Synechiae in little girls and women: what is the danger. ICD code for synechia of the foreskin Synechia code for ICD 10 in children

• nukka canal congenital
• vaginal embryonic

Congenital:

• no vulva
• vulvar cyst
• vulvar anomaly NOS

In Russia, the International Classification of Diseases of the 10th revision (ICD-10) has been adopted as a single normative document to take into account the incidence, the reasons for the population's visits to medical institutions of all departments, and the causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Ministry of Health of Russia dated 05/27/97. No. 170

A new revision (ICD-11) is planned by WHO in 2017 2018.

As amended and supplemented by WHO

Processing and translation of changes © mkb-10.com

Synechiae in boys: causes and treatment

The head of the genital organ in almost every newborn boy does not open. It is not considered a pathology until a certain age. Many parents can observe adhesions of the head of the penis to the foreskin in a child, which are called synechia. In adult men, it is considered a serious illness. Consider what synechiae in boys are, what to do with them, how to carry out treatment.

What it is

Synechia in boys, what kind of pathology is, we will consider in more detail. If the boy's foreskin has grown to the head, adhesions are visible, this indicates the appearance of this disease.

Synechiae of the foreskin, ICD code 10 - N48: other diseases of the penis. This condition of the penis occurs in almost all children. This innate feature is designed to prevent pathogens from entering the foreskin and to prevent injury to the head.

By the age of three years, the baby's adhesions gradually dissolve, the head of the penis begins to partially or completely open. Normally, the disappearance of synechiae should be observed by the age of 7-11. If this does not happen, it is necessary to consult a specialist, since this condition is already considered a pathology.

If the foreskin has grown to the head of an adult man, surgical intervention is necessary, since this condition can lead to unpleasant consequences from the genitourinary system.

Important to remember! In no case should you breed synechiae in boys and adult men! This can lead to serious injury, resulting in problems with urinary excretion and, in adulthood, erectile dysfunction.

Causes of synechia

Synechiae of the foreskin in boys can be observed for various reasons. The most common prerequisites for this pathology are:

1. Development of viruses and infections. The ingress of pathogenic microorganisms into the organs of the genitourinary system is the most common reason that the boy's foreskin has grown to the head of the penis. Inflammatory processes that are observed due to the vigorous activity of pathogens cause the formation of adhesions. Therefore, if the slightest signs of inflammation on the genitals appear, you should immediately consult a doctor. You can prevent infection from entering the organs of the genitourinary system by observing the personal hygiene of the baby.
2. Diseases associated with allergies. Children who, as a result of exposure to certain factors, begin to suffer from allergic attacks, need to regularly visit a urologist for preventive purposes. This will help to timely detect or prevent inflammatory processes of an allergic nature in the genital area.
3. Complications during pregnancy. Every mother who carries a baby should be attentive to her health. Complications during pregnancy caused by infectious or viral diseases can lead to the formation of a significant number of synechiae in the baby, which will have to be eliminated exclusively by a surgical method. Almost every pregnant woman carefully monitors her health, therefore adhesions for this reason appear in a child in extremely rare cases.
4. Injury to the genital organ. Every boy is born with the glans of the penis closed. Vigorous attempts to pull back the foreskin on its own can damage the penis. This is in most cases the reason that the foreskin has grown to the head of the child.
5. Getting burned. Such damage can be caused by radiation, radiation, the ingress of caustic chemicals on the genitals, thermal exposure. As a result, scars are formed, which lead to the appearance of large adhesions. You cannot get rid of them on your own. Only surgery is required to normalize the condition.

The mechanism for the development of adhesions in children is the release of an excessive amount of smegma for various reasons. Its congestion under the foreskin leads to the formation of adhesions.

Important to remember! Every parent needs to pay due attention to the personal hygiene of the baby! This will help prevent the appearance of synechia.

Symptoms of pathology

If a child has physiological synechiae that are not associated with inflammatory processes, then they separate over time. Incomplete adhesion of the head and foreskin with adhesions does not cause discomfort or problems with urination.

If the boy's foreskin has grown together with the head as a result of inflammation, this is accompanied by the following symptoms:

• swelling in the area of ​​the glans penis, the upper part of the organ looks larger than the lower;
• discoloration of the skin on the top of the penis;
• pain, burning and other uncomfortable sensations at the time of urination;
• sharp pain in the penis even in a calm state;
• excessive discharge with particles of pus;
• problems with urine excretion, fluid comes out in small quantities, drop by drop.

Synechiae in men is characterized by painful sensations in a state of erection, as well as at the time of sexual contact. Young people in most cases refuse to have sex until complete recovery.

Diagnosis of the disease

It is quite simple to detect synechiae of the penis. The specialist only needs to conduct a visual examination of the penis. The doctor should be consulted in cases where the synechiae of the foreskin in boys is not divided until the age of three.

In addition to examination, the child is sent for such additional research:

1. General urine analysis. It is necessary to exclude the development of a disease such as urethritis. Because the symptoms are similar.
2. General blood analysis. It is required to take it at an elevated body temperature to exclude the development of infectious diseases.
3. Ultrasound diagnostics of the organs of the genitourinary system. The penis, scrotum, bladder, kidneys are examined. Ultrasound examination is carried out in cases where there is a suspicion of the rapid spread of inflammatory processes.

Based on the results of the studies carried out, the urologist establishes an accurate diagnosis. Then he prescribes the necessary treatment. If the adhesions are too large, then the patient is referred for surgery.

Treatment of synechia in boys

If synechiae are observed in boys, what to do in this case, we will consider in more detail. There are several ways to normalize the condition of the penis. Their use depends on the size of the adhesions and the age of the child. Let's consider each method of influence.

Self-separation of adhesions

Treatment of synechia in boys at home is advisable to carry out up to 6-7 years. To do this, it is necessary to carry out the following manipulations:

• place the child in a bathtub with warm water;
• 30–40 minutes after steaming, separation of the boy's synechia should be carried out, without stopping contact with water;
• slowly and carefully pull back the foreskin, trying to bare the glans penis.

The division of the synechiae of the foreskin in boys in this way should be carried out 2-3 times a week. The duration of such treatment takes about 3–6 months. It all depends on the size and number of adhesions.

Drug therapy

If the synechiae of the foreskin in boys causes inflammation, treatment at home is required with the use of medications. For this, creams and ointments of the glucocorticosteroid group are used. Hormonal drugs help eliminate unpleasant symptoms such as swelling, redness, and cracks in the head of the penis. Regular use of glucocorticosteroids restores the firmness and elasticity of the flesh, due to which the adhesions gradually disperse. The most common topical drugs in this group are Hydrocortisone Ointment and Contractubex.

It is necessary to apply ointments or creams to the head and foreskin. This should be done carefully so as not to damage the surface of the skin. The duration of such treatment for synechia in boys is determined by a specialist.

Surgical intervention

If the boy's synechiae persists, what to do? Usually, a surgical method for treating synechia in boys is prescribed after reaching 12 years of age. Up to this point, they can disperse on their own. Spontaneous dilution of adhesions is observed as a result of exposure to such factors:

• sudden, unreasonable erections typical of boys during puberty;
• inflammation of the prepuce;
• secretion of enzymes of the sebaceous glands.

But without surgery and other treatment methods, only minor adhesions can be eliminated. Large synechiae require more radical actions to eliminate them.

Large synechiae causing regular inflammatory processes must be removed with surgery. It is usually performed under local anesthesia and does not require any special training.

The essence of the operation is to free the head and flesh of the penis from the adhesions present.

In some cases, an operation such as circumcision is performed. Its essence lies in the partial or complete excision of the foreskin. In other words, circumcision is done. This type of surgical intervention allows you to get rid of not only synechiae, but also from physiological or pathological phimosis.

In the postoperative period, it is necessary to carefully monitor the hygiene of the penis. It is necessary to rinse the head daily under running water, and then treat it with antibacterial drugs such as Erythromycin, Levomekol, Miramistin and others.

It is also useful to make local baths based on decoctions of medicinal herbs such as calendula, chamomile, mint. It is necessary to carry out such procedures within 1 week after surgery.

If the boy's rehabilitation period is delayed, then for full recovery he is prescribed antibacterial drugs for oral administration.

Possible consequences

Synechia of the foreskin in boys requires appropriate treatment if it has not disappeared by the age of 12. If you ignore this pathology, then inaction can lead to such unpleasant consequences:

1. Problems with urination. Large adhesions over time lead to a blockage of the urethra. As a result, the boy experiences severe pain, burning and stinging sensations in the process of urine excretion. He also has a constant feeling of an empty bladder.
2. Balanoposthitis. This disease is characterized by an inflammatory process in the head and foreskin. It is observed due to the accumulation of an excessive amount of natural secretions under the foreskin. Large synechiae do not allow adequate hygiene of the penis. The danger of balanoposthitis is that after a certain period of time it transforms into a chronic form.
3. Cicatricial phimosis. As a result of excessive adhesions, the foreskin narrows. In the future, this leads to the fact that the young man cannot enter into intimacy. Erection and sex are painful.

The most dangerous complication of synechia in a child is the development of benign or malignant tumors under the foreskin of the penis. Due to the pinching of the head, smegma accumulates, which has carcinogenic properties. It is extremely difficult to get rid of such a pathology. The treatment will take a long period of time. It is difficult to predict the successful outcome of therapy in this case.

The main rule that will help prevent the formation of pathological adhesions is strict adherence to the hygiene of the genital organ in boys. It consists in carrying out such events:

1. Daily rinsing of the head of the penis under running water. It is better to use warm boiled water for this procedure. It is also useful to wash the genitals in a decoction of medicinal herbs. To do this, you need to brew 1 tsp in 1 glass of boiling water. dried chamomile, calendula, mint or St. John's wort.
2. Do not try to pull back the foreskin on your own if it is difficult. This can lead to injury to the penis, the formation of cracks, which are accompanied by discomfort.
3. Change diapers in a timely manner. Long-term presence of a child in an overfilled diaper causes irritation and inflammation. When changing a diaper, it is useful for a child to take air baths. As for the use of diapers during the hot season, it is better to refuse them for this period. Since the baby is sweating, as a result of which a favorable environment is formed for the active development of pathogenic microorganisms.
4. Choose the right underwear. Children's panties should be made only from natural materials. Synthetics can cause allergic reactions. Also, do not forget about the selection of the correct size of panties for the baby. They should not chafe or squeeze the penis.

Compliance with these rules will help parents avoid complications that cause synechiae. Even if the boy has adhesions under the foreskin, proper care of the penis will help prevent them from transforming into a pathological form.

The penis requires strict hygiene and careful handling from the very birth of the baby. The formation of synechia in newborns is not pathological. Contacting a specialist requires their presence after the age of three. But this is also not a reason to raise a panic. Up to 7 years old, you can do without surgery. If the adhesions cause swelling, redness, or inflammation, it is best to consult a surgeon. At an early age, the healing process of postoperative wounds does not take long. But the operation in this case will save the boy from the dangerous consequences of pathological synechiae in the future.

International Classification of Diseases

The International Statistical Classification of Diseases (ICD for short) is a document used to classify diseases in health care. This classifier is revised every ten years under the guidance of the World Health Organization. ICD is a normative document that ensures the unity of methodological approaches and international comparability of materials. Currently, the International Classification of Diseases of the Tenth Revision (ICD-10 or ICD-10) is in force, which includes the names and codes of 12,255 diseases. The ICD is used to convert the verbal formulation of disease diagnoses into alphanumeric codes.

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ICD code: N85.6

Intrauterine synechiae

Intrauterine synechiae

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ICD 10. Class XIV (N00-N99)

ICD 10. CLASS XIV. DISEASES OF THE Urogenital System (N00-N99)

Excludes: certain conditions originating in the perinatal period (P00-P96)

complications of pregnancy, childbirth and the puerperium (O00-O99)

congenital malformations, deformities and chromosomal abnormalities (Q00-Q99)

endocrine system diseases, eating disorders and metabolic disorders (E00-E90)

trauma, poisoning and some other consequences of exposure to external causes (S00-T98)

symptoms, signs and abnormalities identified in clinical and laboratory tests, not elsewhere classified (R00-R99)

This class contains the following blocks:

N10-N16 Tubulo-interstitial kidney disease

N30-N39 Other diseases of the urinary system

N70-N77 Female pelvic inflammatory disease

N80-N98 Non-inflammatory diseases of female genital organs

N99 Other disorders of the genitourinary system

The following categories are marked with an asterisk:

N22 * Urinary tract stones in diseases classified elsewhere

N37 * Disorders of the ureter in diseases classified elsewhere

N74 * Pelvic inflammatory disease in women with diseases classified elsewhere

GLOMERULAR DISEASES (N00-N08)

If it is necessary to identify an external cause (class XX) or in the presence of renal failure (N17-N19), use an additional code.

Excludes: hypertension with predominant renal impairment (I12. -)

The following fourth characters may be used with headings N00-N07 to classify morphological changes in Sub-headings. 0 to .8 should not be used unless specific studies have been performed to identify lesions (eg, renal biopsy or autospy). The triple-digit headings are based on clinical syndromes.

