What happens to the tissues
With this disease, chronic inflammation develops in the skin and mucous membranes, after which normal elastic tissue is replaced by dense scar tissue. Outwardly, this manifests itself as whitish, slightly shiny areas, the skin becomes thin, but at the same time hard and unyielding.
The process slowly spreads: first the foreskin and head are affected, then the external opening of the urethra can be involved, and in advanced cases, the urethra itself over a considerable length.
The exact reason has not been established. Autoimmune mechanisms, genetic predisposition, the role of chronic urinary irritation in impaired outflow and tissue trauma are discussed. In some patients, the disease is combined with other autoimmune conditions, including thyroid pathology.
Symptoms
- Whitish, porcelain-white spots and plaques on the glans and inner layer of the foreskin
- Itching and burning
- Dry and tight skin
- Gradual development of phimosis: the foreskin stops moving
- Dense white ring around the edge of the foreskin
- Pain and pain during erection and sexual intercourse
- Narrowing of the external opening of the urethra with thinning of the urine stream
- Difficulty urinating, straining, splashing stream
- Recurrent balanoposthitis
- Reduced sensitivity of the head
- Sometimes - completely asymptomatic at an early stage
Why is it considered a precancerous condition?
Long-term lichen sclerosus increases the risk of developing squamous cell carcinoma of the penis. The mechanism is associated with chronic inflammation and constant renewal of damaged cells.
- There is a risk, but the vast majority of patients do not get cancer
- The danger increases sharply with prolonged course without treatment.
- Alarming: non-healing ulcer, dense nodule, proliferation, bleeding area
- For any suspicious change, a biopsy is indicated
- Regular observation by a urologist is the main way to identify the problem at an early stage
The practical conclusion is simple: diagnosis requires not a one-time ointment, but a system - treatment and routine monitoring with examinations. This significantly reduces the risk and allows you to notice unfavorable dynamics in time.
Diagnostics
- Examination by a urologist or dermatologist - the characteristic picture is often recognizable visually
- Biopsy with histological examination confirms the diagnosis and excludes a malignant process
- Uroflowmetry - assessment of urine outflow disorders
- Ultrasound of the bladder with determination of residual urine
- Retrograde urethrography and ultrasound of the urethra in case of suspected lesions
- Urethroscopy
- Blood glucose - excludes diabetes mellitus, which aggravates the course
- Thyroid examination and screening for autoimmune diseases as indicated
- Screening for infections in cases of recurrent inflammation
Treatment
- Local high-potency corticosteroid ointments are the basis of treatment in the early stages; are assigned a course according to a specific scheme
- Calcineurin inhibitors as an alternative when prescribed by a doctor
- Emollients and barrier skin care products
- Careful but gentle hygiene without aggressive antiseptics
- Circumcision - for cicatricial phimosis; often turns out to be a radical solution, since the bulk of the affected tissue is removed
- Meatotomy and plastic surgery of the external urethral meatus when it is narrowed
- Buccal urethroplasty - if the urethra is affected throughout; The buccal mucosa is resistant to this disease and serves as an optimal material
- Bougienage and optical urethrotomy are temporary measures; with this disease give unstable results
- Compensation for diabetes mellitus
- Regular monitoring with examination and uroflowmetry
Observation and prevention of complications
- Regular examinations by a urologist even in the absence of complaints
- Self-examination and treatment if ulcers, nodules, or bleeding appear
- Control of urine stream; if it weakens, contact without waiting for a scheduled visit
- Periodic uroflowmetry
- Biopsy for any suspicious change
- Skin care with emollients
- Quitting smoking
- Glucose control
- Elimination of aggressive antiseptics and irritating hygiene products
Where is treatment in Tashkent
An examination by a urologist, the possibility of a biopsy, a voiding assessment and, if the urethra is affected, reconstructive surgery are required.
In Tashkent, examination and treatment of lichen sclerosus, including circumcision and buccal urethroplasty, is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
If you have white lumps on the glans or foreskin, do not treat with ointments at random: this diagnosis requires confirmation and routine monitoring due to the risk of malignant transformation. Clinic contacts are below.
