Synechia of the foreskin as a cause of inflammatory processes and a breeding ground for bacteria. Synechia (fusion) of small lips in girls: how can a mother recognize the problem and solve it? N42 Other diseases of the prostate

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

What is synechia?

Adhesions, or synechia - a condition when the male penis reveals areas of fusion of the foreskin and head. Spikes, with their strong severity, do not allow the head to be exposed and continue from the urethral opening to the coronal groove.

Adhesions are not always considered a pathology. In boys, they are normal at birth to protect the head from infection and damage. Later, by the age of 3, synechiae gradually begin to dissolve, and the head gradually moves forward 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.

By international classification ICD-10, synechias have code No. 47 (excessive foreskin, phimosis and).

In the photo, the development of the foreskin in boys

Causes of the problem

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

The reasons may be the following:

1. Injuries, carrying out various manipulations with the head of the penis. For example, a rough attempt to bring the head into early age almost always leads to the appearance of places of growth of the foreskin. Also, scars can form during circumcision, dissection of the foreskin, and most often they persist until adulthood.
2. Transferred infections. If a child or an adult has had tuberculosis, syphilis, a number of other pathologies, the process may end in the appearance of adhesions.
3. Burns after irradiation, radiation, hits chemical substances, thermal burns. In this case, the synechiae are large and difficult to treat.

Men have the most common cause the appearance of synechia already in adulthood are infectious diseases and injury. 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 that prevents normal urination, then symptoms can only be noticed upon examination. Outwardly, synechiae look like white-gray strands located around the glans penis. At the same time, it is not possible to expose the head by moving the foreskin.

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

Synechia in adult men looks similar, and traumatic adhesions can be thick, irregularly shaped, resembling scars.

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

• swelling of the upper part of the penis;
• Redness of the head;
• Cutting, burning during urination;
• Soreness even at rest, sometimes sharp;
• Discharge with pus;
• Urine drop by drop.

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

Diagnostic Measures

If by the age of 3 the boy has not begun the process of separation of adhesions, you should go to a pediatric urologist. In this case, treatment is not carried out, but the doctor will assess the severity of the situation and give a forecast for an independent resolution of the problem.

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

• General urinalysis to exclude urethritis;
• Complete blood count at elevated temperature to rule out systemic infection;
• Ultrasound of the penis, scrotum, Bladder, kidneys with suspected further distribution inflammation.

How to treat?

By 6-7 years, in the absence of improvement, the urologist will recommend the separation of synechia at home. The method is the following:

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 back the skin of the foreskin, making attempts to expose the head).
3. Procedures to be performed 1-3 times a week.
4. The process of separation of adhesions can take 3-5 months.

In most cases, you can get rid of trouble in this way. In the absence of results, the urologist will perform the procedure in the medical room. A special cream is applied to the skin, an hour later (after the adhesion has softened), synechia is rapidly diluted.

An indication for the surgical separation of synechia is age over 12 years (in adults, the problem is treated only with the help of surgery), the presence of cicatricial phimosis, and the presence of frequent inflammatory reactions. Synechia is usually operated under local anesthesia, occasionally under the general.

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

If a man or boy has an active inflammatory process, disconnection 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 (with severe inflammation). In severe situations, antibiotics are prescribed in tablets. With rough scars, after the dissection of the foreskin is performed, Plastic surgery 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 swelling, pain, the transition of pathology into a chronic relapsing form.

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

Prevention

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

• Canal Nukka congenital
• fetal vagina

Congenital:

• absence of a vulva
• vulvar cyst
• vulvar anomaly NOS

In Russia, the International Classification of Diseases of the 10th revision (ICD-10) is adopted as a single regulatory document for accounting for morbidity, reasons for medical institutions all departments, causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Synechia in boys: causes and treatment

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

What it is

Synechia in boys, what kind of pathology is this, 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.

Synechia 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 under the foreskin, as well as to prevent injury to the head.

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

If the foreskin is attached to the head in an adult male, surgery is necessary, since this condition can lead to unpleasant consequences from the genitourinary system.

