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Suggest Remedy For Phimosis In Child

Posted on Mon, 23 Feb 2015

Question: My son who is 4.5 years old had attached foreskin (phimosis). While we had been gradually trying to open the foreskin over the last year using coconut oil, the skin had unevenly detatched. Yesterday when we showed him to our paediatrician he used slight force to evenly detatch the foreskin. The penis had turned red but there was no actual bleeding at that time. The doctor asked us to use metrogyl plus cream thrice a day for 5 days and keep the foreskin clean. However since then the foreskin and surrounding area has become very red and if we try to open to clean or apply medicine a drop or two of blood also come out. Its been just 24 hours since the doc had opened the foreskin. I am attaching a photo and request tou to kindly take a look and advise if this redness and slight bleeding is normal or is there is cause of any concern. Thanks.

Answered by Dr. Naveen Poola (2 hours later)

Brief Answer:
First of all, there is usually no need to forcefully retract foreskin.

Detailed Answer:
Hi,

First of all, there is usually no need to forcefully retract foreskin. Physiological phimosis is a common finding in many children. It should gradually retract on it's own. The majority of boys will have a retractile foreskin by ten years of age and 95 percent by 16-17 years of age.

However, in your kid's case, as the there was trauma, there is chance of adhesion formation which might later result in problem. Boy needs physical examination by a General Surgeon and treatment should then be planned. I find no photo attachment here.

Thanks!

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Naveen Poola (2 hours later)

Doctor, sending you the photo which had got missed out the last time. Can you kindly check and advise.

Answered by Dr. Naveen Poola (22 hours later)

Brief Answer:
I have seen the photograph now.

Detailed Answer:
Hi,

I have seen the photograph now. As the there was trauma and there seems to be some inflammation, there is chance of adhesion formation later, if neglected. I suggest physical exam and management by a General Surgeon.

Thanks!

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Naveen Poola (16 hours later)

Hi doctor. I took my son for examination to a paedeatric surgeon basis your recommendation. His advice was in line with what you suggested i.e. The foreskin should never be forcibly opened. He has prescribed ointment Flucort N to be applied over the trauma area. As per him the steroid will help fill the micro cracks and let the foreskin heal. Can i ask you if Flucort N ointment will be safe for my 4.5 year old son, i needed a second opinion since we were seeing this surgeon for the first time and want to be doubly sure that the medicine is safe. Also should we continue applying Metrogyl plus alongwith Flucort N (we have used Metrogyl plus for 3 days till now on the advice of our regular paedeatricia). Many thanks for your help and advise.n

Answered by Dr. Naveen Poola (5 hours later)

Brief Answer:
It can be used but judiciously, as instructed by the treating doctor

Detailed Answer:
Hi,

It can be used but judiciously, as instructed by the treating doctor.
Flucort N already contains antibacterial ointment and so I do not think there is need of Metrogyl again.

Thanks!

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj