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Phimosis

391 bytes added, 13:56, 2 November 2019
Add Wahlin citation.
From a medical standpoint, an otherwise symptom-free [[phimosis]], even after dissolution of preputial adhesions, does not require any treatment before the child enters puberty. The widespread notion that full retractability has to be achieved by a certain age, derives from obsolete assumptions and studies which only covered children's development until they entered school, but not beyond that point.
 
 
Even though the data from Jakob Øster's studies have been known for 51 years,<ref name="Øster1968">{{REFjournal
* Dorsal slit with transverse suturing: this technique places a single lengthwise cut into the stenotic ring which is then closed transversely.
* Lateral preputioplasty: this is a refinement of the dorsal slit with transverse suturing. It consists of two lateral, longitudinal incisions sutured transversely.
* Triple incision: this is a method of foreskin widening. It typically consists of three incisions across the tight ring. They are closed from side to side, thereby increasing the circumference of the tight ring relative to the length of the cuts. From an aesthetic view, it has results far superior to those of a dorsal slit, and usually yields a good cosmetic result.<ref>{{REFjournal |last=Wahlin |first=N |author-link= |etal=yes |title="Triple incision plasty". A convenient procedure for preputial relief |trans-title= |language= |journal=Scand J Urol Nephrol |location= |date=1992 |volume=26 |issue=2 |pages= |url=107-10 |quote= |pubmedID=1626197 |pubmedCID= |DOI=10.1080/00365599.1992.11690439 |accessdate=2019-11-02}}</ref>
Preputioplasty also preserves the foreskin and its many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| physiologial functions]]
If after a failed attempt to stretch the foreskin with corticosteroid cream a surgical intervention is necessary, a preputioplasty is always to be preferred over classic circumcision, due to its lower morbidity, lower rate of complications and lower costs.
 
===Circumcision===
Circumcision is the classic treatment for phimosis, but has many disadvantages and drawbacks. Circumcision is less performed today, because it is becoming outmoded by newer and better treatments.<ref name="shahid2012" />
* Circumcision has a long, painful, and difficult recovery. Recovery time is placed at six weeks. Erections may cause sutures to pull out, thus opening the surgical wound. Sexual and psychological issues abound. As with other surgery, complications are surgical misadventure, hemorrhage, and infection. Loss of the penis and death is rare.<ref name="shahid2012" /> <ref name="williams-kapila1993">{{REFjournal
|last=Williams
|first=NNeville
|author-link=
|last2=Kapila
|first2=LLeela
|author2-link=
|etal=no
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