Important to remember! In no case should you breed synechia in boys and adult men! This can lead to serious injury, resulting in problems with the process of excretion of urine, and in adulthood - erectile dysfunction.

Causes of synechia

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

1. The development of viruses and infections. The entry 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 active activity of pathogens cause the formation of adhesions. Therefore, when the slightest signs of inflammation appear on the genitals, you should immediately consult a doctor. It is possible to prevent infection from entering the organs of the genitourinary system by observing the personal hygiene of the baby.
2. Allergy related diseases. 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 detect or prevent inflammatory processes of an allergic nature in the genital area in a timely manner.
3. Complications during pregnancy. Every mother who bears 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 amount of synechia in a baby, which will have to be eliminated exclusively surgical method. Almost every pregnant woman carefully monitors her health, so adhesions for this reason appear in a child in extremely rare cases.
4. Injury to the penis. Every boy is born with a closed glans penis. Active attempts to retract the foreskin on your 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 irradiation, radiation, contact with caustic chemicals on the genitals, thermal exposure. As a result, scars are formed, which lead to the appearance of large adhesions. It is impossible to 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 stagnation 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 synechia that is not associated with inflammatory processes, then they separate over time. Incomplete fusion 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 at the top of the penis;
• pain, burning and other uncomfortable sensations at the time of urination;
• sharp pain in the penis even at rest;
• excessive discharge with particles of pus;
• problems with the excretion of urine, the liquid comes out in small quantities, drop by drop.

Synechia in men is characterized by painful sensations in the state of erection, as well as at the time of sexual contact. Young people in most cases refuse sexual activity until full recovery.

Diagnosis of the disease

Finding synechia of the penis is quite simple. The specialist only needs to conduct a visual examination of the penis. A doctor should be consulted in cases where the synechiae of the foreskin in boys have not separated before the age of three.

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

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 be taken at elevated body temperature to exclude the development of infectious diseases.
3. Ultrasound diagnostics of the genitourinary system. The penis, scrotum, bladder, kidneys are examined. Ultrasound examination is performed in cases where there is a suspicion of rapid spread inflammatory processes.

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

Treatment of synechia in boys

If synechia is 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. For this, it is necessary to carry out such manipulations:

• put the child in a bath with warm water;
• 30-40 minutes after steaming, the synechia should be separated from the boy without stopping contact with water;
• slowly and carefully pull back the foreskin, trying to expose the head of the penis.

Separation of 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.

Medical therapy

If the synechia of the foreskin in boys causes inflammation, home treatment is required using medications. For this, creams and ointments of the glucocorticosteroid group are used. Hormonal drugs help to eliminate such unpleasant symptoms as swelling, redness, cracks on 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 local preparations this group are Hydrocortisone ointment and Contractubex.

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

Surgical intervention

If the boy's synechia does not go away, what should I do? Usually, the surgical method for the treatment of synechia in boys is prescribed after reaching the age of 12. Up to this point, they can diverge on their own. Spontaneous dilution of adhesions is observed as a result of the influence of such factors:

• sudden causeless erections, characteristic of boys during puberty;
• inflammation of the prepuce;
• secretion of sebaceous enzymes.

But without surgical intervention and other treatments, only minor adhesions can be eliminated. Synechia of a large size require more radical actions aimed at their elimination.

Large synechia that cause regular inflammatory processes must be removed with the help of surgery. It is usually performed under local anesthesia and does not require special preparation.

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 being made. This type of surgical intervention allows you to get rid of not only synechia, but also physiological or pathological phimosis.

AT postoperative period it is necessary to carefully monitor the hygiene of the penis. It is necessary to wash 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 for 1 week after surgery.

If a rehabilitation period the boy is delayed, then for a full recovery he is prescribed antibacterial drugs for ingestion.

