Foreskin: Difference between revisions
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=== Physiological Phimosis === | === Physiological Phimosis === | ||
Physiological phimosis can be divided into three main categories - symptom-free, in need of therapy and in need of surgery. | Physiological phimosis can be divided into three main categories - symptom-free, in need of therapy, and in need of surgery. | ||
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. | 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. | ||
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stretching exercises, if needed with the aid of corticosteroid cream. Depending on the active | stretching exercises, if needed with the aid of corticosteroid cream. Depending on the active | ||
substances, success rates of 80-90% have been documented. | substances, success rates of 80-90% have been documented. | ||
<ref>Orsola A, Caffaratti J, Garat JM. Conservative treatment of [[phimosis]] in children using a topical steroid. | <ref>Orsola A, Caffaratti J, Garat JM. Conservative treatment of [[phimosis]] in children using a topical steroid. ''Urology'' 2000;56(2):307-10.</ref> | ||
<ref>Ashfield JE, Nickel KR, Siemens DR,et al. Treatment of [[phimosis]] with topical steroids in 194 children. J | <ref>Ashfield JE, Nickel KR, Siemens DR,et al. Treatment of [[phimosis]] with topical steroids in 194 children. ''J Urol.'' 2003;169(3):1106-8.</ref> | ||
<ref>Pileggi Fde O, Vicente YA. Phimotic ring topical corticoid cream (0.1% mometasone furoate) treatment in children. J Pediatr Surg. 2007 Oct;42(10):1749-52.</ref> | <ref>Pileggi Fde O, Vicente YA. Phimotic ring topical corticoid cream (0.1% mometasone furoate) treatment in children. ''J Pediatr Surg''. 2007 Oct;42(10):1749-52.</ref> | ||
<ref>Ghysel C, Vander Eeckt K, Bogaert GA.Long-term efficiency of skin stretching and a topical corticoid cream application for unretractable foreskin and [[phimosis]] in prepubertal boys.Urol Int. 2009;82(1):81-8.</ref> | <ref>Ghysel C, Vander Eeckt K, Bogaert GA.Long-term efficiency of skin stretching and a topical corticoid cream application for unretractable foreskin and [[phimosis]] in prepubertal boys. ''Urol Int''. 2009;82(1):81-8.</ref> | ||
<ref>Reddy S, Jain V, Dubey M, Deshpande P, Singal AK.Local | <ref>Reddy S, Jain V, Dubey M, Deshpande P, Singal AK. Local steroid therapy as the first line treatment For boys | ||
with symptomatic [[Phimosis|phimosis]] - A Long Term Prospective Study. ''Acta Paediatr''. 2011 Nov 21. [Epub ahead of print]</ref> | |||
Should those therapies not yield the desired outcomes, there is a surgical option, namely a preputioplasty. | Should those therapies not yield the desired outcomes, there is a surgical option, namely a preputioplasty. | ||
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There are several different methods: | There are several different methods: | ||
<ref>http://de.wikipedia.org/wiki/Phimose#Pr.C3.A4putiumsplastik</ref> | <ref>[http://de.wikipedia.org/wiki/Phimose#Pr.C3.A4putiumsplastik| Phimose]</ref> | ||
* Dorsal slit with transverse suturing: this technique places a single lengthwise cut into the stenotic ring which is then closed transversely. | * Dorsal slit with transverse suturing: this technique places a single lengthwise cut into the stenotic ring which is then closed transversely. | ||