Fimosi e parafimosi sono due disturbi che caratterizzano il pene sia nel bambino che nell’uomo adulto. Scopriamo insieme di cosa si tratta, quale la differenza tra loro, le cause, i sintomi e la terapia eventuale.
Cos’è la fimosi?
Con questo termine si indica l’incapacità di ritrarre il prepuzio dietro il glande, nei maschi. La fimosi in genere è divisa in fisiologica e patologica.
Quali sono le cause della fimosi?
La fimosi fisiologica è la condizione normale in cui i bambini nascono con un prepuzio stretto e la separazione (o apertura) si verifica durante la tarda infanzia e nella prima adolescenza, in genere senza la necessità di un intervento esterno, cioè naturalmente. La maggior parte dei bambini nasce con fimosi.
La fimosi patologica invece si verifica a causa di infezioni, infiammazioni come la balanite, o cicatrici.
Quali sono i sintomi di fimosi?
L’incapacità del prepuzio a ritirarsi dietro il glande è il sintomo caratterizzante il problema. Questo provoca una difficile pulizia della zona che può dare origine a balanite, e quindi erezione e minzione dolorosa o anche parafimosi. La diagnosi si effettua attraverso una visita clinica.
Come si cura la fimosi?
La cura dipende dall’età del paziente, dalla gravità del problema e dai conseguenti sintomi.
La prima scelta di trattamento è di solito un unguento steroideo che viene applicato localmente (cortisone): il tasso di successo arriva al 70% della casistica totale. Questo trattamento ammorbidisce il prepuzio favorendo la fuoriuscita del glande. La terapia si protrae in genere per 4-6 settimane prima di arrivare alla risoluzione del disturbo.
Se il trattamento con steroidi non ha successo, una circoncisione potrebbe essere utile.
Cos’è la parafimosi?
La parafimosi si verifica quando il prepuzio viene retratto dietro il glande e non può essere riportato alla sua posizione originale. Questo si trasforma in una emergenza urologica quando il flusso di sangue in afflusso al pene diminuisce.
Quali sono le cause parafimosi?
La parafimosi è una condizione rara che si manifesta a causa di un involontario trauma meccanico (tirando dietro il prepuzio da soli o in ospedale inserendo ad esempio un catetere).
Quali sono i sintomi di parafimosi?
Una volta che la pelle è intrappolata, si verifica un edema, ovvero un gonfiore nell’area circostante peggiorando la restrizione del prepuzio, come a formare un “anello di pelle” molto stretto: dolore e gonfiore sono i sintomi caratteristici.
Diagnosi e cura della parafimosi
Anche in questo caso basta un esame fisico per procedere con la diagnosi. La riduzione meccanica, manuale del problema è di solito il trattamento di prima scelta. Per aiutare contro il dolore, il medico potrebbe applicare una crema anestetica locale, dare farmaci antidolorifici per via orale, o fare un’anestesia locale al pene. Anche l’applicazione di ghiaccio puà essere utile in questa fase, per controllare l’edema.
In alcuni casi si effettua un’iniezione locale di ialuronidasi, efficace nel ridurre il gonfiore e quindi per favorire la riduzione del problema.
Se nessuna di queste tecniche ha successo il medico può intervenire con una piccola incisione chirurgica. A questa in genere, in un secondo momento viene fatta seguire una circoncisione onde evitare recidive. La circoncisione può prevenire sia la parafimosi che la fimosi.
Prognosi per fimosi e parafimosi?
La fimosi guarisce molto facilmente, mentre per la parafimosi dipende da vari fattori come la diagnosi rapida e l’intervento ancora più veloce. Un ritardo nell’azione può provocare qualche problema, anche serio, se si tarda troppo, addirittura una cancrena della punta del pene in caso di prolungato e mancato afflusso di sangue. Per fortuna questo avviene rarissimamente.
Potrebbero interessarvi anche i seguenti articoli:
- Igiene del neonato, il pisellino non si tocca
- Parafimosi
- Sintomi dell’infezione da candida
- Balanite: sintomi e cause
- Prostatite: tipi, cause, sintomi e terapia
Foto: Thinkstock
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