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 blockage of the urethra. As a result, the boy experiences strong pain, burning sensation and pain in the process of excretion of urine. He also observes constant feeling an unemptied 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 synechia do not allow sufficient hygiene of the penis. The danger of balanoposthitis lies in the fact that after a certain period of time it is converted 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. Erections and sex cause pain.

by the most dangerous complication synechia in a child is the development of benign or malignant tumors under the foreskin of the penis. Due to pinching of the head, smegma accumulates, which has carcinogenic properties. It is extremely difficult to get rid of such a pathology. 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 penis in boys. It consists of the following activities:

1. Daily washing of the head of the penis under running water. For this procedure, it is better to use warm boiled water. It is also useful to wash the genitals in a decoction of medicinal herbs. To do this, brew 1 tsp in 1 cup of boiling water. dried chamomile, calendula, mint or St. John's wort.
2. Do not try to retract the foreskin yourself if this causes difficulty. This can lead to injury to the penis, the formation of cracks, which are accompanied by discomfort.
3. Change diapers promptly. Prolonged stay of the 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 in the hot season, it is better to refuse them for this period. Since the baby sweats, resulting in a favorable environment for the active development of pathogenic microorganisms.
4. Choose the right underwear. Children's underpants should be made only from natural materials. Synthetics can cause allergic reactions. Also, do not forget about choosing the right size panties for your baby. They should not rub or squeeze the genitals.

Compliance with these rules will help parents avoid complications that cause synechia. Even if the boy has adhesions under the foreskin, proper care behind the penis will help prevent their transformation 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. Appeal to a specialist requires their presence after the age of three. But this is also no reason to panic. Up to 7 years, you can do without surgery. If adhesions cause swelling, redness or inflammation, it is better to consult a surgeon. At an early age, the healing process of postoperative wounds will not take much time. But the operation in this case will save the boy from dangerous consequences pathological synechia 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. Once every ten years, this classifier is reviewed under the guidance of the World Health Organization. ICD is normative document, ensuring the unity of methodological approaches and international comparability of materials. The International Classification of Diseases of the Tenth Revision (ICD-10 or ICD-10) is currently 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.

Pediatrics. Family doctor's guide

The New Therapist's Handbook

Handbook of gastroenterology

Prescription guide for children's doctor

Emergency Medicine Physician's Handbook

Nursing Handbook. Practical guide

Handbook of pharmacotherapy of genitourinary diseases

Complete reference book of traditional medicine

Full medical reference book diagnostics

Practitioner's Handbook for Psychiatry, Narcology and Sexual Pathology

ICD code: N85.6

Intrauterine synechia

Intrauterine synechia

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ICD 10. Class XIV (N00-N99)

ICD 10. CLASS XIV. DISEASES OF THE URINARY SYSTEM (N00-N99)

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

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

congenital anomalies, deformities and chromosomal disorders (Q00-Q99)

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

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

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

This class contains the following blocks:

N10-N16 Tubulointerstitial diseases of the kidneys

N30-N39 Other diseases of the urinary system

N70-N77 Inflammatory diseases of 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:

N22* Stones of the urinary tract in diseases classified elsewhere

N37* Disorders of ureter in diseases classified elsewhere

N74* Pelvic inflammatory disease in women in diseases classified elsewhere

GLOMERULAR DISEASES (N00-N08)

If necessary to identify an external cause (Class XX) or if renal failure (N17-N19) is present, use an additional code.

Excludes: hypertension with primary renal involvement (I12.-)

The following fourth characters classifying morphological changes may be used with the N00-N07 rubrics. Subcategories.0-.8 should not be used unless specific investigations have been performed to identify the lesions (e.g. kidney biopsy or autopsy). The three-digit rubrics are based on clinical syndromes.