0 Minor glomerular disorders. Minimal damage

1 Focal and segmental glomerular lesions

Focal and segmental:

2 Diffuse membranous glomerulonephritis

3 Diffuse mesangial proliferative glomerulonephritis

4 Diffuse endocapillary proliferative glomerulonephritis

5 Diffuse mesangiocapillary glomerulonephritis. Membranoproliferative glomerulonephritis (type 1 and 3 or NOS)

6 Disease of dense sediment. Membranous-proliferative glomerulonephritis (type 2)

7 Diffuse sickle glomerulonephritis. Extracapillary glomerulonephritis

8 Other changes. Proliferative glomerulonephritis NOS

9 Unspecified change

N00 Acute nephritic syndrome

Excludes: acute tubulointerstitial nephritis (N10)

N01 Rapidly progressive nephritic syndrome

Included: rapidly progressive (s):

Excludes: nephritic syndrome NOS (N05 .-)

N02 Recurrent and persistent hematuria

Benign (familial) (children)

With morphological lesion, specified in v.0- .8

Excludes: hematuria NOS (R31)

N03 Chronic nephritic syndrome

Excludes: chronic tubulointerstitial nephritis (N11. -)

nephritic syndrome NOS (N05 .-)

N04 Nephrotic syndrome

Includes: congenital nephrotic syndrome

N05 Unspecified nephritic syndrome

Includes: glomerular disease>

nephropathy NOS and renal disease NOS with morphological lesion, specified v.0- .8

Excludes: nephropathy NOS of unknown cause (N28.9)

renal disease NOS of unknown cause (N28.9)

tubulointerstitial nephritis NOS (N12)

N06 Isolated proteinuria with specified morphological lesion

Includes: proteinuria (isolated) (orthostatic)

(persistent) with morphological lesion, specified

N07 Hereditary nephropathy, not elsewhere classified

Excludes: Alport syndrome (Q87.8)

hereditary amyloid nephropathy (E85.0)

nail-patellar syndrome (absence) (underdevelopment) (Q87.2)

hereditary familial amyloidosis without neuropathy (E85.0)

N08 * Glomerular lesions in diseases classified elsewhere

Includes: nephropathy in diseases classified elsewhere

Excludes: renal tubulointerstitial lesions in diseases classified elsewhere (N16. - *)

Glomerular lesions in:

N08.1 * Glomerular lesions in neoplasms

Glomerular lesions in:

N08.2 * Glomerular lesions in blood diseases and immune disorders

Glomerular lesions in:

Disseminated intravascular coagulation [defibrination syndrome] (D65 +)

N08.3 * Glomerular lesions in diabetes mellitus (E10-E14 + with common fourth character 2)

N08.4 * Glomerular lesions in other diseases of the endocrine system, eating disorders and metabolic disorders

Glomerular lesions in:

Deficiency of lecithin cholesterol acyltransferase (E78.6 +)

N08.5 * Glomerular lesions in systemic connective tissue diseases

Glomerular disorders in:

Thrombotic thrombocytopenic purpura (M31.1 +)

N08.8 * Glomerular lesions in other diseases classified elsewhere

Glomerular disorders in subacute bacterial endocarditis (I33.0 +)

TUBULOINTERSTITIAL DISEASES OF KIDNEY (N10-N16)

Excludes1: cystic pyeloureteritis (N28.8)

N10 Acute tubulointerstitial nephritis

N11 Chronic tubulointerstitial nephritis

Infectious interstitial nephritis

N11.0 Non-obstructive chronic pyelonephritis associated with reflux

Pyelonephritis (chronic) associated with (vesicoureteral) reflux

Excludes: vesicoureteral reflux NOS (N13.7)

N11.1 Chronic obstructive pyelonephritis

Pyelonephritis (chronic) associated with:

Excludes: calculous pyelonephritis (N20.9)

N11.8 Other chronic tubulo-interstitial nephritis

Non-obstructive chronic pyelonephritis NOS

N11.9 Chronic tubulo-interstitial nephritis, unspecified

Interstitial nephritis NOS

N12 Tubulo-interstitial nephritis, not specified as acute or chronic

Interstitial nephritis NOS

Excludes1: calculous pyelonephritis (N20.9)

N13 Obstructive uropathy and reflux uropathy

Excludes: stones of the kidney and ureter without hydronephrosis (N20 .-)

congenital obstructive changes in the renal pelvis and ureter (Q62.0-Q62.3)

obstructive pyelonephritis (N11.1)

N13.0 Hydronephrosis with obstruction of the ureteropelvic junction

N13.1 Hydronephrosis with ureteral stricture, not elsewhere classified

N13.2 Hydronephrosis with obstruction of kidney and ureter calculus

N13.3 Other and unspecified hydronephrosis

N13.5 Kink and stricture of ureter without hydronephrosis

Conditions listed in the headings N13.0-N13.5, with infection. Obstructive uropathy with infection

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N13.7 Uropathy due to vesicoureteral reflux

Excludes1: pyelonephritis associated with vesicoureteral reflux (N11.0)

N13.8Other obstructive uropathy and reflux uropathy

N13.9 Obstructive uropathy and reflux uropathy, unspecified Urinary tract obstruction NOS

N14 Tubulointerstitial and tubular lesions due to drugs and heavy metals

If it is necessary to identify a toxic substance, an additional external cause code (class XX) is used.

N14.0 Nephropathy due to analgesics

N14.1 Nephropathy due to other drugs, medicaments or biologically active substances

N14.2 Nephropathy due to unspecified drug, medicament and biologically active substance

N14.3 Heavy metal nephropathy

N14.4 Toxic nephropathy, not elsewhere classified

N15 Other tubulointerstitial renal diseases

N15.0 Balkan nephropathy. Balkan endemic nephropathy

N15.1 Abscess of kidney and perirenal tissue

N15.8 Other specified renal tubulo-interstitial disorders

N15.9 Unspecified tubulointerstitial renal disease Kidney infection NOS

Excludes1: urinary tract infection NOS (N39.0)

N16 * Tubulo-interstitial renal disease in diseases classified elsewhere

N16.1 * Tubulointerstitial renal disease in neoplasms

Tubulointerstitial kidney damage in:

N16.2 * Tubulointerstitial renal disease in blood diseases and disorders involving the immune mechanism

Tubulointerstitial kidney damage in:

N16.3 * Tubulo-interstitial kidney damage in metabolic disorders

Tubulointerstitial kidney damage in:

N16.4 * Tubulo-interstitial kidney damage in systemic connective tissue diseases

Tubulointerstitial kidney damage in:

N16.5 * Tubulointerstitial renal disease in transplant rejection (T86. - +)

N16.8 * Tubulointerstitial renal disease in other diseases classified elsewhere

RENAL FAILURE (N17-N19)

If it is necessary to identify the external agent, an additional external reason code (class XX) is used.

Excludes: congenital renal failure (P96.0)

tubulointerstitial and tubular lesions caused by drugs and heavy metals (N14.-)

extrarenal uremia (R39.2)

hemolytic uremic syndrome (D59.3)

hepatorenal syndrome (K76.7)

N17 Acute renal failure

N17.0 Acute renal failure with tubular necrosis

N17.1 Acute renal failure with acute cortical necrosis

N17.2 Acute renal failure with medullary necrosis

Medullary (papillary) necrosis:

N17.8 Other acute renal failure

N17.9 Acute renal failure, unspecified

N18 Chronic renal failure

Includes: chronic uremia, diffuse sclerosing glomerulonephritis

Excludes1: chronic renal failure with hypertension (I12.0)

N18.0 End-stage renal disease

N18.8 Other manifestations of chronic renal failure

N18.9 Chronic renal failure, unspecified

N19 Renal failure, unspecified

Excludes: renal failure with hypertension (I12.0)

URINE STEALTH DISEASE (N20-N23)

N20 Kidney and ureter stones

Excludes: with hydronephrosis (N13.2)

N20.0 Kidney stones. Nephrolithiasis NOS. Calculi or kidney stones. Coral calculi. Kidney stone

N20.1 Ureteral stones Ureteral calculus

N20.2 Kidney stones with ureteral stones

N20.9 Urinary stones, unspecified Calculous pyelonephritis

N21 Lower urinary tract stones

Includes: with cystitis and urethritis

N21.0 Stones in the bladder. Concretions in the diverticulum of the bladder. Bladder stone

Excludes: coral calculi (N20.0)

N21.8 Other lower urinary tract stones

N21.9Lower urinary tract calculi, unspecified

N22 * Urinary tract stones in diseases classified elsewhere

N22.0 * Urinary stones in schistosomiasis [bilharziasis] (B65. - +)

N22.8 * Urinary tract calculi in other diseases classified elsewhere

N23 Renal colic, unspecified

OTHER DISEASES OF THE KIDNEY AND URETER (N25-N29)

N25 Disorders resulting from renal tubular dysfunction

Excludes: metabolic disorders classified under E70-E90

N25.0 Renal osteodystrophy Azotemic osteodystrophy. Tubular Disorders Associated with Phosphate Loss

N25.1 Nephrogenic diabetes insipidus

N25.8 Other disorders due to renal tubular dysfunction

Lightwood-Albright Syndrome. Renal tubular acidosis NOS. Secondary hyperparathyroidism of renal origin

N25.9 Renal tubular dysfunction, specified

N26 Shrinked kidney, unspecified

Kidney atrophy (terminal). Renal sclerosis NOS

Excludes: shriveled kidney with hypertension (I12. -)

diffuse sclerosing glomerulonephritis (N18 .-)

hypertensive nephrosclerosis (arteriolar) (arteriosclerotic) (I12. -)

small kidney for no known reason (N27.-)

N27 Small kidney of unknown origin

N27.0 Small kidney, unilateral

N27.1 Small kidney, bilateral

N27.9 Small kidney, unspecified

N28 Other diseases of kidney and ureter, not elsewhere classified

kink and stricture of the ureter:

N28.0 Ischemia or infarction of kidney

Excludes: Goldblatt's kidney (I70.1)

renal artery (extrarenal part):

N28.1 Kidney cyst, acquired Cyst (multiple) (single) kidney, acquired

Excludes1: cystic kidney disease (congenital) (Q61. -)

N28.8 Other specified diseases of kidney and ureter Kidney hypertrophy. Megaloureter. Nephroptosis

N28.9 Diseases of kidney and ureter, unspecified Nephropathy NOS. Renal disease NOS

Excluded: nephropathy NOS and renal disorders NOS with morphological lesions specified in the rubrics. 0- .8 (N05 .-)

N29 * Other disorders of the kidney and ureter in diseases classified elsewhere

Lesions of the kidney and ureter with:

N29.8 * Other disorders of the kidneys and ureters in other diseases classified elsewhere

OTHER DISEASES OF THE URINARY SYSTEM (N30-N39)

Excludes: urinary tract infection (complicating):

N30 Cystitis

If necessary to identify the infectious agent (B95-B97) or the corresponding external factor (class XX), use an additional code.

Excludes1: prostatocystitis (N41.3)

N30.1 Interstitial cystitis (chronic)

N30.2 Other chronic cystitis

N30.3 Trigonite Urethrotrigonitis

N30.8 Other cystitis Bladder abscess

N31 Bladder neuromuscular dysfunction, not elsewhere classified

Excludes: spinal bladder NOS (G95.8)

due to spinal cord injury (G95.8)

neurogenic bladder associated with cauda equina syndrome (G83.4)

N31.0 Uninhibited bladder, not elsewhere classified

N31.1 Reflex bladder, not elsewhere classified

N31.2 Neurogenic weakness of the bladder, not elsewhere classified

Neurogenic bladder:

Atonic (motor impairment) (sensory impairment)

N31.8 Other neuromuscular dysfunctions of urinary bladder

N31.9 Unspecified neuromuscular dysfunction of urinary bladder

N32 Other disorders of the bladder

Excludes: stone of bladder (N21.0)

hernia or prolapse of the bladder in women (N81.1)

N32.0 Obturation of the bladder neck Bladder neck stenosis (acquired)

N32.1 Vesico-intestinal fistula Vesico-colonic fistula

N32.2 Cystic fistula, not elsewhere classified

Excludes: fistula between bladder and female genital tract (N82.0-N82.1)

N32.3 Bladder diverticulum. Bladder diverticulitis

Excludes: stone in bladder diverticulum (N21.0)

N32.4 Rupture of bladder, non-traumatic

N32.8 Other specified disorders of bladder

N32.9 Disorder of bladder, unspecified

N33 * Disorders of the bladder in diseases classified elsewhere

N33.8 * Disorders of the bladder in other diseases classified elsewhere

Bladder disorders in schistosomiasis [bilharziasis] (B65. - +)

N34 Urethritis and urethral syndrome

If necessary, identify the infectious agent

Excludes: Reiter's disease (M02.3)

urethritis in diseases primarily sexually transmitted (A50-A64)

Excludes: urethral caruncle (N36.2)

N34.1 Nonspecific urethritis

N34.2 Other urethritis Urethral meatitis. Ulcer of the urethra (external opening)

N34.3 Urethral syndrome, unspecified

N35 Urethral stricture

Excludes1: stricture of the urethra after medical procedures (N99.1)

N35.0 Posttraumatic urethral stricture

N35.1 Postinfectious urethral stricture, not elsewhere classified

N35.8 Other urethral stricture

N35.9 Urethral stricture, unspecified Outer hole of NOS

N36 Other diseases of the urethra

N36.0 Urethral fistula False urethral fistula

N36.1 Urethral diverticulum

N36.2 Urethral caruncle

N36.3 Prolapsed urethral mucosa Prolapsed urethra. Urertocele in men

Excludes: urethrocele in women (N81.0)

N36.8 Other specified diseases of urethra

N36.9 Disease of urethra, unspecified

N37 * Disorders of the urethra in diseases classified elsewhere

N37.0 * Urethritis in diseases classified elsewhere. Candidal urethritis (B37.4 +)

N37.8 * Other disorders of the urethra in diseases classified elsewhere

N39 Other diseases of the urinary system

N39.0 Urinary tract infection without localization

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N39.1 Persistent proteinuria, unspecified

Excludes: complicating pregnancy, childbirth and the puerperium (O11-O15)

with specified morphological changes (N06. -)

N39.2 Orthostatic proteinuria, unspecified

Excludes: with specified morphological changes (N06. -)

N39.3 Involuntary urination

N39.4 Other specified types of urinary incontinence

Reflex> urinary incontinence

N39.8 Other specified diseases of urinary system

N39.9 Disorder of urinary system, unspecified

DISEASES OF THE MALE GENITAL ORGANS (N40-N51)

N40 Prostatic hyperplasia

Enlargement (benign)> of the prostate

Median lobe (prostate) adenoma

Blockage of prostate duct NOS

Excludes: benign tumors other than adenoma, fibroma

and prostate fibroids (D29.1)

N41 Inflammatory diseases of the prostate gland

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N41.1 Chronic prostatitis

N41.2 Abscess of prostate

N41.8 Other inflammatory diseases of the prostate

N41.9 Inflammatory prostate disease, unspecified Prostatitis NOS

N42 Other diseases of the prostate

N42.0 Prostate stones Prostatic stone

N42.1 Prostate congestion and hemorrhage

N42.2 Atrophy of prostate

N42.8 Other specified diseases of prostate

N42.9 Disease of prostate gland, unspecified

N43 Hydrocele and spermatocele

Includes: dropsy of the spermatic cord, testis, or testicular sheath

Excludes: congenital hydrocele (P83.5)

N43.0 Encapsulated hydrocele

N43.1 Infected hydrocele

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N43.2 Other forms of hydrocele

N43.3 Hydrocele, unspecified

N44 Testicular torsion

N45 Orchitis and epididymitis

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N45.0 Orchitis, epididymitis and epididymo-orchitis with abscess Abscess of the epididymis or testicle

N45.9 Orchitis, epididymitis and epididymo-orchitis without mention of abscess Epididymitis NOS. Orchitis NOS

N46 Male infertility

Azoospermia NOS. Oligospermia NOS

N47 Excessive foreskin, phimosis and paraphimosis

Tight-fitting foreskin. Tight foreskin

N48 Other diseases of the penis

N48.0 Leukoplakia of the penis Kraurosis of the penis

Excludes1: carcinoma in situ of the penis (D07.4)

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N48.2 Other inflammatory diseases of the penis

Carbuncle>

Penile cavernitis

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N48.3 Priapism Painful erection

N48.4 Impotence of organic origin

If necessary, an additional code is used to identify the cause.

