BXO / Lichen Sclerosus Atrophicus (LSA) and Grade 5 Phimosis – A need for early ZSR circumcision

Today’s case is a 25 year old healthy male with severe grade 5 Phimosis. For grades of phimosis see this video.

As you can see in the attached pictures, the Glans has completely closed off and the pee hole is not visible.

This is a classic case of ignored BXO or LSA induced phimosis, and this can cause severe problems for the patient.

Why do patients ignore BXO and LSA induced Phimosis ?

There can be multiple reasons. But the 2 most common reasons are

  • Patient ignorance – When the patient isn’t sexually active, they tend to ignore their worsening skin condition.
  • Ignorance of general physicians and dermatologist – Even dermatologists and physicians continue to prescribe Steroids and Tacrolimus for BXO. All it leads to is increase in severity without actually curing the disease.

Problems of BXO and LSA on the Glans and Foreskin

BXO and LSA can have severe untoward consequences on the Glans when left untreated.

  • Disfigurement of the Glans head
  • Loss of foreskin length
  • Shortening of frenulum
  • UTI
  • Meatal stenosis
  • Development of Urethral strictures
  • Loss of sensation
  • Balanitis
  • Loss of sexual pleasure

The correct treatment of BXO and LSA induced phimosis is early circumcision.

Zsr circumcision is the best method for handling these conditions.

But an experienced surgeon needs to perform these surgeries as these are very difficult circumcision to perform.

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