0 Minor glomerular disorders. Minimum 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 Dense sediment disease. Membranoproliferative glomerulonephritis (type 2)

7 Diffuse sickle-shaped 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's)

With morphological lesion specified in .0-.8

Excludes: hematuria NOS (R31)

N03 Chronic nephritic syndrome

Excl.: chronic tubulointerstitial nephritis (N11.-)

nephritic syndrome NOS (N05.-)

N04 Nephrotic syndrome

Includes: congenital nephrotic syndrome

N05 Nephritic syndrome, unspecified

Inclusions: glomerular disease >

nephropathy NOS and renal disease NOS with morphological lesion specified in c.0-.8

Excl.: 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

Excl.: Alport syndrome (Q87.8)

hereditary amyloid nephropathy (E85.0)

syndrome (absence) (underdevelopment) of nail-patella (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 of neoplasms

Glomerular lesions in:

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

Glomerular lesions in:

Disseminated intravascular coagulation [defibrination syndrome] (D65+)

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

N08.4* Glomerular lesions in other endocrine, nutritional and metabolic disorders

Glomerular lesions in:

Deficiencies of lecithincholesterol 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 KIDNEY DISEASES (N10-N16)

Excludes: 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:

Excl.: calculous pyelonephritis (N20.9)

N11.8 Other chronic tubulointerstitial nephritis

Non-obstructive chronic pyelonephritis NOS

N11.9 Chronic tubulointerstitial nephritis, unspecified

Interstitial nephritis NOS

N12 Tubulointerstitial nephritis, not specified as acute or chronic

Interstitial nephritis NOS

Excludes: calculous pyelonephritis (N20.9)

N13 Obstructive uropathy and reflux uropathy

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

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

obstructive pyelonephritis (N11.1)

N13.0 Hydronephrosis with ureteropelvic junction obstruction

N13.1 Hydronephrosis with ureteral stricture, not elsewhere classified

N13.2 Hydronephrosis with obstruction of kidney and ureter by stone

N13.3 Other and unspecified hydronephrosis

N13.5 Bend and stricture of ureter without hydronephrosis

Conditions listed under N13.0-N13.5 with infection. Obstructive uropathy with infection

Use an additional code (B95-B97) if necessary to identify the infectious agent.

N13.7 Uropathy due to vesicoureteral reflux

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

Use an additional external cause code (class XX) if necessary to identify the toxic substance.

N14.0 Nephropathy due to analgesics

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

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

N14.3 Heavy metal nephropathy

N14.4 Toxic nephropathy, not elsewhere classified

N15 Other tubulointerstitial kidney diseases

N15.0 Balkan nephropathy. Balkan endemic nephropathy

N15.1 Abscess of kidney and perirenal tissue

N15.8 Other specified tubulointerstitial disorders of kidney

N15.9 Tubulointerstitial disorder of kidneys, unspecified Kidney infection NOS

Excludes: urinary tract infection NOS (N39.0)

N16* Tubulointerstitial disorders of the kidneys in diseases classified elsewhere

N16.1* Tubulointerstitial kidney disease in neoplasms

Tubulointerstitial kidney disease in:

N16.2* Tubulointerstitial kidney disease in blood disorders and disorders involving immune mechanism

Tubulointerstitial kidney disease in:

N16.3* Tubulointerstitial kidney disease in metabolic disorders

Tubulointerstitial kidney disease in:

N16.4* Tubulointerstitial kidney disease in systemic connective tissue diseases

Tubulointerstitial kidney disease in:

N16.5* Tubulointerstitial kidney injury due to graft rejection (T86.-+)

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

RENAL INSUFFICIENCY (N17-N19)

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

Excludes: congenital kidney failure(P96.0)

tubulointerstitial and tubular lesions due to 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

Excludes: 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)

URINAL STONE DISEASE (N20-N23)

N20 Kidney and ureter stones

Excl.: with hydronephrosis (N13.2)

N20.0 Kidney stones. Nephrolithiasis NOS. Stones or stones in the kidney. Coral stones. kidney stone

N20.1 Stones of the ureter. Stone in the ureter

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 Bladder stones. Stones in the bladder diverticulum. bladder stone

Excludes: staghorn calculi (N20.0)

N21.8 Other lower urinary tract stones

N21.9 Stones in lower urinary tract, unspecified

N22* Stones of the urinary tract in diseases classified elsewhere

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

N22.8* Urinary tract stones 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 Shriveled 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 of unknown cause (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 Renal cyst, acquired. Cyst (multiple) (single) kidney acquired

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

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

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

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

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

Damage to the kidney and ureter with:

N29.8* Other disorders of 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, identify infectious agent (B95-B97) or related external factor(class XX) use additional code.