Excludes1: psychogenic impotence (F52.2)

N48.6 Balanitis Plastic induration of the penis

N48.8 Other specific diseases of the penis

Hypertrophy of the corpus cavernosum and penis

N48.9 Disease of penis, unspecified

N49 Inflammatory diseases of male genital organs, not elsewhere classified

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N49.0 Inflammatory diseases of the seminal vesicle Vesiculitis NOS

N49.1 Inflammatory diseases of the spermatic cord, tunica vaginalis and vas deferens. Vazit

N49.2 Inflammatory diseases of scrotum

N49.8 Inflammatory diseases of other specified male genital organs

N49.9 Inflammatory diseases of unspecified male genital organ

Furuncle> unspecified male

Carbuncle> of the penis

N50 Other diseases of male genital organs

Excludes: testicular torsion (N44)

N50.1 Vascular disorders of male genital organs

Hemorrhage> male genital organs

N50.8 Other specific diseases of male genital organs

Hypertrophy> seminal vesicle, spermatic cord,

Edema> testicle [other than atrophy], vaginalis ulcer> ulcer and vas deferens

Chilocele of the vaginal membrane (non-filarial) NOS

N50.9 Disease of male genital organs, unspecified

N51 * Disorders of male genital organs in diseases classified elsewhere

N51.0 * Disorders of the prostate in diseases classified elsewhere

N51.1 * Disorders of testicles and epididymis in diseases classified elsewhere

N51.2 * Balanitis in diseases classified elsewhere

N51.8 * Other disorders of male genital organs in diseases classified elsewhere

Filarial chilocele of the tunica vaginalis (B74. - +)

Herpes infection of male genital organs (A60.0 +)

Seminal tuberculosis (A18.1 +)

DISEASES OF THE BREAST (N60-N64)

Excludes: diseases of breast associated with childbirth (O91-O92)

N60 Benign breast dysplasia

Includes: fibrocystic breast disease

N60.0 Solitary cyst of breast. Breast cyst

N60.1 Diffuse cystic breast disease Cystic mammary gland

Excludes: with epithelial proliferation (N60.3)

N60.2 Fibroadenosis of breast

Excludes1: breast fibroadenoma (D24)

N60.3 Fibrosclerosis of the breast Cystic mastopathy with epithelial proliferation

N60.4 Ectasia of breast ducts

N60.8 Other benign mammary dysplasias

N60.9 Benign mammary dysplasia, unspecified

N61 Inflammatory diseases of the breast

Abscess (acute) (chronic) (not postpartum):

Carbuncle of the mammary gland

Mastitis (acute) (subacute) (not postpartum):

Excludes1: infectious mastitis of newborn (P39.0)

N62 Breast hypertrophy

Breast hypertrophy:

N63 Unspecified mass of mammary gland

Breast nodule (s) NOS

N64 Other diseases of the breast

N64.0 Fissure and fistula of nipple

N64.1 Fatty necrosis of the mammary gland Fat necrosis (segmental) of the breast

N64.2 Breast atrophy

N64.3 Galactorrhea not associated with childbirth

N64.5 Other signs and symptoms of the breast. Breast induration. Discharge from the nipple

N64.8 Other specified diseases of the breast Galactocele. Subinvolution of the mammary gland (post-lactation)

N64.9 Disease of breast, unspecified

INFLAMMATORY DISEASES OF FEMALE PELVIC ORGANS (N70-N77)

N70 Salpingitis and oophoritis

tubo-ovarian inflammatory disease

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N70.0 Acute salpingitis and oophoritis

N70.1 Chronic salpingitis and oophoritis Hydrosalpinx

N70.9 Salpingitis and oophoritis, unspecified

N71 Inflammatory diseases of the uterus, other than the cervix

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N71.0 Acute inflammatory disease of uterus

N71.1 Chronic inflammatory disease of uterus

N71.9 Inflammatory disease of uterus, unspecified

N72 Inflammatory disease of the cervix

Endocervicitis> with or without erosion or ectropion

If necessary, identify the infectious agent

Excludes: erosion and ectropion of the cervix without cervicitis (N86)

N73 Other female pelvic inflammatory diseases

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

N73.0 Acute parametritis and pelvic cellulite

Broad ligament> specified as

Pelvic phlegmon in women>

N73.1 Chronic parametritis and pelvic cellulitis

Any condition in N73.0 specified as chronic

N73.2 Parametritis and pelvic phlegmon, unspecified

Any condition in N73.0 not specified as acute or chronic

N73.3 Acute female pelvic peritonitis

N73.4 Chronic pelvic peritonitis in women

N73.5 Female pelvic peritonitis, unspecified

N73.6 Female pelvic peritoneal adhesions

Excludes: postoperative pelvic peritoneal adhesions in women (N99.4)

N73.8 Other specified female pelvic inflammatory diseases

N73.9 Female pelvic inflammatory disease, unspecified

Infectious or inflammatory diseases of the female pelvic organs NOS

N74 * Female pelvic inflammatory disease in diseases classified elsewhere

N74.1 * Inflammatory diseases of female pelvic organs of tuberculous etiology (A18.1 +)

N74.2 * Female pelvic inflammatory disease caused by syphilis (A51.4 +, A52.7 +)

N74.3 * Gonococcal inflammatory diseases of female pelvic organs (A54.2 +)

N74.4 * Female pelvic inflammatory disease due to chlamydia (A56.1 +)

N74.8 * Female pelvic inflammatory disease in other diseases classified elsewhere

N75 Diseases of the bartholin gland

N75.0 Bartholin gland cyst

N75.1 Bartholin gland abscess

N75.8 Other diseases of the bartholin gland Bartholinitis

N75.9 Disease of Bartholin gland, unspecified

N76 Other inflammatory diseases of vagina and vulva

If necessary, an additional code (B95-B97) is used to identify the infectious agent.

Excludes: senile (atrophic) vaginitis (N95.2)

N76.0 Acute vaginitis Vaginitis NOS

N76.1 Subacute and chronic vaginitis

N76.2 Acute vulvitis Vulvitis NOS

N76.3 Subacute and chronic vulvitis

N76.4 Abscess of vulva Boil of the vulva

N76.5 Ulceration of vagina

T76.8Other specified inflammatory diseases of vagina and vulva

N77 * Ulceration and inflammation of the vulva and vagina in diseases classified elsewhere

Ulceration of the vulva with:

Vaginitis, vulvitis and vulvovaginitis with:

N77.8 * Ulceration and inflammation of vulva and vagina in diseases classified elsewhere

Ulceration of vulva in Behcet's disease (M35.2 +)

NON-INFLAMMATORY DISEASES OF FEMALE GENITAL ORGANS (N80-N98)

N80 Endometriosis

N80.0 Endometriosis of the uterus Adenomyosis

N80.1 Ovarian endometriosis

N80.2 Endometriosis of fallopian tubes

N80.3 Endometriosis of pelvic peritoneum

N80.4 Endometriosis of rectovaginal septum and vagina

N80.5 Intestinal endometriosis

N80.6 Endometriosis of cutaneous scar

N80.9 Endometriosis, unspecified

N81 Female genital prolapse

Excludes: prolapse of genital organs complicating pregnancy, labor or delivery (O34.5)

prolapse and hernia of ovary and fallopian tube (N83.4)

prolapse of vaginal stump after hysterectomy (N99.3)

Excluded: urethrocele with:

N81.1 Cystocele. Cystocele with urethrocele. Prolapsed vaginal wall (anterior) NOS

Excludes: cystothele with prolapsed uterus (N81.2-N81.4)

N81.2 Incomplete prolapse of uterus and vagina Prolapse of the cervix NOS

N81.3 Complete prolapse of uterus and vagina. Residence (uterus) NOS. Uterine prolapse of the third degree

N81.4 Uterine and vaginal prolapse, unspecified Uterine prolapse NOS

N81.5 Enterocele of vagina

Excludes: enterocele with prolapsed uterus (N81.2-N81.4)

N81.6 Rectocele. Prolapse of the back of the vagina

Excludes: rectal prolapse (K62.3)

N81.8 Other prolapse of female genital organs Lack of pelvic floor muscles

Old tears of the pelvic floor muscles

N81.9 Female genital prolapse, unspecified

N82 Fistula involving female genital organs

Excludes1: gallbladder fistula (N32.1)

N82.0 Vesicovaginal fistula

N82.1 Other fistulas of female genitourinary tract

N82.2 Vaginal-small intestinal fistula

N82.3 Colonic vaginal fistula Rectovaginal fistula

N82.4 Other female intestinal-genital fistulas Intestinal fistula

N82.5 Female genital-cutaneous fistulas

N82.8 Other fistulas of female genital organs

N82.9 Fistula of female genital organs, unspecified

N83 Noninflammatory lesions of ovary, fallopian tube and broad ligament of uterus

Excludes: hydrosalpinx (N70.1)

N83.0 Follicular ovarian cyst Graafian follicle cyst. Hemorrhagic follicular cyst (ovary)

N83.1 Cyst of corpus luteum Hemorrhagic cyst of the corpus luteum

N83.2 Other and unspecified ovarian cysts

Simple cyst> ovary

Excludes: ovarian cyst:

polycystic ovary syndrome (E28.2)

N83.3 Acquired atrophy of ovary and fallopian tube

N83.4 Prolapse and hernia of ovary and fallopian tube

N83.5 Torsion of ovary, pedicle and fallopian tube

Excluded: hematosalpinx with:

N83.7 Hematoma of broad ligament of uterus

N83.8 Other non-inflammatory diseases of ovary, fallopian tube and broad ligament

Broad ligament rupture syndrome [Masters-Allen]

N83.9 Noninflammatory disease of ovary, fallopian tube and broad ligament of uterus, unspecified

N84 Polyp of female genital organs

Excludes: adenomatous polyp (D28.-)

Excludes1: polypoid endometrial hyperplasia (N85.0)

N84.1 Polyp of cervix uteri Polyp of the mucous membrane of the cervix

N84.3 Polyp of vulva. Labia polyp

N84.8 Polyp of other parts of female genital organs

N84.9 Polyp of female genital organs, unspecified

N85 Other non-inflammatory diseases of the uterus, excluding cervix

inflammatory diseases of the uterus (N71 .-)

N85.0 Glandular endometrial hyperplasia

N85.1 Adenomatous endometrial hyperplasia Endometrial hyperplasia atypical (adenomatous)

N85.2 Uterine hypertrophy Large or enlarged uterus

Excludes1: postpartum uterine hypertrophy (O90.8)

Excludes1: postpartum subinvolution of the uterus (O90.8)

N85.4 Incorrect position of uterus

Excludes: as a complication of pregnancy, childbirth or after childbirth (O34.5, O65.5)

Excludes: current obstetric injury (O71.2)

postpartum uterine prolapse (N71.2)

N85.6 Intrauterine synechiae

N85.7 Hematometer. Hematosalpinx with hematometer

Excludes: hematometer with hematocolpos (N89.7)

N85.8 Other specified inflammatory diseases of the uterus Acquired uterine atrophy. Fibrosis of the uterus NOS

N85.9 Noninflammatory disease of uterus, unspecified Uterine lesions NOS

N86 Erosion and ectropion of cervix uteri

Decubital (trophic) ulcer>

Inversion> cervix

N87 Cervical dysplasia

Excludes1: carcinoma in situ of the cervix (D06 .-)

N87.0 Mild cervical dysplasia Grade I cervical intraepithelial neoplasia

N87.1 Moderate cervical dysplasia Grade II cervical intraepithelial neoplasia

N87.2 Severe cervical dysplasia, not elsewhere classified

Severe dysplasia NOS

Excludes: cervical intraepithelial neoplasia grade III with or without mention

severe dysplasia (D06 .-)

N87.9 Dysplasia of cervix uteri, unspecified

N88 Other non-inflammatory diseases of the cervix

Excludes: inflammatory diseases of the cervix (N72)

N88.0 Leukoplakia of cervix uteri

N88.1 Old rupture of the cervix Adhesions of the cervix

N88.2 Cervical stricture and stenosis

Excludes: as complication of labor (O65.5)

N88.3 Insufficiency of cervix uteri

Examination and care for (suspected) ischemic-cervical insufficiency outside of pregnancy

Excludes: complicating fetus and newborn (P01.0)

complicating pregnancy (O34.3)

N88.4 Hypertrophic lengthening of cervix uteri

N88.8 Other specified non-inflammatory diseases of cervix uteri

Excludes: current obstetric injury (O71.3)

N88.9 Noninflammatory disease of cervix uteri, unspecified

Excludes: carcinoma in situ of the vagina (D07.2), inflammation of the vagina (N76.-), senile (atrophic) vaginitis (N95.2)

N89.0 Mild vaginal dysplasia Intraepithelial neoplasia of the vagina, grade I

N89.1 Moderate vaginal dysplasia Grade II vaginal intraepithelial neoplasia

N89.2 Severe vaginal dysplasia, not elsewhere classified

Severe vaginal dysplasia NOS

Excludes: grade III vaginal intraepithelial neoplasia with or without mention

severe dysplasia (D07.2)

N89.3 Vaginal dysplasia, unspecified

N89.4 Vaginal leukoplakia

N89.5 Vaginal stricture and atresia

Excludes: postoperative vaginal adhesions (N99.2)

N89.6 Dense hymen. Rigid hymen. Dense virgin ring

Excludes: hymen covered with hymen (Q52.3)

N89.7 Hematocolpos. Hematokolpos with hematometer or with hematosalpinx

N89.8 Other non-inflammatory diseases of the vagina Beli NOS. Old vaginal tear. Vaginal ulcer

old rupture with involvement of pelvic floor muscles (N81.8)

N89.9 Noninflammatory disorder of vagina, unspecified

N90 Other non-inflammatory diseases of the vulva and perineum

Excludes1: carcinoma in situ of the vulva (D07.1)

N90.0 Mild vulvar dysplasia Intraepithelial neoplasia of the vulva, grade I

N90.1 Moderate vulvar dysplasia. Intraepithelial neoplasia of the vulva II degree

N90.2 Severe vulvar dysplasia, not elsewhere classified

Severe vulvar dysplasia NOS

Excludes: grade III intraepithelial neoplasia of the vulva with or without mention

severe dysplasia (D07.1)

N90.3 Vulvar dysplasia, unspecified

N90.5 Vulvar atrophy. Vulvar stenosis

N90.6 Vulvar hypertrophy. Hypertrophy of the labia

N90.8 Other specified non-inflammatory diseases of the vulva and perineum Vulvar adhesions. Clitoris hypertrophy

N90.9 Noninflammatory disease of vulva and perineum, unspecified

N91 Lack of menses, scanty and infrequent menses

Excludes1: ovarian dysfunction (E28 .-)

N91.0 Primary amenorrhea Violation of menstruation in puberty

N91.1 Secondary amenorrhea Lack of menstruation in women who have had them before

N91.2 Amenorrhea, unspecified Lack of menses NOS

N91.3 Primary oligomenorrhea. Scanty or infrequent periods from the onset

N91.4 Secondary oligomenorrhea. Lean or infrequent menses in women with previously normal periods

N91.5 Oligomenorrhea, unspecified Hypomenorrhea NOS

N92 Heavy, frequent and irregular menses

Excludes1: bleeding after menopause (N95.0)

N92.0 Profuse and frequent menses with regular cycle

Periodically profuse menses NOS. Menorrhagia NOS. Polymenorrhea

N92.1 Heavy and frequent menses with irregular cycle

Irregular bleeding during the intermenstrual period

Irregular, shortened intervals between menstrual bleeding. Menometrorrhagia. Metrorrhagia

N92.2 Heavy menses during puberty

Profuse bleeding at the beginning of the menstrual period. Puberty menorrhagia. Puberty bleeding

N92.3 Ovulatory bleeding Regular menstrual bleeding

N92.4 Profuse bleeding in premenopausal period

Menorrhagia or metrorrhagia:

