Phimosis in adults: what it is, what its symptoms are, and how it can affect your sex life

Phimosis is a condition doctor which consists of a foreskin that is too narrow, which does not allow its skin to retract over the glans, also known as the “head” of the penis. penis .

Although it is a disease that generally tends to be diagnosed during childhood, There are cases where it is not detected in time, so the problem persists in the health patients .

And with that, There are other variables, discussed later in this note, that can trigger the onset of a case of phimosis in adulthood. .

The urologist of Bupa Santiago Clinic Diego Reyes, explains to La Tercera that This tends to be identified in children before the age of 5. .

“Practically, All children have some degree of phimosis, but this age is like the limit to define if they already suffer from a disease. pathological It is a problem. In these scenarios, the only solution is surgery. “, explains the specialist.

Also It is commonly detected during puberty, when young people begin to have spontaneous erections and notice that they feel discomfort. which can lead, at that time or later, to complications such as difficulty urinating, pain with erections and development of infections .

These usually occur due to the lack of proper sanitation in that area. , which is a consequence of the fact that the skin of the foreskin cannot retract optimally to carry out cleaning. In other words, does not facilitate – or directly enable – access .

The academic from the Faculty of Medicine of University of the Andes urologist at the clinic of the said establishment and director of Chilean Society of Urology Ignacio Morales Denmark, emphasizes that “The causes can be multiple” .

“Although in newborns it is almost 100% physiological and as they grow the skin acquires elasticity, There is a percentage of 6% of children who have difficulty lowering the foreskin correctly. (…) As the penis grows during pubertal development, it cannot descend well below the head of the glans and This generates a constriction that the adult perceives when cleaning this area in the shower. (…) Also causes during erection and activity sexual generates pain itself . Although this does not affect the erection per se, it does cause pain as this ring continues to tighten continuously. »

It’s just one of the reasons why someone might be facing a case of phimosis.

And to this is added, according to Reyes, that There is no standardized measure detailing how this condition should present. . That’s to say, There may be cases in which the foreskin is exposed with difficulty and others in which the tightness is so severe that it is not possible at all. .

“There, the glans is completely covered at all times. The main risk of this type of phimosis (the second) is that it can cause infections of the glans and foreskin. , in addition to difficulty urinating. There are even patients who arrive with urinary retention due to complete closure. And the worst thing we have is that The difficulty in cleaning the glans can lead, 15 or 20 years later, to inflammation caused by this continued lack of hygiene leading to penile cancer “.

The latter disease could occur in patients who do not maintain the cleanliness of the glans and This occurs “because of the same chronic inflammation of the normal secretion of the glans and foreskin, which we call smegma.” .

“Being continually in contact with the skin and glans without such hygiene causes inflammation. (…) we are talking about someone who really has no hygiene in this area.

On another side, In those who manage to retract it, but with difficulty, the main symptom they face is pain during sexual activity. .

“It causes sexual dysfunction. It is not that they cannot have an erection or penetrate their partner, but that this phimosis when compressing the penis causes pain and ends up not being a pleasant and satisfying situation. which is what is expected of sexual activity.

Morales explains that paraphimosis is defined by doctors as a urological emergency which is a complication of phimosis itself.

In this sense, the academic from the University of the Andes comments that This occurs when “this ring compresses and generates a constriction, so that once the sexual act is completed (…), the patient is unable to return the penis to its flaccid state” that is, it fails to cover the glans completely or partially.

Under this line, the urologist from the Bupa Santiago Clinic details that “this ring begins to suffocate the penis and its head to a certain extent, which causes inflammation and can even lead to necrosis of the glans.

“What does that mean? Deep down, it hangs him and The tissue begins to become damaged due to insufficient blood flow reaching it. . However, the vast majority of patients consult beforehand (to get to this point), because it is painful, they continually have the glans exposed and they cannot return to the normal position (with the foreskin covering the glans).

In addition to the aforementioned phimosis which arises from late or non-existent identification during childhood, Morales reports that “often There are irritant causes that can be due to poor hand hygiene and the handling of a chemical or substance that generates irritation, damages the foreskin and triggers an inflammatory event that persists over time. chronic inflammation that damages the elasticity of this skin.

“It is common to see people working with chemicals, obviously with poor supervision from a work control perspective. to hand hygiene. They go to the toilet, there are no good toilets and they transfer this chemical into the area (…) which can generate a chronic inflammatory phenomenon which If not treated properly, it can lead to phimosis. “.

Likewise, Morales and Reyes assure LT that A case of this disease could develop in adult patients diagnosed with diabetes. .

Faced with these latest cases, the director of the Chilean Society of Urology explains that “generally These are diabetics who start out very poorly controlled, with a metabolic alteration or very high blood sugar levels, above 200 or 250, and who have had it for at least more than six months. “.

“Depending on the extent or severity of the metabolic alteration, They eliminate a lot of sugar in the urine and this causes inflammation. Inflammation and this skin lesion often weaken the local immune system and allow the arrival of fungi. . The latter further perpetuate this chronic inflammation, which it thickens the skin . And when this happens, patients find that they cannot descend or retract the foreskin properly.

This is why, when an adult patient arrives with symptoms of phimosis, but who has never had problems or symptoms related to this pathology, “Usually what you have to do is ask for a blood sugar test, because it’s a little different than usual” specifies Morales.

“You would have expected him to have problems since he was young, but We sometimes find men over 45 or 50 years old who start with these critical pictures, with significant redness. throughout the region. Here, we must consider among the possible causes associated with the disorder, a metabolic decompensation attributable to diabetes (…) Once the diagnosis is made and the metabolic part is managed, the disease often recovers, but the skin is so damaged that the patient still gets circumcised. “.

Reyes points out that To treat this pathology, circumcision must be performed directly. .

“There are no medical alternatives, medications, creams or manual maneuvers like dilation” says the urologist at the Bupa Santiago clinic.

This is a low-risk outpatient surgical procedure that normally takes between 30 and 45 minutes and is performed under anesthesia. due to the sensitivity of the penis.

“It can be regional or general. Sometimes we do this under local anesthesia, but usually under regional anesthesia. Most patients go home the same day. “.

Although the chances of facing adverse risks are low, Reyes says that In rare cases (about 1%), patients may experience a hematoma. in the surgical area.

“This means it starts to bleed and it looks like a big bruise (…) a clot swells and this may require an operation or additional treatment. However, in the vast majority of cases, the problem is resolved quickly. “.

Patients undergoing circumcision should be given a week of rest from all physical activity and Full recovery takes between three weeks and a month, so they can resume sexual activity. .

“You don’t have to be in bed. The next day, you can walk, move, but do not do intense physical efforts like sports during the first 7 or 10 days. » Reyes said.

Notably It is always advisable to consult a doctor to evaluate your particular case. and the best ways to treat it.