Excludes: prostatocystitis (N41.3)

N30.1 Interstitial cystitis (chronic)

N30.2 Other chronic cystitis

N30.3 Trigonite. Urethrotrigonitis

N30.8 Other cystitis Bladder abscess

N31 Neuromuscular dysfunction of bladder, not elsewhere classified

Excludes: spinal bladder NOS (G95.8)

due to defeat spinal cord(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 bladder weakness, not elsewhere classified

Neurogenic bladder:

Atonic (motor disturbances) (sensory disturbances)

N31.8 Other neuromuscular disorders of bladder

N31.9 Bladder neuromuscular dysfunction, unspecified

N32 Other disorders of bladder

Excludes: bladder stone (N21.0)

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

N32.0 Bladder neck obturation. Bladder neck stenosis (acquired)

N32.1 Vesicointestinal fistula. Vesicocolonic fistula

N32.2 Vesicular fistula, not elsewhere classified

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

N32.3 Bladder diverticulum. Bladder diverticulitis

Excludes: bladder diverticulum stone (N21.0)

N32.4 Rupture of bladder, non-traumatic

N32.8 Other specified disorders of bladder

N32.9 Bladder disorder, unspecified

N33* Bladder disorders in diseases classified elsewhere

N33.8* Bladder disorders in other diseases classified elsewhere

Bladder affections in schistosomiasis [bilharzia] (B65. -+)

N34 Urethritis and urethral syndrome

If necessary, identify the infectious agent

Excludes: Reiter's disease (M02.3)

urethritis in predominantly sexually transmitted diseases (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

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

N35.0 Post-traumatic stricture of urethra

N35.1 Postinfectious urethral stricture, not elsewhere classified

N35.8 Urethral stricture other

N35.9 Urethral stricture, unspecified Outer opening NOS

N36 Other disorders of urethra

N36.0 Urethral fistula. False urethral fistula

N36.1 Urethral diverticulum

N36.2 Urethral caruncle

N36.3 Prolapse of urethral mucosa. Prolapse of the urethra. Urertocele in men

Excludes: female urethrocele (N81.0)

N36.8 Other specified diseases of urethra

N36.9 Disease of urethra, unspecified

N37* Urethral disorders in diseases classified elsewhere

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

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

N39 Other diseases of the urinary system

N39.0 Urinary tract infection, unspecified

Use an additional code (B95-B97) if necessary 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

Excluded: with specified morphological changes (N06.-)

N39.3 Involuntary urination

N39.4 Other specified urinary incontinence

Reflex > urinary incontinence

N39.8 Other specified diseases of urinary system

N39.9 Urinary tract disorder, unspecified

DISEASES OF THE MALE GENITAL ORGANS (N40-N51)

N40 Prostatic hyperplasia

Enlargement (benign) > of the prostate

Adenoma of the median lobe (prostate)

Obstruction of prostate duct NOS

Excludes: benign tumors other than adenoma, fibroma

and prostate fibroids (D29.1)

N41 Inflammatory diseases of the prostate

Use an additional code (B95-B97) if necessary to identify the infectious agent.

N41.1 Chronic prostatitis

N41.2 Abscess of prostate

N41.8 Other inflammatory diseases of prostate

N41.9 Inflammatory disease of the prostate, unspecified Prostatitis NOS

N42 Other diseases of the prostate

N42.0 Stones of the prostate. prostatic stone

N42.1 Congestion and hemorrhage of prostate

N42.2 Atrophy of prostate

N42.8 Other specified disorders of prostate

N42.9 Disorder of prostate, unspecified

N43 Hydrocele and spermatocele

Includes: dropsy of spermatic cord, testicle, or testicular sheath

Excludes: congenital hydrocele (P83.5)

N43.0 Encapsulated hydrocele

N43.1 Infected hydrocele

Use an additional code (B95-B97) if necessary to identify the infectious agent.

