Which of the following is a treatment of choice for phimosis?

IGNOU PB Bsc Nsg Entrance-2017

Medical Surgical Nursing

Easy

Appeared in: IGNOU PB Bsc Nsg Entrance-2017

Explanation

Phimosis is a condition where the foreskin cannot be retracted over the glans penis.
While physiologic phimosis is normal in infants and often resolves, pathologic phimosis caused by scarring or inflammation requires intervention.
Circumcision, the surgical removal of the foreskin, is the definitive treatment for persistent or symptomatic phimosis.
Conservative treatment with topical corticosteroids may be effective in some cases, but if it fails or if symptoms like ballooning of the foreskin during urination are present, circumcision is recommended.

Option B: Excision is a general surgical term for the removal of tissue. While circumcision is a form of excision, it is not the most specific or accurate term for the procedure used to treat phimosis.
Option C: Penectomy, the removal of the penis, is a radical and disfiguring surgery. It is not a treatment for phimosis, which is a benign condition of the foreskin.
Option D: Removal of the testes (orchiectomy) is a procedure that involves the scrotum and its contents, not the penis or foreskin. It has no role in the treatment of phimosis.

Clinical Relevance

Nursing practice connection: Knowing Surgical treatment for phimosis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
It is crucial for nurses to differentiate between physiologic phimosis in infants, which is normal and requires only gentle hygiene, and pathologic phimosis, which may require medical or surgical intervention.
Post-circumcision care is a key nursing responsibility, focusing on pain management, preventing infection, and monitoring for bleeding. Educating parents on proper care is essential for a good outcome.
What if? If a patient with phimosis also presents with paraphimosis (a urologic emergency where the retracted foreskin cannot be returned to its normal position), immediate manual reduction is the first step. If unsuccessful, an emergency dorsal slit or circumcision is required to prevent vascular compromise to the glans.

How to Approach the Question

First, understand the question stem. It asks for the 'treatment of choice' for 'phimosis'.
Define phimosis: It's the inability to retract the foreskin.
Evaluate the options based on this definition.
Option A, Circumcision, is the surgical removal of the foreskin. This directly addresses the problem.
Option B, Excision, is a general term. While technically correct, 'circumcision' is the specific medical procedure.
Option C, Penectomy (penis removal), and Option D, Removal of testes, are radical surgeries for cancer and are clearly incorrect for a foreskin issue.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 pp. 1100-1102, 1101-1103

E6 Obstetrics Williams p. 4-11