N92.5 Other specified irregular menses

N92.6 Irregular menses, unspecified

Excludes: irregular menstruation in the background:

Shortened intervals or profuse bleeding (N92.1)

N93 Other abnormal uterine and vaginal bleeding

Excludes: neonatal vaginal bleeding (P54.6)

N93.0 Postcoital or contact bleeding

N93.8 Other specified abnormal uterine and vaginal bleeding

Dysfunctional or functional uterine or moisture bleeding NOS

N93.9 Abnormal uterine and vaginal bleeding, unspecified

N94 Pain and other conditions associated with female genital organs and menstrual cycle

N94.0 Pain in the middle of menstrual cycle

Excludes1: psychogenic dyspareunia (F52.6)

Excludes1: psychogenic vaginismus (F52.5)

N94.3 Premenstrual tension syndrome

N94.4 Primary dysmenorrhea

N94.5 Secondary dysmenorrhea

N94.6 Dysmenorrhea, unspecified

N94.8 Other specified conditions associated with female genital organs and menstrual cycle

N94.9 Conditions associated with female genital organs and menstrual cycle, unspecified

N95 Disorders of menopause and other disorders of the peri-menopausal period

Excludes: profuse bleeding in the premenopausal period (N92.4)

premature menopause NOS (E28.3)

N95.0 Postmenopausal bleeding

N95.1 Menopause and climacteric state in women

Menopause-related symptoms such as hot flashes, insomnia, headaches, impaired attention

Excludes: associated with artificial menopause (N95.3)

N95.2 Postmenopausal atrophic vaginitis Senile (atrophic) vaginitis

Excludes: associated with artificial menopause (N95.3)

N95.3 Conditions associated with artificially induced menopause Post-Artificial Menopause Syndrome

N95.8 Other specified disorders of menopausal and perimenopausal narrow period

N95.9 Menopausal and perimenopausal disorders, unspecified

N96 Habitual miscarriage

Examination or medical care outside of pregnancy. Relative infertility

Excludes: current pregnancy (O26.2)

N97 Female infertility

Included: inability to get pregnant

female sterility NOS

Excludes: relative infertility (N96)

N97.0 Female infertility due to lack of ovulation

N97.1 Female infertility of tubal origin Associated with congenital malformation of the fallopian tubes

N97.2 Female infertility of uterine origin Associated with congenital malformation of the uterus

Egg implantation defect

N97.3 Female infertility of cervical origin

N97.4 Female infertility due to male factors

N97.8 Other forms of female infertility

N97.9 Female infertility, unspecified

N98 Complications associated with artificial insemination

N98.0 Infection associated with artificial insemination

N98.1 Ovarian hyperstimulation

Associated with induced ovulation

N98.2 Complications of attempted implantation of a fertilized egg after extracorporeal

N98.3 Complications of attempted embryo implantation

N98.8 Other complications associated with artificial insemination

Complications of artificial insemination:

N98.9 Complications associated with artificial insemination, unspecified

OTHER DISEASES OF THE Urogenital System (N99)

N99 Disorders of the genitourinary system after medical procedures, not elsewhere classified

Excludes: radiation cystitis (N30.4)

osteoporosis after surgical removal of the ovary (M81.1)

conditions associated with artificially induced menopause (N95.3)

N99.0 Postoperative renal failure

N99.1 Postoperative urethral stricture Urethral stricture after catheterization

N99.2 Postoperative vaginal adhesions

N99.3 Prolapse of vaginal fornix after extirpation of uterus

N99.4 Postoperative adhesions in small pelvis

N99.5 Dysfunction of external urinary tract stoma

N99.8 Other disorders of the genitourinary system after medical procedures. Residual ovary syndrome

N99.9 Disorder of genitourinary system after medical procedures, unspecified

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CLASS XIV. DISEASES OF THE Urogenital System (N00-N99)

This class contains the following blocks:
N00-N08 Glomerular diseases
N10-N16 Kidney tubulointerstitial disease
N17-N19 Renal failure
N20-N23 Urolithiasis disease
N25-N29 Other diseases of the kidney and ureter
N30-N39 Other diseases of the urinary system
N40-N51 Diseases of the male genital organs
N60-N64 Breast diseases
N70-N77 Inflammatory diseases of the female pelvic organs
N80-N98 Non-inflammatory diseases of the female genital organs
N99 Other disorders of the genitourinary system

The following categories are marked with an asterisk:
N08* Glomerular lesions in diseases classified elsewhere
N16* Tubulointerstitial renal disease in diseases classified elsewhere
N22* Urinary tract stones in diseases classified elsewhere
N29* Other disorders of the kidney and ureter in diseases classified elsewhere
N33* Disorders of the bladder in diseases classified elsewhere
N37* Disorders of the ureter in diseases classified elsewhere
N51* Lesions of the male genital organs in diseases classified elsewhere
N74* Inflammatory lesions of the pelvic organs in women with diseases classified elsewhere
N77* Ulceration and inflammation of the vulva and vagina in diseases classified elsewhere

GLOMERULAR DISEASES (N00-N08)

If necessary, identify an external cause (class XX) or in the presence of renal failure ( N17-N19) use additional code.

Excludes: hypertension with predominant kidney damage ( I12. -)

With headings N00-N07 the following fourth characters may be used to classify morphological changes: Subcategories. 0- .8 should not be used unless specific studies have been performed to identify lesions (eg, renal biopsy or autospy). The triple-digit headings are based on clinical syndromes.

0 Minor glomerular disorders. Minimal damage
.1 Focal and segmental glomerular lesions
Focal and segmental:
hyalinosis
sclerosis
Focal glomerulonephritis
.2 Diffuse membranous glomerulonephritis
.3 Diffuse mesangial proliferative glomerulonephritis
.4 Diffuse endocapillary proliferative glomerulonephritis
.5 Diffuse mesangiocapillary glomerulonephritis. Membranoproliferative glomerulonephritis (type 1 and 3 or NOS)
.6 Disease of dense sediment. Membranous-proliferative glomerulonephritis (type 2)
.7 Diffuse sickle glomerulonephritis. Extracapillary glomerulonephritis
.8 Other changes. Proliferative glomerulonephritis NOS
.9 Unspecified change

N00 Acute nephritic syndrome

Included: acute:
glomerular disease
glomerulonephritis
nephritis
renal disease NOS
Excludes: acute tubulointerstitial nephritis ( N10)
nephritic syndrome NOS ( N05. -)

N01 Rapidly progressive nephritic syndrome

Included: rapidly progressive (s):
glomerular disease
glomerulonephritis
nephritis
Excludes: nephritic syndrome NOS ( N05. -)

N02 Recurrent and persistent hematuria

Included: hematuria:
benign (familial) (children)
with morphological lesion, specified v.0- .8
Excludes: hematuria NOS ( R31)

N03 Chronic nephritic syndrome

Included: chronic (s):
glomerular disease
glomerulonephritis
nephritis
renal disease NOS
Excludes: chronic tubulointerstitial nephritis ( N11. -)
N18. -)
nephritic syndrome NOS ( N05. -)

N04 Nephrotic syndrome

Includes: congenital nephrotic syndrome
lipoid nephrosis

N05 Unspecified nephritic syndrome

Includes: glomerular disease)
glomerulonephritis) NOS
jade)
nephropathy NOS and renal disease NOS with morphological lesion, specified v.0- .8
Excluded: nephropathy NOS for unknown cause ( N28.9)
renal disease NOS for unknown cause ( N28.9)
tubulointerstitial nephritis NOS ( N12)

N06 Isolated proteinuria with specified morphological lesion

Includes: proteinuria (isolated) (orthostatic)
(persistent) with morphological lesion, specified
v.0- .8
Excludes: proteinuria:
NOS ( R80)
Bence Jones ( R80)
caused by pregnancy ( O12.1)
isolated NOS ( R80)
orthostatic NOS ( N39.2)
persistent NOS ( N39.1)

N07 Hereditary nephropathy, not elsewhere classified

Excluded: Alport syndrome ( Q87.8)
hereditary amyloid nephropathy ( E85.0)
syndrome (absence) (underdevelopment) of the nails-supra-epilepticus ( Q87.2)
hereditary familial amyloidosis without neuropathy ( E85.0)

N08 * Glomerular lesions in diseases classified elsewhere

Includes: nephropathy in diseases classified elsewhere
Excludes: renal tubulointerstitial lesions in diseases classified elsewhere ( N16. -*)

Includes: pyelonephritis
Excludes: cystic pyeloureteritis ( N28.8)

N10 Acute tubulointerstitial nephritis

Spicy:

pyelitis
pyelonephritis
B95-B97).

N11 Chronic tubulointerstitial nephritis

Included: chronic:
infectious interstitial nephritis
pyelitis
pyelonephritis
B95-B97).

N11.0 Non-obstructive chronic pyelonephritis associated with reflux
Pyelonephritis (chronic) associated with (vesicoureteral) reflux
Excludes: vesicoureteral reflux NOS ( N13.7)
N11.1 Chronic obstructive pyelonephritis
Pyelonephritis (chronic) associated with:
anomaly) (pelvic-ureteric
inflection) (connections
obstruction) (pelvic ureteral segment
structure) (ureter
Excluded: calculous pyelonephritis ( N20.9)
obstructive uropathy ( N13. -)
N11.8 Other chronic tubulointerstitial nephritis
Non-obstructive chronic pyelonephritis NOS
N11.9 Chronic tubulo-interstitial nephritis, unspecified
Chronic:
interstitial nephritis NOS
pyelitis NOS
pyelonephritis NOS

N12 Tubulo-interstitial nephritis, not specified as acute or chronic

Interstitial nephritis NOS
Pyelitis NOS
Pyelonephritis NOS
Excludes: calculous pyelonephritis ( N20.9)

N13 Obstructive uropathy and reflux uropathy

Excludes: kidney and ureteral stones without hydronephrosis ( N20. -)
congenital obstructive changes in the renal pelvis and ureter ( Q62.0-Q62.3)
obstructive pyelonephritis ( N11.1)

N13.0 Hydronephrosis with obstruction of the ureteropelvic junction
Excluded: with infection ( N13.6)
N13.1 Hydronephrosis with ureteral stricture, not elsewhere classified
Excluded: with infection ( N13.6)
N13.2 Hydronephrosis with obstruction of the kidney and ureter with calculus
Excluded: with infection ( N13.6)
N13.3 Other and unspecified hydronephrosis
Excluded: with infection ( N13.6)
N13.4 Hydroureter
Excluded: with infection ( N13.6)
N13.5 Kink and stricture of the ureter without hydronephrosis
Excluded: with infection ( N13.6)
N13.6 Pyonephrosis
Conditions listed under headings N13.0-N13.5, with an infection. Obstructive uropathy with infection
If it is necessary to identify the infectious agent, use an additional code ( B95-B97).
N13.7 Vesicoureteral reflux uropathy
Vesicoureteral reflux:
NOS
with scarring
Excludes: pyelonephritis associated with vesicoureteral reflux ( N11.0)
N13.8 Other obstructive uropathy and reflux uropathy
N13.9 Obstructive uropathy and reflux uropathy, unspecified. Urinary tract obstruction NOS

N14 Tubulointerstitial and tubular lesions due to drugs and heavy metals

If it is necessary to identify a toxic substance, an additional external cause code (class XX) is used.

N14.0 Analgesic nephropathy
N14.1 Nephropathy due to other drugs, medications or biologically active substances
N14.2 Unspecified drug, medication and biologically active substance nephropathy
N14.3 Heavy metal nephropathy
N14.4 Toxic nephropathy, not elsewhere classified

N15 Other tubulointerstitial renal diseases

N15.0 Balkan nephropathy. Balkan endemic nephropathy
N15.1 Abscess of the kidney and perirenal tissue
N15.8 Other specified renal tubulointerstitial lesions
N15.9 Unspecified tubulointerstitial renal disease. Kidney infection NOS
Excludes: urinary tract infection NOS ( N39.0)

N16 * Tubulo-interstitial renal disease in diseases classified elsewhere

leukemia ( C91-C95+)
lymphoma ( C81-C85+, C96. -+)
multiple myeloma ( C90.0+)
N16.2* Tubulointerstitial kidney damage in blood diseases and disorders involving the immune mechanism
Tubulointerstitial kidney damage in:
mixed cryoglobulinemia ( D89.1+)
sarcoidosis ( D86. -+)
N16.3* Tubulointerstitial kidney damage in metabolic disorders
Tubulointerstitial kidney damage in:
cystinosis ( E72.0+)
glycogen storage diseases ( E74.0+)
Wilson's disease ( E83.0+)
N16.4* Tubulo-interstitial kidney damage in systemic connective tissue diseases
Tubulointerstitial kidney damage in:
dryness syndrome [Sjogren] ( M35.0+)
systemic lupus erythematosus ( M32.1+)
N16.5* Tubulointerstitial kidney damage in transplant rejection ( T86. -+)
N16.8* Tubulointerstitial renal disease in other diseases classified elsewhere

RENAL FAILURE (N17-N19)

If it is necessary to identify the external agent, an additional external reason code (class XX) is used.