N43.2 Other forms of hydrocele

N43.3 Hydrocele, unspecified

N44 Testicular torsion

N45 Orchitis and epididymitis

Use an additional code (B95-B97) if necessary to identify the infectious agent.

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

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 disorders of the penis

N48.0 Leukoplakia of the penis. Kraurosis of the penis

Excludes: carcinoma in situ of penis (D07.4)

Use an additional code (B95-B97) if necessary to identify the infectious agent.

N48.2 Other inflammatory diseases of penis

Carbuncle >

Cavernitis of the penis

Use an additional code (B95-B97) if necessary to identify the infectious agent.

N48.3 Priapism painful erection

N48.4 Organic impotence

Use an additional code if necessary to identify the cause.

Excludes: psychogenic impotence (F52.2)

N48.6 Balanitis. Plastic induration of the penis

N48.8 Other specific disorders of penis

Hypertrophy > cavernous body and penis

N48.9 Disease of penis, unspecified

N49 Inflammatory diseases of the male genital organs, not elsewhere classified

Use an additional code (B95-B97) if necessary to identify the infectious agent.

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 scrotum

N49.8 Inflammatory diseases of other specified male genital organs

N49.9 Inflammatory disorders of male genital organ, unspecified

Furuncle > unspecified male

Carbuncle > 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 > testis [other than atrophy], vaginal mucosa Ulcer > vulva and vas deferens

Chylocele vaginalis (nonfilarial) NOS

N50.9 Disease of male genital organs, unspecified

N51* Disorders of the male genital organs in diseases classified elsewhere

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

N51.1* Disorders of testis and its appendages in diseases classified elsewhere

N51.2* Balanitis in diseases classified elsewhere

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

Filarious chylocele of vaginal membrane (B74. -+)

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

Tuberculosis of seminal vesicles (A18.1+)

BREAST DISEASES (N60-N64)

Excludes: breast disease associated with childbearing (O91-O92)

N60 Benign dysplasia of breast

Includes: fibrocystic mastopathy

N60.0 Solitary cyst of the mammary gland. breast cyst

N60.1 Diffuse cystic mastopathy cystic mammary gland

Excludes: with proliferation of epithelium (N60.3)

N60.2 Fibroadenosis of breast

Excludes: breast fibroadenoma (D24)

N60.3 Fibrosclerosis of mammary gland. Cystic mastopathy with epithelial proliferation

N60.4 Ductal ectasia of breast

N60.8 Other benign dysplasias of breast

N60.9 Benign dysplasia of mammary gland, unspecified

N61 Inflammatory diseases of the mammary gland

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

Breast carbuncle

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

Excludes: infectious mastitis of the newborn (P39.0)

N62 Breast hypertrophy

Breast hypertrophy:

N63 Mass in mammary gland, unspecified

Nodule(s) in breast NOS

N64 Other disorders of breast

N64.0 Fissure and fistula of nipple

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

N64.2 Atrophy of mammary gland

N64.3 Galactorrhea not associated with childbearing

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

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

N64.9 Disease of mammary gland, unspecified

INFLAMMATORY DISEASES OF THE FEMALE PELVIC ORGANS (N70-N77)

N70 Salpingitis and oophoritis

tubo-ovarian inflammatory disease

Use an additional code (B95-B97) if necessary 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 uterus other than cervix

Use an additional code (B95-B97) if necessary 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 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 inflammatory diseases of female pelvic organs

Use an additional code (B95-B97) if necessary to identify the infectious agent.

N73.0 Acute parametritis and pelvic cellulitis

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 Female acute pelvic peritonitis

N73.4 Female chronic pelvic peritonitis

N73.5 Female pelvic peritonitis, unspecified

N73.6 Female pelvic peritoneal adhesions

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

N73.8 Other specified inflammatory diseases of female pelvic organs

N73.9 Inflammatory diseases of female pelvic organs, unspecified

Infectious or inflammatory diseases of female pelvic organs NOS

N74* Inflammatory diseases of the female pelvic organs in diseases classified elsewhere

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

N74.2* Pelvic inflammatory disease due to syphilis (A51.4+, A52.7+)

