1.3 Treatment
Treatment of phimosis in children is dependent on parents' preferences and can be plastic or radical circumcision after completion of the second year of life. In case of complicating findings, such as recurrent urinary tract infections (UTIs) or ballooning of the foreskin during micturition, circumcision should be performed without delay regardless of the patient's age. Plastic circumcision has the objective of achieving a widening of the foreskin circumference with full retractability, while the foreskin is preserved cosmetically. In the same session, adhesions are released and an associated frenulum breve is corrected by frenulotomy with ligation of the frenular artery. Routine neonatal circumcision to prevent penile carcinoma is not indicated. Contraindications of the operation are acute local infection and congenital anomalies of the penis, particularly hypospadias, as the foreskin may be required for plastic correction.
As a conservative treatment option, a corticoid ointment (0.05-0.1 %) can be administered twice a day over a period of 20-30 days. This treatment is not indicated in babies and children still wearing diapers, but may be considered around the third year of life.
Treatment of paraphimosis consists of manual compression of the oedomatous tissue with the subsequent attempt to retract the tightened foreskin over the glans penis. If this manoeuvre fails, a dorsal incision of the constrictive ring is required. Depending on the local findings, a circumcision is carried out immediately or can be performed in a second session.
- 1. Phimosis
- 1.1 Background
- 1.2 Diagnosis
- 1.3 Treatment
- 1.4 References
- 2.2 Diagnosis
- 2.3 Treatment
- V Therapy
- 3.3 Treatment
- 3.3.1 Complications
- Tube-onlay
- 15. Duckett jw.
- 4.2 Classification
- 4.2.1 Enuresis
- 4.2.2 Urinary incontinence
- 4.3 Diagnosis
- 4.4 Treatment
- 4.4.1 Nocturnal enuresis (mono-symptomatic)
- 4.4.2 Diurnal enuresis (in children with attention disorders)
- 4.4.3 Urinary incontinence
- 4.4 References
- 14. Madersbacher h, Schultz-Lampel d.
- 5.2.2 Voiding cystourethrography (vcug)
- 5.2.3 Diuresis renography
- 5.2.4 Static renal scintigraphy
- 5.2.5 Intravenous urogram (ivu)
- 5.2.6 Whitaker's test
- 5.3 Treatment
- 5.3.2 Megaureter
- 5.3.3 Ureterocele
- 5.3.4 Retrocaval ureter
- 5.3.5 Bilateral hydronephrosis
- 5.4 References
- 6.3 Treatment
- 6.3.1 Asymptomatic bacteriuria
- 6.3.2 Acute uti without pyelonephritis
- 6.3.3 Pyelonephritis
- 6.3.4 Complicated uti
- 6.3.5 Antibiotic prophylaxis
- 6.4 References
- 7.7.1 Secondary reflux
- 7.2 Classification
- 7.3 Diagnosis
- 7.3.1 Secondary reflux
- 7.4 Treatment
- 7.4.1 Conservative therapy
- 7.4.2 Surgical therapy
- 7.4.3 Endoscopic therapy
- 7.4.4 Open surgery
- 7.4.5 Follow-up
- 7.5 References
- 32. McGladdery sl, Aparicio s, Verrier Jones k, Roberts r, Sacks sh.
- 8.2 Diagnosis
- 8.3 Treatment
- 8.3.1 Conservative treatment
- 8.3.2 Metaphylaxis of paediatric nephrolithiasis
- 8.4 References
- 1. Brandle e, Hautmann r.
- 2. Brandle e, Hautmann r.
- 6. Diamond da, Rickwood am, Lee ph, Johnston jh.
- 19. Kovacevic l, Kovacevic s, Smoljanic z, Peco-Antic a, Kostic n, Gajic m, Kovacevic n, Jovanovic o.
- 20. Kroovand rl.
- 24. Minevich e, Rousseau mb, Wacksman j, Lewis ag, Sheldon ca.
- 9.2 Classification
- 9.2.1 Ectopic ureterocele
- 9.2.2 Orthotopic ureterocele
- 9.2.3 Caecoureterocele
- 9.3 Diagnosis
- 9.3.1 Ureterocele
- 9.3.2 Ectopic ureter
- 9.4 Treatment
- 9.4.1 Ureterocele
- 9.4.2 Ectopic ureter
- 10.2 Classification
- VI. Miscellaneous (? Dysgenetic testes ? teratogenic factors)
- 10.3.2 Late diagnosis and management
- 10.4 Treatment
- 10.4.1 Genitoplasty
- 10.4.2 Indications for the removal of gonads
- 10.5 References
- 11.1.4 Video-urodynamic evaluation
- 11.1.5 Urethral pressure profile (sphincterometry)
- 11.1.6 Electromyography (emg) of the external sphincter
- 11.2 References
- 22. Starr nt.
- 23. Wan j, Greenfield s.
- 26. Zermann dh, Lindner h, Huschke t, Schubert j.
- 12 Abbreviations used in the text