What's phimosis? - Mothering Forums

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#1 of 6 Old 12-19-2003, 05:20 AM - Thread Starter
 
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I've tried reading some posts to get an idea but still am not sure.

My ds is circ'd but I am pregnant now- looks like a girl but not positive. So I want to inform myself b/c I do not want to circ anymore of my sons.

TIA

Mom of 3 sons and one daughter
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#2 of 6 Old 12-19-2003, 07:09 AM
 
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Phimosis is a very rare condition and an absolutely normal condition. I know that is confusing but please bear with me. . . . .

The absolutely nmormal form of phimosis is called developmental phimosis. Almost all boys foreskins are tight at the tip and the foreskin will not retract until a later age because the opening is not elastic. At some point, the opening becomes elastic and the foreskin will retract. A very, very few will be retractable shortly after birth. This is only about 1%. At 6 years old, 2/3 will be elastic and retractable. By 10 years old, 90% will be retractable and all of the rest will become retractable in their teen years. there is no normal age for retraction. This is developmental phimosis.

The other type is pathological phimosis and is also very rare occuring in less than 1/1,000 boys. Pathological phimosis is caused by disease, infection, trauma, etc. Probably the number 1 cause of phimosis is forced retraction of the foreskin and cleaning inside. This is a recipe for disaster just as cleaning a baby girl's vagina would be a recipe for disaster. First, it causes trauma to the foreskin opening and destroys the natural beneficial flora in the foreskin leaving the area open to infection. Far on down the line would be unresolved but easily treatable staph infections followed much further down the line by BXO infections. We are talking about 1/10,000 chances here so not something to be concerned about!

Your son's foreskin will be tight and do not listen to a doctor that tells you he has phimosis. Some how, there is this rumor that permeates the medical profession that a boy's foreskin should retract by a certain age. (Usually between 3 and 5 years) Untold absolutely normal boys have been circumcised for "tight foreskins," ie., phimosis when they were absolutely normal.

Here is a description of phimosis with pictures of developmental phimosis and pathological phimosis:

http://www.mja.com.au/public/issues/...w10610_fm.html




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#3 of 6 Old 12-19-2003, 10:48 AM
 
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It's important to note that there is no logic in circumcising a boy in hopes of preventing phimosis (or surgery later in life)

Why?

Because phimosis is a circumcision complication that strikes MORE circumcised boys in it's iotragenic form than strikes intact boys in it's pathological form. Circumcisers CAUSE phimosis at a greater rate than would occur if all boys were left alone.

More surgeries are caused (above and beyond the surgery happening right then) than avoided.

Check the AAP statement to read the list of complications- right at the top of the list- Phimosis.

http://www.cirp.org/library/statements/aap1999/

"There also are isolated case reports of other complications such as recurrent phimosis, wound separation, concealed penis, unsatisfactory cosmesis because of excess skin, skin bridges, urinary retention, meatitis, meatal stenosis, chordee, inclusion cysts, and retained Plastibell devices.26 Case reports have been noted associating circumcision with such rare events as scalded skin syndrome, necrotizing fasciitis, sepsis, and meningitis, as well as with major surgical problems such as urethral fistula, amputation of a portion of the glans penis, and penile necrosis"

Their numbers do not reflect the actual incidence though. Here is a article outlining cases and their incidence within one practice:

http://www.cirp.org/library/complications/blalock1/

If you feel concerned or uneasy about a decision to not circumcise just because you heard of this "phimosis" ... you can relax and know that for people who are afraid of phimosis- NON-circumcision is the obvious answer.

Love Sarah
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#4 of 6 Old 12-19-2003, 06:45 PM
 
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Sarah:

It always befuddles me when I see "isolated case reports" of circumcision complications when it is well established that the incidence of meatal stenosis alone is in excess of 10%. I think that goes well beyond a description of "isolated." It makes me wonder why they are trying to pull the wool over our eyes.

Of course, the medical industry as a vested interest in continuing circumcision, right?



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#5 of 6 Old 12-20-2003, 02:46 AM
 
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Phimosis: Contraction of the orifice of the prepuce, so that it cannot be retracted.

Developmental or natural phimosis is normal. It is the natural condition of a non-retractile child's foreskin at birth and up to the time when it becomes elastic.
The foreskin is bonded to the glans by a special lining, called the synechia. It is rigid and tight. At the opening (meatus) there is a sphincter muscle which keeps the foreskin tightly closed and assists in keeping out germs, bacteria, and dirt.

The only thing that should be coming out of the meatus is urine and nothing should be able to get in.

“Developmental phimosis” should never be confused with “pathological phimosis”.

(The fact that many circumcisions are recommended for boys between the ages of 3 and 15 years old for "tight foreskin" clearly illustrates that many physicians do not understand the normal condition of the foreskin and the distinction between normal and pathological phimosis.)

Pathological phimosis is an abnormal condition resulting from numerous untreated infections, trauma, disease, or forcible premature retraction. It is the result of collective and cumulative damage.

Pathological phimosis is extremely rare.

Here is a site showing the difference between normal developmental phimosis and pathological phimosis:

http://www.mja.com.au/public/issues/...w10610_fm.html
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#6 of 6 Old 12-20-2003, 04:35 AM - Thread Starter
 
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Wow, thanks!!
I appreciate the lengthy and detailed info!!

Mom of 3 sons and one daughter
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