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PHIMOSIS

Definition
Phimosis is a condition in which the
foreskin can not be retracted into
proximal to the corona glandis .

Epidemiology
occurs in infants or children up to the
age of 3 or 4 years .
1-5 % of cases occur until the age of
16 years .
In 95 % of infants , boil still attached
to the glans penis so it can not pull .
At the age of 3 years old child who
fimosis as much as 10 %
( Association of Children's doctor
Indoneisa , 2008 )

Etiology and Risk Factors


the level of genital hygiene is bad .
Chronic inflammation of the glans
penis and prepuce ( balanoposthitis
chronic ) .
Excessive withdrawal of the prepuce
( forceful retraction ) .
the space between the poles and the
penis does not develop properly .

Pathogenesis
Physiologic phimosis results from
adhesions between the epithelial
layers of the inner prepuce and
glans. These adhesions
spontaneously dissolve with
intermittent foreskin retraction and
erections, so that as males grow,
physiologic phimosis resolves with
age.

Clinical manifestations
urine flow disorders such as difficult
urination,
emission of urine decreases,
ballooning tip of the foreskin of the
penis during micturition,
and lead to urinary retention.

Prevention
1. It is not advisable to do a forced retraction
2. Maintain hygiene especially the penis and did
not wash the penis with plenty of soap.
3. Phimosis accompanied xerotica balanitis
obliterans can be given ointment topical
dexamethasone 0.1% 3/4 times, and it is
expected after 6 weeks of administration of the
foreskin can be retracted spontaneously.
4. Phimosis with complaints of micturition,
ballooning tip of the foreskin during micturition or
infection postitis an indication for circumcision.

PARAPHIMOSIS

Definition
Prepuce penis retracted up in the
coronary sulcus can not be returned
to its original state.
The result is a superficial venous
return disturbance while arterial flow
remained normal
pain and edema
on the glans penis.

Epidemiology
It can occur in men of all ages , but
common occurrence in infancy and
adolescence

Etiology
Attractive prepuce proximally by
force .
Men who have not been
circumcised .
The process of circumcision is less
hygienic .

Pathogenesis
Retraction forcibly preputium
proximally resulted penis foreskin
can not be returned to its first
position
perputium be clamped
shaft of the penis blood flow
resistance
Edem penis
penis
tissue necrosis

Clinical manifestations
Pain in the penis
penis swell
Glans change color to bluish.

Prevention
Prepuce endeavored to position normally
returned to the glans massage technique for
3-5 minutes. Expected edema is reduced
and slowly return the foreskin in place.
If not managed to do dorumsisi in bondage
so that the prepuce can be restored in place.
After edema disappeared recommended to
circumcision.