Phimosis is a congenital defect in the development of the foreskin – it is constricted.
In children, phimosis is normal in the first five years.
Mostly, already before the child’s fifth birthday, the foreskin stops being sticky and it can be pulled back fully to expose the glans. This should be possible at the latest when the child starts school.
This is also the right time to consider an operation if the boy is not yet able to pull back the foreskin completely.
At this age, the child enters the genital phase and recognizes the difference between boys and girls. A boy would then regard a change in his penis as negative and feel at a comparative disadvantage among his peers.
The operation in children always requires a general anaesthesia as the ability to understand what the doctor is doing is not given at this age so a local anaesthesia is not considered sufficient in this case.
The operation is an out-patient procedure and a few hours afterwards the parent and child can leave the operating centre.
The public health insurance fully covers this operation.
Bed wetting is quite a common problem in children.
As a rule, a delayed maturation in a part of the brain responsible for the production of hormones controlling the production of urine is the cause.
This is the case for enuresis nocturna – bed wetting at night – in particular. This form of bed wetting can be treated well with medication.
Alternative treatments such as alarm trousers which wake children at night are also very effective.
Urological testing to check on any neurological damage is necessary in any case. The diagnosis shows quite clearly whether it is a case of physiological delayed maturation or a basic neurological illness.
The parents do not need to worry as the basic tests are not stressful.