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

N74.4* Chlamydia inflammatory diseases of female pelvic organs (A56.1+)

N74.8* Inflammatory diseases of female pelvic organs in other diseases classified elsewhere

N75 Diseases of Bartholin's gland

N75.0 Bartholin gland cyst

N75.1 Bartholin gland abscess

N75.8 Other diseases of Bartholin's gland Bartholinitis

N75.9 Bartholin gland disease, unspecified

N76 Other inflammatory diseases of the vagina and vulva

Use an additional code (B95-B97) if necessary 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. Vulvit NOS

N76.3 Subacute and chronic vulvitis

N76.4 Abscess of vulva. Furuncle of the vulva

N76.5 Ulceration of vagina

T76.8 Other 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 the vulva in Behçet's disease (M35.2+)

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

N80 Endometriosis

N80.0 Endometriosis of uterus. Adenomyosis

N80.1 Endometriosis of ovaries

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 skin scar

N80.9 Endometriosis, unspecified

N81 Female genital prolapse

Excludes: genital prolapse complicating pregnancy, childbirth or delivery (O34.5)

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

prolapse of vaginal stump (vault) after hysterectomy (N99.3)

Excludes: urethrocele with:

N81.1 Cystocele. Cystocele with urethrocele. Prolapse of wall (anterior) of vagina NOS

Excludes: cystotele with uterine prolapse (N81.2-N81.4)

N81.2 Incomplete prolapse of uterus and vagina. Cervical prolapse NOS

N81.3 Complete prolapse of uterus and vagina. Prosidence (uterus) NOS. Third degree uterine prolapse

N81.4 Prolapse of uterus and vagina, unspecified Uterine prolapse NOS

N81.5 Enterocele of vagina

Excludes: enterocele with uterine prolapse (N81.2-N81.4)

N81.6 Rectocele. Prolapse of the posterior wall of the vagina

Excludes: rectal prolapse (K62.3)

N81.8 Other forms of female genital prolapse. Insufficiency of the pelvic floor muscles

old ruptured pelvic floor muscles

N81.9 Female genital prolapse, unspecified

N82 Fistulas involving female genital organs

Excludes: vesicointestinal fistula (N32.1)

N82.0 Vesico-vaginal fistula

N82.1 Other fistulas of female urogenital tract

N82.2 Vagino-intestinal fistula

N82.3 Fistula vulval-colonic. Rectovaginal fistula

N82.4 Other enterogenital fistulas in women 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 Non-inflammatory 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 (of the ovary)

N83.1 Cyst 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, ovarian pedicle and fallopian tube

Excludes: hematosalpinx with:

N83.7 Hematoma of broad ligament of uterus

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

Broad ligament rupture syndrome [Masters-Allen]

N83.9 Non-inflammatory disease of ovary, fallopian tube and broad ligament of uterus, unspecified

N84 Polyp of female genital organs

Excludes: adenomatous polyp (D28.-)

Excludes: polypoid endometrial hyperplasia (N85.0)

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

N84.3 Polyp of vulva. Polyp of the labia

N84.8 Polyp of other parts of female genital organs

N84.9 Female genital polyp, unspecified

N85 Other non-inflammatory diseases of uterus, excluding cervix

inflammatory diseases of the uterus (N71.-)

N85.0 Glandular hyperplasia of endometrium

N85.1 Adenomatous hyperplasia of endometrium. Atypical endometrial hyperplasia (adenomatous)

N85.2 Uterine hypertrophy. Large or enlarged uterus

Excludes: postpartum uterine hypertrophy (O90.8)

Excludes: postpartum subinvolution of uterus (O90.8)

N85.4 Malposition of uterus

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

Excludes: current obstetric injury (O71.2)

postpartum uterine prolapse (N71.2)

N85.6 Intrauterine adhesions

N85.7 Hematometra Hematosalpinx with hematometra

Excludes: hematometra with hematocolpos (N89.7)

N85.8 Other specified inflammatory diseases of uterus Acquired uterine atrophy. Uterine fibrosis NOS