Excluded: congenital renal failure ( P96.0)
tubulointerstitial and tubular lesions caused by drugs and heavy metals ( N14. -)
extrarenal uremia ( R39.2)
hemolytic uremic syndrome ( D59.3)
hepatorenal syndrome ( K76.7)
postpartum ( O90.4)
prerenal uremia ( R39.2)
renal failure:
complicating abortion, ectopic or molar pregnancy ( O00-O07, O08.4)
after childbirth and delivery ( O90.4)
after medical procedures ( N99.0)

N17 Acute renal failure

N17.0 Acute renal failure with tubular necrosis
Tubular necrosis:
NOS
spicy
N17.1 Acute renal failure with acute cortical necrosis
Cortical necrosis:
NOS
spicy
renal
N17.2 Acute renal failure with medullary necrosis
Medullary (papillary) necrosis:
NOS
spicy
renal
N17.8 Other acute renal failure
N17.9 Acute renal failure, unspecified

N18 Chronic renal failure

Includes: chronic uremia, diffuse sclerosing glomerulonephritis
Excludes: chronic renal failure with hypertension ( I12.0)

N18.0 End stage renal disease
N18.8 Other manifestations of chronic renal failure
Uremic neuropathy + ( G63.8*)
Uremic pericarditis + ( I32.8*)
N18.9 Chronic renal failure, unspecified

N19 Renal failure, unspecified

Uremia NOS
Excluded: renal failure with hypertension ( I12.0)
uremia of the newborn ( P96.0)

URINE STEALTH DISEASE (N20-N23)

N20 Kidney and ureter stones

Excluded: with hydronephrosis ( N13.2)

N20.0 Kidney stones. Nephrolithiasis NOS. Calculi or kidney stones. Coral calculi. Kidney stone
N20.1 Ureteral stones. Ureteral calculus
N20.2 Kidney stones with ureteral stones
N20.9 Unspecified urinary stones. Calculous pyelonephritis

N21 Lower urinary tract stones

Includes: with cystitis and urethritis

N21.0 Bladder stones. Concretions in the diverticulum of the bladder. Bladder stone
Excludes: coral calculi ( N20.0)
N21.1 Urethral stones
N21.8 Other stones in the lower urinary tract
N21.9 Lower urinary tract stones, unspecified

N22 * Urinary tract stones in diseases classified elsewhere

N22.0* Urinary stones with schistosomiasis [bilharziasis] ( B65. -+)
N22.8* Urinary tract stones in other diseases classified elsewhere

N23 Renal colic, unspecified

OTHER DISEASES OF THE KIDNEY AND URETER (N25-N29)

Excluded: with urolithiasis ( N20-N23)

N25 Disorders resulting from renal tubular dysfunction

Excludes: metabolic disorders classified in rubrics E70-E90

N25.0 Renal osteodystrophy. Azotemic osteodystrophy. Tubular Disorders Associated with Phosphate Loss
Renal (s):
rickets
dwarfism
N25.1 Nephrogenic diabetes insipidus
N25.8 Other disorders due to renal tubular dysfunction
Lightwood-Albright Syndrome. Renal tubular acidosis NOS. Secondary hyperparathyroidism of renal origin
N25.9 Renal tubular dysfunction, specified

N26 Shrinked kidney, unspecified

Kidney atrophy (terminal). Renal sclerosis NOS
Excludes: shriveled kidney with hypertension ( I12. -)
diffuse sclerosing glomerulonephritis ( N18. -)
hypertensive nephrosclerosis (arteriolar) (arteriosclerotic) ( I12. -)
small kidney for some unknown reason ( N27. -)

N27 Small kidney of unknown origin

N27.0 Small kidney, unilateral
N27.1 Small kidney, bilateral
N27.9 Small kidney, unspecified

N28 Other diseases of kidney and ureter, not elsewhere classified

Excluded: hydroureter ( N13.4)
kidney disease:
acute NOS ( N00.9)
chronic NOS ( N03.9)
kink and stricture of the ureter:
with hydronephrosis ( N13.1)
without hydronephrosis ( N13.5)

N28.0 Ischemia or infarction of the kidney
Renal artery:
embolism
obstruction
occlusion
thrombosis
Kidney infarction
Excluded: Goldblatt's kidney ( I70.1)
renal artery (extrarenal part):
atherosclerosis ( I70.1)
congenital stenosis ( Q27.1)
N28.1 Kidney cyst, acquired. Cyst (multiple) (single) kidney, acquired
Excludes: cystic kidney disease (congenital) ( Q61. -)
N28.8 Other specified diseases of the kidney and ureter. Kidney hypertrophy. Megaloureter. Nephroptosis
Pyelitis)
Pyeloureteritis) cystic
Ureterite)
Ureterocele
N28.9 Diseases of the kidney and ureter, unspecified. Nephropathy NOS. Renal disease NOS
Excluded: nephropathy NOS and renal disorders NOS with morphological lesions, specified in the rubrics. 0-8 ( N05. -)

N29 * Other disorders of the kidney and ureter in diseases classified elsewhere

OTHER DISEASES OF THE URINARY SYSTEM (N30-N39)

Excludes: urinary tract infection (complicating):
O00 -O07 , O08.8 )
O23 . — , O75.3 , O86.2 )
with urolithiasis ( N20-N23)

N30 Cystitis

If necessary, identify the infectious agent ( B95-B97) or the corresponding external factor (class XX) use an additional code.
Excludes: prostatocystitis ( N41.3)

N30.0 Acute cystitis
Excludes: radiation cystitis ( N30.4)
trigonite ( N30.3)
N30.1 Interstitial cystitis (chronic)
N30.2 Other chronic cystitis
N30.3 Trigonitis. Urethrotrigonitis
N30.4 Radiation cystitis
N30.8 Other cystitis. Bladder abscess
N30.9 Cystitis, unspecified

N31 Bladder neuromuscular dysfunction, not elsewhere classified

Excludes: spinal bladder NOS ( G95.8)
due to spinal cord injury ( G95.8)
neurogenic bladder associated with cauda equina syndrome ( G83.4)
urinary incontinence:
NOS ( R32)
refined ( N39.3-N39.4)

N31.0 Uninhibited bladder, not elsewhere classified
N31.1 Reflex bladder, not elsewhere classified
N31.2 Neurogenic bladder weakness, not elsewhere classified
Neurogenic bladder:
atonic (motor impairment) (sensory impairment)
autonomous
non-reflexive
N31.8 Other neuromuscular dysfunctions of the bladder
N31.9 Unspecified neuromuscular dysfunction of the bladder

N32 Other disorders of the bladder

Excludes: bladder stone ( N21.0)
cystocele ( N81.1)
hernia or prolapse of the bladder in women ( N81.1)

N32.0 Bladder neck obturation. Bladder neck stenosis (acquired)
N32.1 Vesico-intestinal fistula. Vesico-colonic fistula
N32.2 Cystic fistula, not elsewhere classified
Excludes: fistula between the bladder and female genital tract ( N82.0-N82.1)
N32.3 Bladder diverticulum. Bladder diverticulitis
Excludes: stone in bladder diverticulum ( N21.0)
N32.4 Bladder rupture, nontraumatic
N32.8 Other specified lesions of the bladder
Bladder:
calcified
wrinkled
N32.9 Unspecified involvement of bladder

N33 * Disorders of the bladder in diseases classified elsewhere

N33.0* Tuberculous cystitis ( A18.1+)
N33.8* Lesions of the bladder in other diseases classified elsewhere
Lesions of the bladder with schistosomiasis [bilharziasis] ( B65. -+)

N34 Urethritis and urethral syndrome

If necessary, identify the infectious agent
use additional code ( B95-B97).
Excluded: Reiter's disease ( M02.3)
urethritis in diseases primarily sexually transmitted ( A50-A64)
urethrotrigonitis ( N30.3)

N34.0 Urethral abscess
Abscess:
Cooper's glands
glands of Littre
periurethral
urethral (glands)
Excludes: urethral caruncle ( N36.2)
N34.1 Nonspecific urethritis
Urethritis:
non-gonococcal
non-venereal
N34.2 Other urethritis. Urethral meatitis. Ulcer of the urethra (external opening)
Urethritis:
NOS
postmenopausal
N34.3 Urethral syndrome, unspecified

N35 Urethral stricture

Excludes: urethral stricture after medical procedures ( N99.1)

N35.0 Post-traumatic urethral stricture
Urethral stricture:
postpartum
traumatic
N35.1 Postinfectious urethral stricture, not elsewhere classified
N35.8 Other urethral stricture
N35.9 Urethral stricture, unspecified. Outer hole of NOS

N36 Other diseases of the urethra

N36.0 Urethral fistula. False urethral fistula
Fistula:
urethroperineal
urethrorectal
urinary NOS
Excluded: fistula:
urethroscrotal ( N50.8)
urethrovaginal ( N82.1)
N36.1 Urethral diverticulum
N36.2 Urethral caruncle
N36.3 Prolapse of the mucous membrane of the urethra. Prolapsed urethra. Urertocele in men
Excludes: urethrocele in women ( N81.0)
N36.8 Other specified diseases of the urethra
N36.9 Disease of urethra, unspecified

N37 * Disorders of the urethra in diseases classified elsewhere

N37.0* Urethritis in diseases classified elsewhere. Candidal urethritis ( B37.4+)
N37.8* Other lesions of the urethra in diseases classified elsewhere

N39 Other diseases of the urinary system

Excluded: hematuria:
NOS ( R31)
recurrent and persistent ( N02. -)
N02. -)
proteinuria NOS ( R80)

N39.0 Urinary tract infection without localization
If it is necessary to identify the infectious agent, use an additional code ( B95-B97).
N39.1 Persistent proteinuria, unspecified
Excluded: complicating pregnancy, childbirth and the postpartum period ( O11-O15)
with refined morphological changes ( N06. -)
N39.2 Orthostatic proteinuria, unspecified
Excludes: with specified morphological changes ( N06. -)
N39.3 Involuntary urination
N39.4 Other specified types of urinary incontinence
Overflow)
Reflex) urinary incontinence
On awakening)
Excludes: enuresis NOS ( R32)
urinary incontinence:
NOS ( R32)
inorganic origin ( F98.0)
N39.8 Other specified diseases of the urinary system
N39.9 Unspecified urinary tract disorder

DISEASES OF THE MALE GENITAL ORGANS (N40-N51)

N40 Prostatic hyperplasia

Adenofibromatous hypertrophy)
Adenoma (benign))
Enlargement (benign)) of the prostate
Fibroadenoma) glands
Fibroma)
Hypertrophy (benign))
Myoma
Median lobe (prostate) adenoma
Blockage of prostate duct NOS
Excludes: benign tumors other than adenoma, fibroma
and prostate fibroids ( D29.1)

N41 Inflammatory diseases of the prostate gland

If it is necessary to identify the infectious agent, use an additional code ( B95-B97).

N41.0 Acute prostatitis
N41.1 Chronic prostatitis
N41.2 Prostate abscess
N41.3 Prostate cystitis
N41.8 Other inflammatory diseases of the prostate
N41.9 Unspecified inflammatory disease of the prostate. Prostatitis NOS

N42 Other diseases of the prostate

N42.0 Prostate stones. Prostatic stone
N42.1 Congestion and hemorrhage in the prostate gland
N42.2 Prostate atrophy
N42.8 Other specified diseases of the prostate
N42.9 Unspecified prostate disease

N43 Hydrocele and spermatocele

Includes: dropsy of the spermatic cord, testis, or testicular sheath
Excludes: congenital hydrocele ( P83.5)

N43.0 Hydrocele encapsulated
N43.1 Infected hydrocele
If it is necessary to identify the infectious agent, use an additional code ( B95-B97).
N43.2 Other forms of hydrocele
N43.3 Hydrocele, unspecified
N43.4 Spermatocele

N44 Testicular torsion

Twisting:
epididymis
spermatic cord
testicles

N45 Orchitis and epididymitis

If it is necessary to identify the infectious agent, use an additional code ( B95-B97).

N45.0 Orchitis, epididymitis and epididymo-orchitis with abscess. Abscess of the epididymis or testicle
N45.9 Orchitis, epididymitis and epididymo-orchitis without mention of an abscess. Epididymitis NOS. Orchitis NOS

N46 Male infertility

Azoospermia NOS. Oligospermia NOS

N47 Excessive foreskin, phimosis and paraphimosis

Tight-fitting foreskin. Tight foreskin

N48 Other diseases of the penis

N48.0 Penile leukoplakia. Kraurosis of the penis
Excludes: carcinoma in situ of the penis ( D07.4)
N48.1 Balanoposthitis. Balanitis
If it is necessary to identify the infectious agent, use an additional code ( B95-B97).
N48.2 Other inflammatory diseases of the penis
Abscess)
Furuncle)
Carbuncle) of the cavernous body and penis
Cellulite)
Penile cavernitis
If it is necessary to identify the infectious agent, use an additional code ( B95-B97).
N48.3 Priapism. Painful erection
N48.4 Organic impotence
If necessary, an additional code is used to identify the cause.
Excludes: psychogenic impotence ( F52.2)
N48.5 Penile ulcer
N48.6 Balanitis. Plastic induration of the penis
N48.8 Other specific diseases of the penis
Atrophy)
Hypertrophy) of the cavernous body and penis
Thrombosis)
N48.9 Disease of the penis, unspecified

N49 Inflammatory diseases of male genital organs, not elsewhere classified

If it is necessary to identify the infectious agent, use an additional code ( B95-B97).
Excludes: inflammation of the penis ( N48.1-N48.2)
orchitis and epididymitis ( N45. -)

N49.0 Inflammatory diseases of the seminal vesicle. Vesiculitis NOS
N49.1 Inflammatory diseases of the spermatic cord, vaginal membrane and vas deferens. Vazit
N49.2 Inflammatory diseases of the scrotum
N49.8 Inflammatory diseases of other specified male genital organs
N49.9 Inflammatory diseases of the unspecified male genital organ
Abscess)
Furuncle) unspecified male
Carbuncle) of the genital organ
Cellulite)

N50 Other diseases of male genital organs

Excludes: testicular torsion ( N44)

N50.0 Testicular atrophy
N50.1 Vascular disorders of the male genital organs
Hematocele)
Hemorrhage) of male genital organs
Thrombosis)
N50.8 Other specific diseases of the male genital organs
Atrophy)
Hypertrophy) of the seminal vesicle, spermatic cord,
Edema) of the testicle [except for atrophy], of the vaginal ulcer and of the vas deferens
Chilocele of the vaginal membrane (non-filarial) NOS
Urethroscrotal fistula
Structure:
spermatic cord
vaginal membrane
vas deferens
N50.9 Disease of male genital organs, unspecified

N51 * Disorders of male genital organs in diseases classified elsewhere

N51.0* Disorders of the prostate gland in diseases classified elsewhere
Prostatitis:
gonococcal ( A54.2+)
caused by Trichomonas ( A59.0+)
tuberculous ( A18.1+)
N51.1* Lesions of the testicle and its appendages in diseases classified elsewhere
Chlamydial:
epididymitis ( A56.1+)
orchitis ( A56.1+)
Gonococcal:
epididymitis ( A54.2+)
orzit ( A54.2+)
Mumps orchitis ( B26.0+)
Tuberculosis:

• epididymis ( A18.1+)

• testicles ( A18.1+)

N51.2* Balanitis in diseases classified elsewhere
Balanitis:
amoebic ( A06.8+)
candidal ( B37.4+)
N51.8* Other lesions of the male genital organs in diseases classified elsewhere
Filarial chilocele of the vaginal membrane ( B74. -+)
Herpes infection of the male genital organs ( A60.0+)
Seminal tuberculosis ( A18.1+)

DISEASES OF THE BREAST (N60-N64)

Excludes: diseases of the breast associated with childbirth ( O91-O92)

N60 Benign Breast Dysplasia
Includes: fibrocystic breast disease
N60.0 Solitary cyst of the mammary gland. Breast cyst
N60.1 Diffuse cystic mastopathy. Cystic mammary gland
Excludes: with epithelial proliferation ( N60.3)
N60.2 Fibroadenosis of the breast
Excludes: breast fibroadenoma ( D24)
N60.3 Fibrosclerosis of the breast. Cystic mastopathy with epithelial proliferation
N60.4 Ectasia of the mammary gland ducts
N60.8 Other benign breast dysplasias
N60.9 Benign breast dysplasia, unspecified

N61 Inflammatory diseases of the breast

Abscess (acute) (chronic) (not postpartum):
areola
breast
Carbuncle of the mammary gland
Mastitis (acute) (subacute) (not postpartum):
NOS
infectious
Excludes: infectious mastitis of the newborn ( P39.0)

N62 Breast hypertrophy

Gynecomastia
Breast hypertrophy:
NOS
massive pubertal

N63 Unspecified mass of mammary gland

Breast nodule (s) NOS

N64 Other diseases of the breast

N64.0 Nipple fissure and fistula
N64.1 Fatty necrosis of the mammary gland. Fat necrosis (segmental) of the breast
N64.2 Breast atrophy
N64.3 Galactorrhea not related to childbirth
N64.4 Mammalgia
N64.5 Other signs and symptoms of the breast. Breast induration. Discharge from the nipple
Inverted nipple
N64.8 Other specified diseases of the breast. Galactocele. Subinvolution of the mammary gland (post-lactation)
N64.9 Unspecified breast disease

INFLAMMATORY DISEASES OF FEMALE PELVIC ORGANS (N70-N77)

Excluded: complicating:
abortion, ectopic or molar pregnancy ( O00 -O07 , O08.0 )
pregnancy, childbirth and the puerperium ( O23. — ,O75.3 , O85 , O86 . -)

N70 Salpingitis and oophoritis

Included: abscess:
fallopian tube
ovary
tubo-ovarian
pyosalpinx
salpingo-oophoritis
tubo-ovarian inflammatory disease
If it is necessary to identify the infectious agent, use an additional code ( B95-B97).

