What is occult phimosis in children?

Hidden phimosis in children refers to the occurrence of phimosis in the child's genital area. It usually occurs in obese children or children with thick flesh around the penis. The occurrence of hidden phimosis can easily affect the normal development of the child's reproductive organs, as well as the child's physical health, leading to poor development of the penis, affecting normal sexual life and fertility.

Concealed penis in children

Concealed penis is more common in children with obese body shape. Its characteristics are phimosis, thick subcutaneous fat around the penis, poor development of penile skin, poor development of penile corpus cavernosum and urethral corpus cavernosum, and the inability of the penis body to enter the penile skin and foreskin cavity.

Concealed penis

Concealed penis is more common in children with obese body shape. Its characteristics are phimosis, thick subcutaneous fat around the penis, poor development of penile skin, poor development of penile corpus cavernosum and urethral corpus cavernosum, and the inability of the penis body to enter the penile skin and foreskin cavity. Therefore, the penis is buried in the foreskin and subcutaneous fat tissue in the pubic area. Concealed penis cannot ejaculate urine due to the curvature of the urethra. In severe cases, it can cause urinary retention. Some children have inferiority complex, and adults often cannot have sexual intercourse. This disease needs to be differentiated from micropenis and apenis, but it is not difficult to distinguish based on the child's body shape and careful physical examination.

The treatment for concealed penis should first control diet and increase exercise to reduce obesity. For newborns, parents can push and pull the child's scrotum backwards several times a day to allow the head of the penis to enter the foreskin cavity to lengthen the penis skin and foreskin cavity. For those with well-developed penis, poor penile skin development and narrow foreskin opening, foreskin incision can be performed to allow the glans penis to emerge outside the foreskin opening. For patients with penile hypoplasia, in addition to circumcision, androgen or gonadotropin treatment is given to promote penile development. Phalloplasty should be performed around 7-8 years of age. At this time, the penis develops faster and the treatment effect is better. Some scholars have proposed that the use of multiple small longitudinal incisions to expand the foreskin opening to treat concealed penis has achieved better results. The specific method is to separate the adhesion between the foreskin and the glans penis, turn the foreskin up, make a 1-1.5 cm longitudinal incision at 10, 12, and 2 o'clock relative to the narrow ring, and then suture it horizontally. When there is too much fat around the penis, it should be removed.

Surgery

Indications

1. The penis skin is poorly developed and too short;

2. The foreskin cavity is too small;

3. The penis skin does not cover the corpus cavernosum, causing the corpus cavernosum to retract into the body without support.

Preoperative preparation

1. Starting from 3 days before the operation, soak and wash the genitals with warm water or 1:5000 potassium permanganate solution every day.

2. Shave pubic hair and prepare skin the day before or on the day of surgery;

3. Determination of sex hormones;

4. Check the size and position of the testicles.

Surgical procedures

1. Flip the foreskin forcefully to reveal the glans penis and sew a traction line there if there is foreskin adhesion or phimosis. It is necessary to make a longitudinal incision on the dorsal side of the foreskin to separate the adhesions of the foreskin so that the foreskin can be turned back to expose the glans penis. The foreskin is cut longitudinally and after being turned over, the incision becomes almost a horizontal incision.

2. Remove the underdeveloped cord-like tissue on the dorsal side of the penis, that is, the underdeveloped tunicate tissue.

3. Extend the incision horizontally to make a circular cut on the remaining skin of the penis and remove the cord-like material on the ventral side of the penis. The fat pad above the pubic bone can also be removed, and the penile skin is sutured to the penis body at the base of the penis.