pull the foreskin forward gently over the penis head as far it could go without hurting.
Within 3 weeks the foreskin has completely healed and the problem has not returned!
I hope you will get to read this!
Kind Regards
Jenni
After a year of posting this question, I happy to give a positive report with regards to my now 9year son and phimosis.
We were starting to panic when no change was observed, and I finally started using a cream called Betnovate Cream, using an earbud and only spreading a tiny amount to the edge of the foreskin. I was advised to teach him that rather than retracting the foreskin, rather pull the foreskin forward gently over the penis head as far it could go without hurting.
Within 3 weeks the foreskin has completely healed and the problem has not returned!
I hope you will get to read this!
Kind Regards
Jenni
Thank you so much for your informative reply!
The relief on my son's face was clearly huge, as we were all concerned!
His urine is not obstructed nor affected in any way, and there is no blood in the urine. The foreskin looks clean, but still tight.
I will give it a few more days before purchasing the cream, while we continue to train him with his personal hygiene.
I will certainly keep you posted, I appreciate this so much!
Kind Regards
Jenni
The relief on my son's face was clearly huge, as we were all concerned!
His urine is not obstructed nor affected in any way, and there is no blood in the urine. The foreskin looks clean, but still tight.
I will give it a few more days before purchasing the cream, while we continue to train him with his personal hygiene.
I will certainly keep you posted, I appreciate this so much!
Kind Regards
Jenni
MEDICAL PROFESSIONAL
Hi,
Please ensure that the urine stream is not affected by the difficulty in retraction.
Phimosis is a condition that does not require emergency care or surgiccal management unless accompanied by complications.
Paraphimosis is a serious condition that requires emergency care and hospitalization. This is characterized by other symptoms like severe pain, blood in the urine stream, swollen and inflammed glans.
"Medical Care
* Daily cleaning, without forceful retraction of the foreskin, is the only treatment necessary for phimosis in patients without urinary obstruction, hematuria, or preputial pain.
*
* Treatment with topical corticosteroids is effective in separating the loose adhesions found between the glans and the foreskin.
*
* In 2001, French researchers Berdeau et al used data from form published reports and from claims by private hospitals for children <13 years. They found that topical application of clobetasol or 0.05% betamethasone cream 2 times/day to the foreskin and glans for 4-8 weeks was effective in allowing full retraction of the foreskin in 85% (range, 70-100%) of the patients who had a mean age of 5 years at inclusion. The 15% failure rate was attributed to verifiable cases of lichen scleroticas et atrophicus or nonspecific chronic inflammatory processes. Success was achieved at approximately 10% of the cost of operative circumcision; this result showed a considerable cost-effectiveness with this approach."
*
www.emedicine.com/ped/topic1791.htm
As mentioned in the extract above, you can follow the topical application of steroids, preferrably with an antibacterial agent combination, such as Betnovate-N (betamethasone with neomycin).
Since the inflammation and infection can recur it is best to train your son in maintaining hygiene.
Additionally, do not hesitate to take him to the emegency department if he develops symptoms of paraphimosis.
Do keep us posted on your doubts and progress
regards
Please ensure that the urine stream is not affected by the difficulty in retraction.
Phimosis is a condition that does not require emergency care or surgiccal management unless accompanied by complications.
Paraphimosis is a serious condition that requires emergency care and hospitalization. This is characterized by other symptoms like severe pain, blood in the urine stream, swollen and inflammed glans.
"Medical Care
* Daily cleaning, without forceful retraction of the foreskin, is the only treatment necessary for phimosis in patients without urinary obstruction, hematuria, or preputial pain.
*
* Treatment with topical corticosteroids is effective in separating the loose adhesions found between the glans and the foreskin.
*
* In 2001, French researchers Berdeau et al used data from form published reports and from claims by private hospitals for children <13 years. They found that topical application of clobetasol or 0.05% betamethasone cream 2 times/day to the foreskin and glans for 4-8 weeks was effective in allowing full retraction of the foreskin in 85% (range, 70-100%) of the patients who had a mean age of 5 years at inclusion. The 15% failure rate was attributed to verifiable cases of lichen scleroticas et atrophicus or nonspecific chronic inflammatory processes. Success was achieved at approximately 10% of the cost of operative circumcision; this result showed a considerable cost-effectiveness with this approach."
*
www.emedicine.com/ped/topic1791.htm
As mentioned in the extract above, you can follow the topical application of steroids, preferrably with an antibacterial agent combination, such as Betnovate-N (betamethasone with neomycin).
Since the inflammation and infection can recur it is best to train your son in maintaining hygiene.
Additionally, do not hesitate to take him to the emegency department if he develops symptoms of paraphimosis.
Do keep us posted on your doubts and progress
regards
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