N70.0 Acute salpingitis and oophoritis
N70.1 Chronic salpingitis and oophoritis. Hydrosalpinx
N70.9 Salpingitis and oophoritis, unspecified

N71 Inflammatory diseases of the uterus, other than the cervix

Includes: endo (myo) metritis
metritis
myometritis
pyometra
uterine abscess
If it is necessary to identify the infectious agent, use an additional code ( B95-B97).

N71.0 Acute inflammatory disease of the uterus
N71.1 Chronic inflammatory disease of the uterus
N71.9 Inflammatory disease of uterus, unspecified

N72 Inflammatory disease of the cervix

Cervicitis)
Endocervicitis) with or without erosion or ectropion
Exocervicitis)
If necessary, identify the infectious agent
use additional code ( B95-B97).
Excluded: erosion and ectropion of the cervix without cervicitis ( N86)

N73 Other female pelvic inflammatory diseases

If it is necessary to identify the infectious agent, use an additional code ( B95-B97).

N73.0 Acute parametritis and pelvic cellulite
Abscess:
broad ligament) specified as
parametria) acute
Pelvic phlegmon in women)
N73.1 Chronic parametritis and pelvic cellulite
N73.0, specified as chronic
N73.2 Parametritis and pelvic phlegmon, unspecified
Any condition in the subheading N73.0 not specified as acute or chronic
N73.3 Acute pelvic peritonitis in women
N73.4 Chronic pelvic peritonitis in women
N73.5 Pelvic peritonitis in women, unspecified
N73.6 Pelvic peritoneal adhesions in women
Excluded: postoperative pelvic peritoneal adhesions in women ( N99.4)
N73.8 Other specified female pelvic inflammatory diseases
N73.9 Unspecified female pelvic inflammatory disease
Infectious or inflammatory diseases of the female pelvic organs NOS

N74 * Female pelvic inflammatory disease in diseases classified elsewhere

N74.0* Tuberculous infection of the cervix ( A18.1+)
N74.1* Inflammatory diseases of the female pelvic organs of tuberculous etiology ( A18.1+)
Tuberculous endometritis
N74.2* Inflammatory diseases of the female pelvic organs caused by syphilis ( A51.4+, A52.7+)
N74.3* Gonococcal inflammatory diseases of the female pelvic organs ( A54.2+)
N74.4* Inflammatory diseases of the female pelvic organs caused by chlamydia ( A56.1+)
N74.8* Female pelvic inflammatory disease in other diseases classified elsewhere

N75 Diseases of the bartholin gland

N75.0 Bartholin gland cyst
N75.1 Bartholin gland abscess
N75.8 Other diseases of the Bartholin gland. Bartholinitis
N75.9 Unspecified Bartholin gland disease

N76 Other inflammatory diseases of vagina and vulva

If it is necessary to identify the infectious agent, use an additional code ( B95-B97).
Excludes: senile (atrophic) vaginitis ( N95.2)

N76.0 Acute vaginitis. Vaginitis NOS
Vulvovaginitis:
NOS
spicy
N76.1 Subacute and chronic vaginitis

Vulvovaginitis:
chronic
subacute
N76.2 Acute vulvitis. Vulvitis NOS
N76.3 Subacute and chronic vulvitis
N76.4 Vulvar abscess. Boil of the vulva
N76.5 Ulceration of the vagina
N76.6 Ulceration of the vulva
T76.8 Other specified inflammatory diseases of the vagina and vulva

N77 * Ulceration and inflammation of the vulva and vagina in diseases classified elsewhere

NON-INFLAMMATORY DISEASES OF FEMALE GENITAL ORGANS (N80-N98)

N80 Endometriosis

N80.0 Endometriosis of the uterus. Adenomyosis
N80.1 Ovarian endometriosis
N80.2 Endometriosis of the fallopian tubes
N80.3 Endometriosis of the pelvic peritoneum
N80.4 Endometriosis of the rectovaginal septum and vagina
N80.5 Intestinal endometriosis
N80.6 Endometriosis of the cutaneous scar
N80.8 Other endometriosis
N80.9 Endometriosis, unspecified

N81 Female genital prolapse

Excludes: prolapse of the genitals complicating pregnancy, childbirth or delivery ( O34.5)
prolapse and hernia of the ovary and fallopian tube ( N83.4)
prolapse of the stump (vault) of the vagina after hysterectomy ( N99.3)

N81.0 Urethrocele in women

Excluded: urethrocele with:
cystocele ( N81.1)
prolapse of the uterus ( N81.2-N81.4)
N81.1 Cystocele. Cystocele with urethrocele. Prolapsed vaginal wall (anterior) NOS
Excludes: cystothele with uterine prolapse ( N81.2-N81.4)
N81.2 Incomplete prolapse of the uterus and vagina. Prolapse of the cervix NOS
Vaginal prolapse:
first degree
second degree
N81.3 Complete prolapse of the uterus and vagina. Residence (uterus) NOS. Uterine prolapse of the third degree
N81.4 Uterine and vaginal prolapse, unspecified. Uterine prolapse NOS
N81.5 Enterocele of the vagina
Excludes: enterocele with prolapse of the uterus ( N81.2-N81.4)
N81.6 Rectocele. Prolapse of the back of the vagina
Excluded: rectal prolapse ( K62.3)
rectocele with prolapse of the uterus ( N81.2-N81.4)
N81.8 Other forms of female genital prolapse. Lack of pelvic floor muscles
Old tears of the pelvic floor muscles
N81.9 Unspecified female genital prolapse

N82 Fistula involving female genital organs

Excludes: vesico-intestinal fistula ( N32.1)

N82.0 Vesicovaginal fistula
N82.1 Other fistulas of the female urinary tract
Fistulas:
cervico-urinary
ureterovaginal
urethrovaginal
utero-ureteric
utero-urinary
N82.2 Vaginal-small intestinal fistula
N82.3 Colonic vaginal fistula. Rectovaginal fistula
N82.4 Other intestinal-genital fistulas in women. Intestinal fistula
N82.5 Genital-cutaneous fistulas in women

Fistula:
utero-abdominal
vaginal-perineal
N82.8 Other female genital fistulas
N82.9 Fistula of female genital organs, unspecified

N83 Noninflammatory lesions of ovary, fallopian tube and broad ligament of uterus

Excluded: hydrosalpinx ( N70.1)

N83.0 Follicular ovarian cyst. Graafian follicle cyst. Hemorrhagic follicular cyst (ovary)
N83.1 Corpus luteum cyst. Hemorrhagic cyst of the corpus luteum
N83.2 Other and unspecified ovarian cysts
Retention cyst)
Simple cyst) of the ovary
Excludes: ovarian cyst:
associated with a developmental anomaly ( Q50.1)
neoplastic ( D27)
polycystic ovary syndrome ( E28.2)
N83.3 Acquired atrophy of the ovary and fallopian tube
N83.4 Prolapse and hernia of the ovary and fallopian tube
N83.5 Torsion of the ovary, pedicle, and fallopian tube
Twisting:
additional pipe
Morgagni cysts
N83.6 Hematosalpinx
Excluded: hematosalpinx with:
hematocolposome ( N89.7)
hematometer ( N85.7)
N83.7 Broad ligament hematoma
N83.8 Other non-inflammatory diseases of the ovary, fallopian tube and broad ligament of the uterus
Broad ligament rupture syndrome [Masters-Allen]
N83.9 Unspecified noninflammatory disease of the ovary, fallopian tube, and broad ligament of the uterus

N84 Polyp of female genital organs

Excludes: adenomatous polyp ( D28. -)
placental polyp ( O90.8)

N84.0 Polyp of the body of the uterus
Polyp:
endometrium
uterus NOS
Excludes: polypoid endometrial hyperplasia ( N85.0)
N84.1 Polyp of the cervix. Polyp of the mucous membrane of the cervix
N84.2 Vaginal polyp
N84.3 Polyp of the vulva. Labia polyp
N84.8 Polyp of other parts of the female genital organs
N84.9 Female genital polyp, unspecified

N85 Other non-inflammatory diseases of the uterus, excluding cervix

Excludes: endometriosis ( N80. -)
inflammatory diseases of the uterus ( N71. -)

non-inflammatory diseases of the cervix uteri ( N86-N88)
polyp of the body of the uterus ( N84.0)
prolapse of the uterus ( N81. -)

N85.0 Endometrial glandular hyperplasia
Endometrial hyperplasia:
NOS
cystic
glandular cystic
polypoid
N85.1 Adenomatous endometrial hyperplasia. Endometrial hyperplasia atypical (adenomatous)
N85.2 Hypertrophy of the uterus. Large or enlarged uterus
Excludes: postpartum uterine hypertrophy ( O90.8)
N85.3 Subinvolution of the uterus
Excludes: postpartum subinvolution of the uterus ( O90.8)
N85.4 Incorrect position of the uterus
Anteversion)
Retroflection) of the uterus
Retroversion)
Excludes: as a complication of pregnancy, childbirth or after childbirth ( O34.5, O65.5)
N85.5 Inversion of the uterus
O71.2)
postpartum uterine prolapse ( N71.2)
N85.6 Intrauterine synechiae
N85.7 Hematometer. Hematosalpinx with hematometer
Excludes: hematometer with hematocolpos ( N89.7)
N85.8 Other specified inflammatory diseases of the uterus. Acquired uterine atrophy. Fibrosis of the uterus NOS
N85.9 Non-inflammatory disease of the uterus, unspecified. Uterine lesions NOS

N86 Erosion and ectropion of cervix uteri

Decubital (trophic) ulcer)
Inversion) of the cervix
Excluded: with cervicitis ( N72)

N87 Cervical dysplasia

Excludes: carcinoma in situ of the cervix ( D06. -)

N87.0 Mild cervical dysplasia. Grade I cervical intraepithelial neoplasia
N87.1 Moderate dysplasia of the cervix. Grade II cervical intraepithelial neoplasia
N87.2 Severe cervical dysplasia, not elsewhere classified
Severe dysplasia NOS
Excludes: cervical intraepithelial neoplasia grade III with or without mention
D06. -)
N87.9 Dysplasia of cervix uteri, unspecified

N88 Other non-inflammatory diseases of the cervix

Excludes: inflammatory diseases of the cervix ( N72)
polyp of the cervix ( N84.1)

N88.0 Leukoplakia of the cervix
N88.1 Old lacerations of the cervix. Adhesions of the cervix
O71.3)
N88.2 Cervical stricture and stenosis
Excluded: as a complication of childbirth ( O65.5)
N88.3 Insufficiency of the cervix
Examination and care for (suspected) ischemic-cervical insufficiency outside of pregnancy
Excluded: complicating the condition of the fetus and newborn ( P01.0)
complicating pregnancy ( O34.3)
N88.4 Hypertrophic lengthening of the cervix
N88.8 Other specified non-inflammatory diseases of the cervix
Excludes: current obstetric trauma ( O71.3)
N88.9 Noninflammatory disease of cervix uteri, unspecified

Excludes: carcinoma in situ of the vagina ( D07.2), vaginal inflammation ( N76... -), senile (atrophic) vaginitis ( N95.2)
leucorrhoea with trichomoniasis ( A59.0)
N89.0 Mild vaginal dysplasia. Intraepithelial neoplasia of the vagina, grade I
N89.1 Moderate vaginal dysplasia. Grade II vaginal intraepithelial neoplasia
N89.2 Severe vaginal dysplasia, not elsewhere classified
Severe vaginal dysplasia NOS
Excludes: grade III vaginal intraepithelial neoplasia with or without mention
about pronounced dysplasia ( D07.2)
N89.3 Vaginal dysplasia, unspecified
N89.4 Vaginal leukoplakia
N89.5 Vaginal stricture and atresia
Vaginal:
adhesions
stenosis
Excludes: postoperative vaginal adhesions ( N99.2)
N89.6 Dense hymen. Rigid hymen. Dense virgin ring
Excludes: hymen overgrown ( Q52.3)
N89.7 Hematokolpos. Hematokolpos with hematometer or with hematosalpinx
N89.8 Other non-inflammatory diseases of the vagina. Beli NOS. Old vaginal tear. Vaginal ulcer
Excluded: current obstetric trauma ( O70. — , O71.4,O71.7-O71.8)
old rupture with involvement of the pelvic floor muscles ( N81.8)
N89.9 Non-inflammatory vaginal disease, unspecified

N90 Other non-inflammatory diseases of the vulva and perineum

Excludes: carcinoma in situ of the vulva ( D07.1)
current obstetric trauma ( O70. — , O71.7-O71.8)
inflammation of the vulva ( N76. -)

N90.0 Mild vulvar dysplasia. Intraepithelial neoplasia of the vulva, grade I
N90.1 Moderate dysplasia of the vulva. Intraepithelial neoplasia of the vulva II degree
N90.2 Severe vulvar dysplasia, not elsewhere classified
Severe vulvar dysplasia NOS
Excludes: grade III intraepithelial neoplasia of the vulva with or without mention
about pronounced dysplasia ( D07.1)
N90.3 Vulvar dysplasia, unspecified
N90.4 Leukoplakia of the vulva
Dystrophy)
Krauroz) vulva
N90.5 Vulvar atrophy. Vulvar stenosis
N90.6 Vulvar hypertrophy. Hypertrophy of the labia
N90.7 Vulvar cyst
N90.8 Other specified non-inflammatory diseases of the vulva and perineum. Vulvar adhesions. Clitoris hypertrophy
N90.9 Non-inflammatory disease of vulva and perineum, unspecified

N91 Lack of menses, scanty and infrequent menses

Excludes: ovarian dysfunction ( E28. -)

N91.0 Primary amenorrhea. Violation of menstruation in puberty
N91.1 Secondary amenorrhea. Lack of menstruation in women who have had them before
N91.2 Amenorrhea, unspecified. Lack of menses NOS
N91.3 Primary oligomenorrhea. Scanty or infrequent periods from the onset
N91.4 Secondary oligomenorrhea. Lean or infrequent menses in women with previously normal periods
N91.5 Oligomenorrhea, unspecified. Hypomenorrhea NOS

N92 Heavy, frequent and irregular menses

Excludes: bleeding after menopause ( N95.0)

