Phimosis Surgery: the entire process and possible alternatives

Phimosis Surgery: the entire process and possible alternatives

Phimosis Surgery: the entire process and possible alternatives
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For years, in cases of phimosis, the surgical operation of circumcision (phimosis surgery) has been the practice with which the medical sector has intervened to eliminate the conditions that lead to narrowing of the foreskin, preventing the glands from exposing itself.

The proposed intervention is that of circumcision.

In reality, the phimosis operation choice depends on the problem type. There is indeed a specific classification for phimosis that we’ve already discussed on the phimosis page, and will briefly summarise again:

  1. congenital or acquired, depending on whether the problem is due to the prepuce adhesions that are naturally present from birth and failure to develop a prepuce in childhood, or one that has appeared in adulthood, and has been caused by a bacterial or inflammatory causes.
  2. tightened or untightened, depending on the foreskin narrowing degree.

In cases of tightened phimosis, it is impossible to expose the glans even with a flaccid penis, whereas in untightened, this impediment occurs with an erect penis.

Above all, in the former type, many problems can arise in everyday life, from difficulty urinating to difficulty having sexual relations. If neglected and not treated in time, a progressive strangling of the glans is observed which requires an urgent intervention.

The development of phimosis is a progressive process that allows us to intervene promptly before it reaches the point of no return.

Before deciding on phimosis surgery

As soon as the presence of phimosis is suspected, it is advisable to contact your doctor to obtain the correct diagnosis and evaluate any indications for treatment.

Normally, a treatment with ointments or phimosis cream can soften the foreskin and facilitate it sliding over the glans. This intervention is included in the conservative treatments category, and has proven itself effective in congenital phimosis cases at a young ageFor adults, where we observe mainly acquired phimosis, direct surgery is recommended.

At this stage, with either tightened or untightened phimosis, Phimostop can be brought into play. Using the natural principle of epidermal tissue dilation, thanks to the special design and patented technology of appropriate tubes, developed using medical silicone, Phimostop allows the progression of scar tissue to be halted and gradually returns the foreskin to its original state. The medical device acts on the phimotic ring, stimulating the creation of new elastic cells that will replace those rendered inelastic by scar tissue.

Our product offers 13 progressively-sized tubes specifically designed to slowly stretch the foreskin, without force or constriction. Depending on the situation extent , in a short period of time, you can see your phimosis regress until the foreskin is once again over the glans, even with an erection, without any problems.

Phimostop is a medical device that has been validated by the Health Ministry, in Class 1, can be purchased in pharmacies without a prescription and is covered by a European patent.

To date, more than 7,000 products have been sold, and many men have been able to avoid a phimosis surgery in this way. What we regret is the fact that far too often, a surgical circumcision is proposed as the only solution, even where alternative solutions could be offered.

It seems that phimosis surgery is offered because it’s a resolving intervention which is now carried out in day hospital. By performing it in this way, however, the psychological and physiological impacts that such an intervention can have someone are not taken into consideration.

Steps to take when dealing with phimosis surgery

The first action taken is to sign up for the hospital’s admissions list during the urological examination at a clinic. Usually, the waiting time between list registration and the actual phimosis intervention ranges from a few months up to two years.

Once called for the phimosis surgery, you will have the appropriate consultation with the surgeon and anaesthesiologist and if necessary (but not mandatorily) blood tests and an electrocardiogram will be performed.

Before the start of the operation, as a rule the prepuce portion   to be removed is marked out, using a dermographic pen. You can opt for a total circumcision, with removal of the entire foreskin, or a partial circumcision, which aims to eliminate only the pre-putial section that is preventing natural sliding over the glans.

Partial circumcision allows the foreskin to return to covering the glans of a flaccid penis, whilst with total circumcision, this will no longer be possible, and the glans will remain permanently uncovered.

Anaesthesia

The operation for phimosis normally takes place with a local anaesthetic. First, an anaesthetic ointment is applied, around the penis, then intensified by the infiltration of an anaesthetic drug at the base of the penis. However, a spinal or general anaesthetic can also be requested.

Phimosis Operations

There are various intervention options for a urologist to evaluate, even in the field of plastic surgery.

Classical circumcision or total postectomy

On the portion of prepuce to be removed, two parallel incisions are made, the skin is incised up to the subcutaneous layer (dartos) and the blood vessels of the foreskin are coagulated by laser or electric scalpel. Once the excess part has been removed, the skin is sutured by stitches with resorbable material. Usually, in interventions for phimosis, a plastic cast of the frenulum is also made and after the operation, a dressing with a semi-compression elastic bandage is applied. In the days after the phimosis procedure, the penis will tend to swell, to have small losses of blood and have greater sensitivity. With the passage of time, these effects will diminish. After the surgery, we recommend dressing procedures, which can easily be done at home, which should be carried out for seven days afterwards. Total recovery occurs in about 4 weeks, after which sexual activity can be resumed.

Partial postectomy

In this case, there is partial removal of the foreskin with the advantages already described, to maintain partial coverage of the glans, but this may have the disadvantage of phimosis recurrences occurring. Also in this case, the times for healing and recovery of sexual activity are always around 3/4 weeks, but the use of anti – inflammatory ointments can help the recovery.

Laser circumcision

These phimosis operations can be performed with a modern laser technique, with the advantage of having shorter post-operative care. Laser circumcision is very precise and allows the tissues to be incised with simultaneous coagulation of the blood vessels. The result avoids suffering the classic postoperative swelling produced by traditional surgery.

After the operation, there is a post-operative dressing for 2 -3 days, an antibiotic therapy for 3 – 4 days (along with analgesics) and the sutures inserted are reabsorbed in 7 – 10 days. Physical activity can be resumed after two weeks, and sexual activity after 3 – 4 weeks.

Finally there are a series of possible plastic surgery interventions which remove the phimotic ring, leaving the prepuce intact. They are more expensive and delicate interventions.

In every case, it’s important to remember that phimosis surgery must be performed with very fine and delicate instruments, and requires precision and delicacy to guarantee a result that is functional (frees the penis from the phimotic ring) and aesthetic (avoids visible and annoying scars). Like every operation, the results depend on the responses of the individual person, especially for the postoperative phase.

Discharge

Hospitalisation lasts about 24 hours, after which the patient is discharged with a letter informing him of the medication procedures to be carried out and of a few measures they should follow, such as: the application of anti-inflammatory creams, the use of painkillers, abstention from washing the penis for at least 3 days etc … The post-operative phase lasts about 3 or 4 weeks.

The alternative to surgery for phimosis

Phimostop was created with the aim of avoiding circumcision (except for cases of paraphimosis) by applying a consolidated principle (the natural ability of the skin to stretch using appropriate devices for progressive expansion)

Phimostop is a medical device that’s been specially designed, covered by patent, validated by the Ministry of Health and awarded a Gold Medal at the Geneva International Exhibition of Inventions.

In future, circumcisions will become increasingly rare, in line with ongoing research into methods that are minimally invasive and, wherever possible, not bloody. With great advantages for patients and huge savings to public spending (Phimostop has saved 12 million euros to date according to estimates).