Phimosis Treatment in Dhaka

Preoperative diagnosis for phimosis in adults is a fairly simple procedure that your urologist will likely perform to determine the severity of your condition and assess your overall health. In most cases, this procedure concludes with a routine physical examination. During this, the surgeon will visually inspect the penis and try to retract the foreskin manually. If the foreskin is unable to slide over the glans or the glans are not completely visible, it is considered to be an indication of phimosis. Alongside this, your doctor may also ask you some questions regarding your medical history, surgical history, the phimosis symptoms you have been facing, and hygiene habits. If you suffer from any preexisting conditions, such as diabetes or hypertension, it is best to let your doctor know about them as well. Once your urologist has determined the exact cause of your condition, they can move on to treatment. However, to better understand your condition, they may perform such additional tests as well. These typically include:

• Urethral Discharge Swab: A urethral discharge swab or urethral discharge culture is a commonly performed diagnostic test in which your urologist uses a cotton swab to get a sample of your urethral discharge. This swab is then sent to a laboratory for analysis.
• Urinalysis: Commonly referred to as a urine test, urinalysis helps your urologist check for symptoms of UTI and STIs. In this test, the doctor asks you to urinate into a small cup provided by them. This cup will then be sent to a laboratory for further analysis.
• Routine Blood Tests: To assess and evaluate your overall health and uncover any underlying medical conditions you may have, your urologist may perform a blood test. In this test, the urologist draws a small amount of blood from a vein in your arm and send it to a laboratory for further analysis.

How To Prepare for Phimosis Treatment?

To minimize the chances of any complications, your urologist will likely instruct you to follow some simple guidelines before arriving at the hospital. These typically include:

• Avoid eating or drinking anything for at least 6 hours leading up to your foreskin removal surgery.
• Take a shower before arriving at the hospital for your phimosis treatment surgery. It is also advisable to trim down any pubic hair you may have. Pubic hair could interfere with the dressing and cause you additional discomfort after a phimosis operation. However, avoid shaving off any hair around the penis.
• Make sure to leave any jewelry or ornaments you may wear at home. You do not need them in a hospital, and they may even interfere with the procedure.
• Wear loose, comfortable clothes. It is also imperative that you bring an extra pair of snug, comfortable briefs. You will need to wear these briefs after the surgery and continue to wear them until some of the soreness and swelling have eased.
• Refrain from smoking or drinking alcohol for at least 48 hours prior to surgery. Smoking and alcohol could leave you dehydrated, slow down your recovery, and also reduce the effectiveness of the anesthetic.
• Make sure to take a few days off from work. While most patients can return to their daily lives in just 2-3 days after phimosis operation, each patient has different healing capabilities, and depending on several factors, recovery time after phimosis operation may vary.
• It is imperative that you avoid driving home after your foreskin removal. Due to anesthetic after-effects, you may feel disoriented, nauseous, and blurred vision. It is advisable to plan and have someone drive you home or at least accompany you in a cab.

Surgical Options for Phimosis

As previously mentioned, minor cases of phimosis are generally treatable with non-surgical alternatives such as topical steroid creams and foreskin stretching exercises. However, if your condition is severe, your doctor may advise undergoing a circumcision or foreskin removal surgery for effective phimosis treatment.

There are primarily 3 methods of performing a circumcision surgery to treat phimosis. While all 3 methods are considered safe and effective phimosis in adulthood treatment, they vary in their overall procedure and the equipment they use.

• Laser Foreskin Removal: Laser circumcision (or laser-assisted foreskin removal surgery) or laser phimosis treatment is an advanced and minimally invasive urological procedure that utilizes a medical-grade laser to cut and remove the foreskin. It is an extremely precise procedure that does not involve the risk of deep cuts or excessive bleeding. During the procedure, the laser is manually operated by the surgeon and slowly moved along a predetermined incision line to ensure minimal damage to the tissue surrounding the penis. Additionally, its high operating temperature cauterizes any cut blood vessels almost immediately. As a result, the recovery period is relatively short, and the chances of any complications, such as bleeding or infection, are minimal as well. The entire procedure is typically performed under local anesthesia and does not take more than 10 to 15 minutes to complete. It is also an outpatient surgery. This means that once your surgery is complete and there are no immediate complications, you will be able to go home on the same day of the procedure.
• Stapler Foreskin Removal: Sometimes referred to as stapler circumcision, this is another commonly performed urological procedure that your doctor may prefer to treat phimosis. Stapler circumcision utilizes a stapler device to remove the foreskin completely. A stapler device is a disposable surgical tool that is specially designed to remove the foreskin and close the incision wound almost immediately. This device is placed over the head of the penis itself and, if placed correctly, should fit snugly around it. Once the device is in place, it is fired by the surgeon, and the foreskin is removed in one quick motion. Additionally, to minimize bleeding and boost recovery, this stapler device is fitted with a silicone ring that wraps itself around the incision wound almost as soon as the foreskin is removed. Once your recovery is complete, which usually takes 7 to 14 days to complete, this silicone ring will fall off on its own. Similar to laser phimosis treatment, a stapler procedure is typically performed under local anesthesia. It does not take more than 15-20 minutes to compete as well, and you will likely be able to go home on the same day of the surgery. The recovery period usually ranges between 7 to 14 days.
• Open Surgery: Open circumcision is a more conventional form of foreskin removal surgery that utilizes a scalpel and surgical scissors to cut and remove the foreskin. Compared to laser phimosis treatment and stapler procedures, open circumcision is more invasive and, as a result, carries a slightly increased risk of complications. However, actual cases of any postoperative complications are rare. In an open foreskin removal surgery, the doctor makes an incision along the outer edge of the foreskin to slowly separate it from the underlying tissue. Once the foreskin has been separated, the incisions are closed off with dissolvable sutures. The entire surgery usually takes 35 to 40 minutes to complete and is typically performed on an outpatient basis. However, to ensure minimal risk of complication, your surgeon may instruct you to spend a night at the hospital.