N92.0 Heavy and frequent menstruation with a regular cycle
Periodically profuse menses NOS. Menorrhagia NOS. Polymenorrhea
N92.1 Heavy and frequent menstruation with an irregular cycle
Irregular bleeding during the intermenstrual period
Irregular, shortened intervals between menstrual bleeding. Menometrorrhagia. Metrorrhagia
N92.2 Heavy menstruation during puberty
Profuse bleeding at the beginning of the menstrual period. Puberty menorrhagia. Puberty bleeding
N92.3 Ovulatory bleeding. Regular menstrual bleeding
N92.4 Heavy bleeding in the premenopausal period
Menorrhagia or metrorrhagia:
climacteric
in menopause
premenopausal
premenopausal
N92.5 Other specified forms of irregular menses
N92.6 Irregular menses, unspecified
Irregular:
bleeding NOS
menstrual cycles NOS
Excludes: irregular menstruation in the background:
lengthened intervals or scanty bleeding ( N91.3-N91.5)
shortened intervals or profuse bleeding ( N92.1)

N93 Other abnormal uterine and vaginal bleeding

Excludes: neonatal vaginal bleeding ( P54.6)
false menstruation ( P54.6)

N93.0 Postcoital or contact bleeding
N93.8 Other specified abnormal uterine and vaginal bleeding
Dysfunctional or functional uterine or moisture bleeding NOS
N93.9 Abnormal uterine and vaginal bleeding, unspecified

N94 Pain and other conditions associated with female genital organs and menstrual cycle

N94.0 Pain in the middle of the menstrual cycle
N94.1 Dyspareunia
Excludes: psychogenic dyspareunia ( F52.6)
N94.2 Vaginismus
Excludes: psychogenic vaginismus ( F52.5)
N94.3 Premenstrual tension syndrome
N94.4 Primary dysmenorrhea
N94.5 Secondary dysmenorrhea
N94.6 Dysmenorrhea, unspecified
N94.8 Other specified conditions associated with female genital organs and menstrual cycle
N94.9 Conditions associated with female genital organs and menstrual cycle, unspecified

N95 Disorders of menopause and other disorders of the peri-menopausal period

Excluded: profuse bleeding in the premenopausal period ( N92.4)
postmenopausal:
osteoporosis ( M81.0)
with a pathological fracture ( M80.0)
urethritis ( N34.2)
premature menopause NOS ( E28.3)

N95.0 Postmenopausal bleeding
N95.3)
N95.1 Menopause and climacteric state in a woman
Menopause-related symptoms such as hot flashes, insomnia, headaches, impaired attention
Excludes: associated with artificial menopause ( N95.3)
N95.2 Postmenopausal atrophic vaginitis. Senile (atrophic) vaginitis
Excludes: associated with artificial menopause ( N95.3)
N95.3 Conditions associated with artificially induced menopause. Post-Artificial Menopause Syndrome
N95.8 Other specified disorders of the menopausal and perimenopausal period
N95.9 Menopausal and perimenopausal disorders, unspecified

N96 Habitual miscarriage

Examination or medical care outside of pregnancy. Relative infertility
Excluded: current pregnancy ( O26.2)
with current abortion ( O03-O06)

N97 Female infertility

Included: inability to get pregnant
female sterility NOS
Excludes: relative infertility ( N96)

N97.0 Female infertility due to lack of ovulation
N97.1 Female infertility of tubal origin. Associated with congenital malformation of the fallopian tubes
Pipe:
obstruction
blockage
stenosis
N97.2 Female infertility of uterine origin. Associated with congenital malformation of the uterus
Egg implantation defect
N97.3 Female infertility of cervical origin
N97.4 Female Infertility Associated with Male Factors
N97.8 Other forms of female infertility
N97.9 Female infertility, unspecified

N98 Complications associated with artificial insemination

N98.0 Infection associated with artificial insemination
N98.1 Ovarian hyperstimulation
Ovarian hyperstimulation:
NOS
associated with induced ovulation
N98.2 Complications associated with attempted implantation of a fertilized egg after extracorporeal
fertilization
N98.3 Complications associated with attempted embryo implantation
N98.8 Other complications associated with artificial insemination
Complications of artificial insemination:
donor sperm
husband's sperm
N98.9 Complications associated with artificial insemination, unspecified

OTHER DISEASES OF THE Urogenital System (N99)

N99 Disorders of the genitourinary system after medical procedures, not elsewhere classified

Excludes: radiation cystitis ( N30.4)
osteoporosis after surgical removal of the ovary ( M81.1)
with a pathological fracture ( M80.1)
conditions associated with artificially induced menopause ( N95.3)

N99.0 Postoperative renal failure
N99.1 Postoperative urethral stricture. Urethral stricture after catheterization
N99.2 Postoperative vaginal adhesions
N99.3 Prolapse of the vaginal fornix after extirpation of the uterus
N99.4 Postoperative adhesions in the small pelvis
N99.5 Dysfunction of the external urinary tract stoma
N99.8 Other disorders of the genitourinary system after medical procedures. Residual ovary syndrome
N99.9 Disorder of the genitourinary system after medical procedures, unspecified

The head of the genital organ in almost every newborn boy does not open. It is not considered a pathology until a certain age. Many parents can observe the child adhesions of the head of the penis to the foreskin, which are called synechia. In adult men, it is considered a serious illness. Consider what are synechiae in boys what to do with them, how to treat them.

What it is

Synechia in boys, what is it for pathology, we will consider in more detail. If the boy's foreskin has grown to the head, adhesions are visible, this indicates the appearance of this disease.

Synechiae of the foreskin, ICD code 10- N48: other diseases of the penis. This condition of the penis occurs in almost all children. This innate feature is designed to prevent pathogens from entering the foreskin and to prevent injury to the head.

By the age of three years, the baby's adhesions gradually dissolve, the head of the penis begins to partially or completely open. Normally, the disappearance of synechiae should be observed by the age of 7-11. If this does not happen, it is necessary to consult a specialist, since this condition is already considered a pathology.

If the foreskin has grown to the head of an adult man, surgical intervention is necessary, since this condition can lead to unpleasant consequences from the genitourinary system.

Important to remember! In no case should you breed synechiae in boys and adult men! This can lead to serious injury, resulting in problems with urinary excretion and, in adulthood, erectile dysfunction.

Causes of synechia

They can be observed for various reasons. The most common prerequisites for this pathology are:

1. Development of viruses and infections. The ingress of pathogenic microorganisms into the organs of the genitourinary system is the most common reason that a boy has the foreskin has grown to the head penis. Inflammatory processes that are observed due to the vigorous activity of pathogens cause the formation of adhesions. Therefore, if the slightest signs of inflammation on the genitals appear, you should immediately consult a doctor. You can prevent infection from entering the organs of the genitourinary system by observing the personal hygiene of the baby.
2. Diseases associated with allergies. Children who, as a result of exposure to certain factors, begin to suffer from allergic attacks, need to regularly visit a urologist for preventive purposes. This will help to timely detect or prevent inflammatory processes of an allergic nature in the genital area.
3. Complications during pregnancy. Every mother who carries a baby should be attentive to her health. Complications during pregnancy caused by infectious or viral diseases can lead to the formation of a significant number of synechiae in the baby, which will have to be eliminated exclusively by a surgical method. Almost every pregnant woman carefully monitors her health, therefore adhesions for this reason appear in a child in extremely rare cases.
4. Injury to the genital organ. Every boy is born with the glans of the penis closed. Vigorous attempts to pull back the foreskin on its own can damage the penis. This is in most cases the reason that the foreskin has grown to the head of a child.
5. Getting burned. Such damage can be caused by radiation, radiation, the ingress of caustic chemicals on the genitals, thermal exposure. As a result, scars are formed, which lead to the appearance of large adhesions. You cannot get rid of them on your own. Only surgery is required to normalize the condition.

The mechanism for the development of adhesions in children is the release of an excessive amount of smegma for various reasons. Its congestion under the foreskin leads to the formation of adhesions.

Important to remember! Every parent needs to pay due attention to the personal hygiene of the baby! This will help prevent the appearance of synechia.

Symptoms of pathology

If a child has physiological synechiae that are not associated with inflammatory processes, then they separate over time. Incomplete adhesion of the head and foreskin with adhesions does not cause discomfort or problems with urination.

If the boy the foreskin is fused with the head as a result of inflammation, this is accompanied by the following symptoms:

• swelling in the area of ​​the glans penis, the upper part of the organ looks larger than the lower;
• discoloration of the skin on the top of the penis;
• pain, burning and other uncomfortable sensations at the time of urination;
• sharp pain in the penis even in a calm state;
• excessive discharge with particles of pus;
• problems with urine excretion, fluid comes out in small quantities, drop by drop.

Synechiae in men characterized by painful sensations in a state of erection, as well as at the time of sexual contact. Young people in most cases refuse to have sex until complete recovery.

Diagnosis of the disease

Discover synechiae of the penis simple enough. The specialist only needs to conduct a visual examination of the penis. A doctor should be consulted in cases where synechiae of the foreskin in boys did not split up until the age of three.

In addition to examination, the child is sent for such additional research:

1. General urine analysis. It is necessary to exclude the development of a disease such as urethritis. Because the symptoms are similar.
2. General blood analysis. It is required to take it at an elevated body temperature to exclude the development of infectious diseases.
3. Ultrasound diagnostics of the organs of the genitourinary system. The penis, scrotum, bladder, kidneys are examined. Ultrasound examination is carried out in cases where there is a suspicion of the rapid spread of inflammatory processes.

Based on the results of the studies carried out, the urologist establishes an accurate diagnosis. Then he prescribes the necessary treatment. If the adhesions are too large, then the patient is referred for surgery.

Treatment of synechia in boys

If observed synechiae in boys, what to do in this case, we will consider in more detail. There are several ways to normalize the condition of the penis. Their use depends on the size of the adhesions and the age of the child. Let's consider each method of influence.

Self-separation of adhesions

Treatment of synechia in boys at home it is advisable to spend up to 6-7 years. To do this, it is necessary to carry out the following manipulations:

• place the child in a bathtub with warm water;
• 30-40 minutes after steaming, you should separation of synechiae in a boy without stopping contact with water;
• slowly and carefully pull back the foreskin, trying to bare the glans penis.

Separation of the synechiae of the foreskin in boys in this way it is necessary to carry out 2-3 times a week. The duration of such treatment takes about 3–6 months. It all depends on the size and number of adhesions.

Drug therapy

If synechiae of the foreskin in boys cause inflammation, home treatment it is required to carry out with the use of medications. For this, creams and ointments of the glucocorticosteroid group are used. Hormonal drugs help eliminate unpleasant symptoms such as swelling, redness, and cracks in the head of the penis. Regular use of glucocorticosteroids restores the firmness and elasticity of the flesh, due to which the adhesions gradually disperse. The most common topical drugs in this group are Hydrocortisone Ointment and Contractubex.

It is necessary to apply ointments or creams to the head and foreskin. This should be done carefully so as not to damage the surface of the skin. The duration of such treatment of synechia in boys determined by a specialist.

Surgical intervention

If synechiae in a boy do not pass what to do? Usually an operative method treatment of synechia in boys appointed after reaching 12 years of age. Up to this point, they can disperse on their own. Spontaneous dilution of adhesions is observed as a result of exposure to such factors:

• sudden, unreasonable erections typical of boys during puberty;
• inflammation of the prepuce;
• secretion of enzymes of the sebaceous glands.

But without surgery and other treatment methods, only minor adhesions can be eliminated. Large synechiae require more radical actions to eliminate them.

Large synechiae causing regular inflammatory processes must be removed with surgery. It is usually performed under local anesthesia and does not require any special training.

The essence of the operation is to free the head and flesh of the penis from the adhesions present.

In some cases, an operation such as circumcision is performed. Its essence lies in the partial or complete excision of the foreskin. In other words, circumcision is done. This type of surgical intervention allows you to get rid of not only synechiae, but also from physiological or pathological phimosis.

In the postoperative period, it is necessary to carefully monitor the hygiene of the penis. It is necessary to rinse the head daily under running water, and then treat it with antibacterial drugs such as Erythromycin, Levomekol, Miramistin and others.

It is also useful to make local baths based on decoctions of medicinal herbs such as calendula, chamomile, mint. It is necessary to carry out such procedures within 1 week after surgery.

If the boy's rehabilitation period is delayed, then for full recovery he is prescribed antibacterial drugs for oral administration.

Possible consequences

Synechia of the foreskin in boys requires appropriate treatment if it has not disappeared by the age of 12. If you ignore this pathology, then inaction can lead to such unpleasant consequences:

1. Problems with urination. Large adhesions over time lead to a blockage of the urethra. As a result, the boy experiences severe pain, burning and stinging sensations in the process of urine excretion. He also has a constant feeling of an empty bladder.
2. Balanoposthitis. This disease is characterized by an inflammatory process in the head and foreskin. It is observed due to the accumulation of an excessive amount of natural secretions under the foreskin. Large synechiae do not allow adequate hygiene of the penis. The danger of balanoposthitis is that after a certain period of time it transforms into a chronic form.
3. Cicatricial phimosis. As a result of excessive adhesions, the foreskin narrows. In the future, this leads to the fact that the young man cannot enter into intimacy. Erection and sex are painful.

The most dangerous complication of synechia in a child is the development of benign or malignant tumors under the foreskin of the penis. Due to the pinching of the head, smegma accumulates, which has carcinogenic properties. It is extremely difficult to get rid of such a pathology. The treatment will take a long period of time. It is difficult to predict the successful outcome of therapy in this case.

The main rule that will help prevent the formation of pathological adhesions is strict adherence to the hygiene of the genital organ in boys. It consists in carrying out such events:

1. Daily rinsing of the head of the penis under running water. It is better to use warm boiled water for this procedure. It is also useful to wash the genitals in a decoction of medicinal herbs. To do this, you need to brew 1 tsp in 1 glass of boiling water. dried chamomile, calendula, mint or St. John's wort.
2. Do not try to pull back the foreskin on your own if it is difficult. This can lead to injury to the penis, the formation of cracks, which are accompanied by discomfort.
3. Change diapers in a timely manner. Long-term presence of a child in an overfilled diaper causes irritation and inflammation. When changing a diaper, it is useful for a child to take air baths. As for the use of diapers during the hot season, it is better to refuse them for this period. Since the baby is sweating, as a result of which a favorable environment is formed for the active development of pathogenic microorganisms.
4. Choose the right underwear. Children's panties should be made only from natural materials. Synthetics can cause allergic reactions. Also, do not forget about the selection of the correct size of panties for the baby. They should not chafe or squeeze the penis.

Compliance with these rules will help parents avoid complications that cause synechiae. Even if the boy has adhesions under the foreskin, proper care of the penis will help prevent them from transforming into a pathological form.

The penis requires strict hygiene and careful handling from the very birth of the baby. The formation of synechia in newborns is not pathological. Contacting a specialist requires their presence after the age of three. But this is also not a reason to raise a panic. Up to 7 years old, you can do without surgery. If the adhesions cause swelling, redness, or inflammation, it is best to consult a surgeon. At an early age, the healing process of postoperative wounds does not take long. But the operation in this case will save the boy from the dangerous consequences of pathological synechiae in the future.

Adhesions on the foreskin can occur in babies, but in adulthood they can also cause a lot of problems. If there are synechiae on the skin of the penis, inflammation will not slow down, because the soil for the reproduction of bacteria is the most suitable. There is a way out - there are modern methods of treating synechiae that can be used at any age.

What is synechiae?

Adhesions, or synechiae, is a condition when areas of fusion of the foreskin and glans are revealed in the male penis. Adhesions, with their strong severity, do not allow the head to be exposed and continue from the opening of the urethra to the coronary groove.

Adhesions are not always considered a pathology. Boys have them at birth to protect the head from infection and damage. Later, by the age of 3, the synechiae gradually begin to dissolve, and the head gradually moves out from behind the foreskin. With the full functioning of the body by the age of 6-11 years, the head can be completely exposed, but sometimes this does not happen. This phenomenon is already recognized as pathological and can be observed even in adult men.

According to the international classification ICD-10, synechiae have a code number 47 (excess foreskin, phimosis and paraphimosis).

In the photo, the development of the foreskin in boys

Causes of the problem

The reasons for the physiological synechiae are clear - nature provides for the prevention of the development of inflammatory diseases of the urethra and other organs of the genitourinary system in children. But why do some boys have partial exposure of the head by the age of 3, and complete exposure by 7, while in others, even by adolescence, the problem persists?

The reasons may be as follows:

1. Injuries, various manipulations with the head of the penis. For example, a rough attempt to remove the head at an early age almost always leads to the appearance of areas of accretion of the foreskin. Also, scars can form during circumcision, dissection of the foreskin, and most often they persist until adulthood.
2. Postponed infections. If a child or an adult has suffered tuberculosis, syphilis, and a number of other pathologies, the process may end with the appearance of adhesions.
3. Burns after radiation, radiation, exposure to chemicals, thermal burns. In this case, synechiae are large, poorly amenable to therapy.

In men, the most common cause of synechiae already in adulthood is infectious diseases and injuries. Occasionally, pathology is provoked by severe allergic reactions, serious hormonal disruptions.

Clinical picture

Outside the development of the inflammatory process, the child is not disturbed by any clinical manifestations. If there is no complete fusion of the foreskin, which interferes with normal urination, then symptoms can only be noticed on examination. Outwardly, synechiae look like white-gray cords located around the glans penis. At the same time, it is not possible to expose the head by shifting the foreskin.

Often there are "pockets" in the place of which the foreskin moves away from the head (in a child, this may mean the beginning of an independent separation of the adhesions). Often in such "pockets" smegma accumulates - white discharge that dries up and forms hard pieces.

Synechiae look similar in adult men, and traumatic adhesions can be thick, irregular in shape, resembling scars.

If a child or adult develops an inflammatory process, which happens due to the development of an infection in a confined space under the commissure, the symptoms will be as follows:

• Swelling of the upper part of the penis;
• Redness of the head;
• Cutting, burning when urinating;
• Soreness even at rest, sometimes sharp;
• Discharge with pus;
• Exit urine drop by drop.

In men, an erection becomes difficult and very painful, and sexual life suffers seriously.

Diagnostic measures

If by the age of 3 the boy has not started the process of separation of adhesions, you should go to a pediatric urologist. In this case, no treatment is carried out, but the doctor will assess the severity of the situation and give a prognosis for resolving the problem on his own.

Usually, an examination is sufficient for diagnosis, but in the presence of an inflammatory process, you will have to pass a number of tests:

• General urinalysis to exclude urethritis;
• Complete blood count at elevated temperature to exclude systemic infection;
• Ultrasound of the penis, scrotum, bladder, kidneys if further spread of inflammation is suspected.

How to treat?

By the age of 6-7 years, in the absence of improvement, the urologist will recommend the separation of synechiae at home. The method is as follows:

1. Pour warm water into the bath, seat the child in the water.
2. After 40 minutes, begin to separate the adhesions without leaving the water (gently pull the skin of the foreskin, making attempts to expose the head).
3. Perform the procedures 1-3 times a week.
4. The adhesion separation process can take 3-5 months.

In most cases, you can get rid of the trouble in this way. In the absence of results, the urologist will carry out the procedure in the medical office. A special cream is applied to the skin, an hour later (after the adhesion softens), the synechiae are quickly diluted.

An indication for the operative separation of synechiae is age over 12 years (in adults, the problem is treated only with the help of an operation), the presence of cicatricial phimosis, the presence of frequent inflammatory reactions. Usually synechiae are operated under local anesthesia, occasionally under general anesthesia.

After the operation, it is important to monitor the hygiene of the genital area, rinse the head of the penis daily, apply antibacterial ointments (Levomekol, Erythromycin and others). On the recommendation of a doctor, you will need to do chamomile baths until the skin heals (3-7 days).

If a man or boy has an active inflammatory process, the separation is made only after it subsides. For the treatment of inflammation, baths and irrigation of the head of the penis with Miramistin, Chlorhexidine are prescribed. In some cases, hydrocortisone is injected with a syringe without a needle (for severe inflammation). In difficult situations, antibiotics are prescribed in tablets. With rough scars, after the dissection of the foreskin is performed, plastic surgery is performed under general anesthesia.

Possible consequences

In children without daily hygiene and lack of timely separation of adhesions, balanoposthitis most often occurs - inflammation of the head with the foreskin. The reason is the accumulation of smegma and the active reproduction of infection in it. The consequence of balanoposthitis can be severe edema, pain, the transition of pathology to a chronic recurrent form.

In adolescents and men, synechiae not removed in time often cause the appearance of cicatricial phimosis. Due to the narrowing of the foreskin, the head is not exposed, normal sex life becomes impossible. Treatment is only operative (removal of the foreskin). More serious complications can be a pinching of the head, the formation of tumors (smegma is carcinogenic, it should not be allowed to accumulate under the skin).

Prophylaxis

Measures to prevent synechiae are regular hygiene of the genitals in children, prevention of foreskin injuries, timely visits to a urologist or andrologist if there are problems.

In chapter Children's health to the question of synechia of the foreskin in a 10-year-old boy asked by the author Anna Soldatova the best answer is You can contact any children's clinic. Where do you live? I'll tell you more precisely in Moscow.

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Answer from Just LANA
Dear Anna, Already at the age of 7-8, this procedure should have been done by a pediatric urologist or surgeon. What a trauma. and you understand. what will it lead to if nothing is done? ! And self-opening leads to scars, adhesions, and this aggravates the situation. All boys from year to year must be observed by a specialist.

Answer from Atka
In general, I heard that before the age of 14, you should not touch, let alone open the head of the penis in boys, if there are no problems with urination. Check with your pediatrician.

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Synechia - fusion of genital tissues. In little girls, this is most often a partial and complete "gluing" of the labia. In women of reproductive and climacteric age, synechiae are localized in the uterine cavity and vagina. Pathology is congenital as well as acquired character. Treatment of synechia in girls and adult women can be conservative or operative. The tactics are determined individually.

Synechiae in the uterine cavity are connective tissue cords, they can be compared with adhesions. Synechiae look like whitish thin "strings" or dense fibrous areas. They can be asymptomatic or manifest clinically. The consequences of both girls and adult women are associated with menstrual dysfunction, pain, unpleasant discharge and even infertility. According to ICD-10, the condition belongs to non-inflammatory diseases and is coded as N90.

Why arise

Given that synechiae in girls and women manifest themselves in different ways, the factors provoking their appearance should be considered by age group.

Girls

During the pre-pubertal period, the female body produces a small amount of estrogen. Namely, they are responsible for the production of a special secret that acts as a lubricant in the vagina and vulva. Its lack leads to adhesion of the labia majora and labia majora to each other, after which they are "soldered" in this position. In addition, synechiae are a consequence of vulvitis and vulvaginitis of various nature. However, not all girls develop such adhesions. Rarely, synechiae can be a congenital pathology. There are factors that contribute to their appearance.

• Disorders in the digestive tract... Dysbacteriosis, helminthic invasion and other gastroenterological problems, due to which the supply of nutrients to the mucous membrane is disrupted and its additional desiccation occurs.
• Infections. Tonsillitis, rhinitis, sinusitis (including chronic) act as a source of infection in the body. Influenza, adenoviral diseases lead to a decrease in immunity and increase the likelihood of dysbiosis, vulvitis.
• Hygiene. Frequent, intensive washing "to a squeak" using soap often lead to minor injuries to the thin, sensitive mucous membrane of the labia. The healing of these wounds also provokes adhesion.
• Linen. Synthetic, tight underwear irritates the skin and mucous membranes, contributes to excess moisture in the crotch area. This provokes the appearance of vulvitis.
• Allergy. The reaction to various internal and external stimuli can affect the labia: there is their inflammation and the subsequent formation of synechia.

Vulvitis in a girl can be the result of an infection from her mother when using only towels and personal hygiene products. Therefore, in the presence of synechia in a child, it is necessary to examine the woman for genital infections.

In the reproductive period

Synechiae in the uterine cavity is called Asherman's syndrome, after the name of the doctor who first described the disease in detail. Such adhesions can form in the vagina and cervical canal. The causes of synechia in women of childbearing age are the following factors.

• Mechanical damage. During abortions, gynecological manipulations, after childbirth, with prolonged use of an intrauterine device, after the introduction of drugs into the uterine cavity.
• Inflammation. Colpitis, endometritis.

Curettage of the uterine cavity after a frozen pregnancy often leads to the formation of adhesions. Necrotic areas of the chorion activate fibroblasts (connective tissue cells), which stimulates collagen production and the formation of synechia.

In menopause

In the climacteric period, in conditions of estrogen deficiency, atrophic processes occur in the genitals. Synechiae more often form in the vagina and cervical canal against the background of chronic colpitis. Moreover, women may not have complaints if they do not have an active sex life.

Classification

The division of the synechiae of the genital organs is carried out according to different criteria. The most common classifications are presented in the table.

Table - Classification of synechia

Criteria	Division	Specifications
Synechiae by the type of tissue fusion	Baby	- Occur in girls before puberty; - affect the labia
	Adults	Formed in the uterine cavity
Synechiae according to the severity of fusion of the labia minora	Partial	Up to 2/3
	Complete	More than 2/3
Uterine synechiae by histological structure	Lungs	"Film" that can be easily excised
	Average	- Fibromuscular synechiae; - dense, bleed when dissected
	Expressed	- Synechiae from connective tissue; - very dense; - extremely difficult to excise and do not bleed at the same time
Uterine synechiae by prevalence	I degree	- Small adhesions; - affect up to 25% of uterine tissues; - not in the fallopian tubes and the fundus of the organ
	II degree	- Synechiae cover from 25% to 75% of uterine tissues; - the mouths of the pipes and the bottom are covered
	III degree	- Synechiae affect more than 75% of uterine tissues; - there is a "sticking" of the walls

Symptoms

In girls, pathology can be asymptomatic at the initial stage or with a small area of ​​fusion. Often, synechiae are a mother's "find" when washing a girl or treating the perineal area. In this case, the labia minora are interconnected, completely or partially covering the entrance to the vagina.

Synechiae can form between the labia majora and labia minora. When trying to separate them, the child cries or does not allow anyone to touch him at all. If the fusion has covered a significant part of the tissue, this may be manifested by the following symptoms:

• difficulty urinating- girls refuse to go to the potty, the stream of urine can be directed upward, like in boys, and not down;
• pain - the child becomes moody, cries for unknown reasons;
• discoloration - redness, itching and flaking of the skin may appear.

In the case of the addition of an infectious-inflammatory process, purulent discharge, bright redness of the vulva, and a rash can be observed.

Intrauterine synechiae in women are manifested by the following symptoms:

• lower abdominal pain;
• scanty menstrual bleeding or amenorrhea;
• pain during menstruation.

With menopausal synechiae, there is discomfort in the vagina, cramps, burning, itching, soreness, especially during sexual intercourse.

Intrauterine synechiae is an insidious violation, since it poses a threat to reproductive function. But with timely and correct therapy, there is a good prognosis for recovery.

Effects

The consequences of synechiae differ in women of different ages.

Girls

In the pre-pubertal period, synechiae do not pose a particular threat to the girl's health. They are common and in most cases disappear without a trace. But synechiae can cause discomfort, pain and, in the absence of correction, provoke an infectious and inflammatory process, which already requires serious treatment.

In the reproductive period

Synechiae in the uterine cavity are dangerous with the following consequences.

• Hematometer. The accumulation of blood between adhesions, difficulty in withdrawing it during menstruation can lead to infectious and inflammatory processes with spread to nearby tissues, which is dangerous not only for health, but also for the life of a woman.
• Infertility. Even single synechiae in the area of ​​the cervical canal or the mouth of the fallopian tubes can become an obstacle for spermatozoa, and the fibromuscular or connective tissue act "like a spiral".
• Miscarriage. In the event of pregnancy, the risks of ectopic, non-developing pregnancy and miscarriages remain.

In menopause

Synechiae during the postmenopausal period are dangerous by the development of an infectious and inflammatory process in the vagina, which can spread to the cervix and cause its dysplasia.

Women with synechiae in the uterine cavity or vagina suffer from menstrual cramps and pain during intercourse. Reviews confirm this.

What kind of examination you need to undergo

Splicing of the labia in girls can be detected on a gynecological examination. Further, the pediatric gynecologist collects the secretions of the vestibule of the vagina for microscopic examination and bacterial seeding. Based on the results, additional treatment is prescribed.

The following methods are used to diagnose intrauterine synechiae.

• Hysteroscopy. Synechiae during the operation are visible as thin whitish joints of various lengths and densities. They reduce the space of the uterus, most often there are no vessels in them.
• Metrosalpingoscopy. Allows you to establish the degree of adhesion inside the uterine cavity. And also the loneliness and multiplicity of pathological fillings of the contrast between the synechiae, which have different sizes and, most often, a lacuna-like shape.

Ultrasound examination in the diagnosis of synechia in most cases is uninformative. Adhesions are not visible, the uterine cavity has a normal structure and shape. In some cases, during ultrasound, synechiae may resemble polyps.

Treatment of synechiae in girls ...

It is necessary to treat synechia depending on which parts of the genitals and to what extent the process has affected. Traditional medicine should be preferred over folk remedies.

Asymptomatic synechiae in the initial stages up to 0.5 cm in length in girls often go away on their own. However, the condition should be monitored together with a specialist so as not to miss complications and the inflammatory process.

The synechiae of the labia of a larger size are treated with special ointments, due to the effect of which the tissues gradually disperse. In difficult cases, surgical separation of synechia is used. It is painless and low-traumatic, but does not protect against their re-formation. Surgical dissection of synechiae is resorted to in extreme cases. For conservative treatment, the following ointments and creams are used:

• treatment - "Kontraktubeks", "Ovestin";
• prevention - baby cream or oil (after the main course of treatment).

Lubricate areas of the labia majora and labia minora daily after washing. Gradually, the seams will separate. It is useful to supplement the treatment with sitz baths with chamomile, calendula. It is important to identify the root cause and address it to prevent relapse.

... and adult patients

Synechiae in the uterus are eliminated by surgical manipulation - hysteroscopic dissection. Depending on the length and density of the synechia, such operations are carried out:

• endoscopic scissors;
• forceps;
• hysteroscope body;
• laser;
• hysteroresectoscope.

To control the procedure and prevent uterine perforation, control ultrasound or laparoscopy is performed.