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

N86 Erosion and ectropion of the cervix

Decubital (trophic) ulcer >

eversion > cervix

N87 Cervical dysplasia

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

N87.0 Mild cervical dysplasia. Cervical intraepithelial neoplasia grade I

N87.1 Moderate cervical dysplasia. Cervical intraepithelial neoplasia II degree

N87.2 Severe cervical dysplasia, not elsewhere classified

Severe dysplasia NOS

Excludes: cervical intraepithelial neoplasia grade III, with or without mention

about pronounced dysplasia (D06. -)

N87.9 Cervical dysplasia, unspecified

N88 Other noninflammatory diseases of cervix

Excludes: inflammatory diseases of the cervix (N72)

N88.0 Leukoplakia of cervix

N88.1 Old cervical tears Adhesions of the cervix

N88.2 Cervical stricture and stenosis

Excl.: as a complication of childbirth (O65.5)

N88.3 Cervical insufficiency

Evaluation and care for (suspected) isthmic-cervical insufficiency outside of pregnancy

Excl.: complicating fetal and neonatal condition (P01.0)

complicating pregnancy (O34.3)

N88.4 Hypertrophic elongation of cervix

N88.8 Other specified non-inflammatory diseases of cervix

Excludes: current obstetric injury (O71.3)

N88.9 Noninflammatory disease of cervix, unspecified

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

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

N89.1 Moderate vaginal dysplasia. Vaginal intraepithelial neoplasia II degree

N89.2 Severe vaginal dysplasia, not elsewhere classified

Severe vaginal dysplasia NOS

Excludes: grade III vaginal intraepithelial neoplasia with or without mention

of pronounced dysplasia (D07.2)

N89.3 Vaginal dysplasia, unspecified

N89.4 Vaginal leukoplakia

N89.5 Stricture and atresia of vagina

Excludes: postoperative vaginal adhesions (N99.2)

N89.6 Tight hymen. Rigid hymen. Tight virgin ring

Excl.: hymen closed (Q52.3)

N89.7 Hematocolpos. Hematocolpos with hematometra or with hematosalpinx

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

old rupture involving pelvic floor muscles (N81.8)

N89.9 Non-inflammatory disease of vagina, unspecified

N90 Other non-inflammatory diseases of vulva and perineum

Excludes: carcinoma in situ of vulva (D07.1)

N90.0 Mild vulvar dysplasia. Vulvar intraepithelial neoplasia 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 vulvar intraepithelial neoplasia with or without mention

of pronounced dysplasia (D07.1)

N90.3 Vulvar dysplasia, unspecified

N90.5 Vulvar atrophy. Stenosis of the vulva

N90.6 Vulvar hypertrophy. Hypertrophy of the labia

N90.8 Other specified non-inflammatory diseases of vulva and perineum Spikes of the vulva. Clitoral hypertrophy

N90.9 Non-inflammatory disease of vulva and perineum, unspecified

N91 Absence of menstruation, scanty and infrequent menstruation

Excludes: ovarian dysfunction (E28.-)

N91.0 Primary amenorrhea. Menstrual disorders during puberty

N91.1 Secondary amenorrhea. Missing periods in women who have had them before

N91.2 Amenorrhea, unspecified. Absence of menses NOS

N91.3 Primary oligomenorrhea. Scanty or infrequent periods from the beginning of their appearance

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

N91.5 Oligomenorrhea, unspecified Hypomenorrhea NOS

N92 Abundant, frequent and irregular menstruation

Excl.: bleeding after menopause (N95.0)

N92.0 Abundant and frequent menstruation with regular cycle

Periodically profuse menstruation NOS. Menorrhagia NOS. Polymenorrhea

N92.1 Abundant and frequent menstruation with irregular cycle

Irregular bleeding in the intermenstrual period

Irregular, shortened intervals between menstrual bleeding. Menometrorrhagia. metrorrhagia

N92.2 Abundant menstruation in puberty

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

N92.3 Ovulatory bleeding. Regular menstrual bleeding

N92.4 Premenopausal profuse bleeding

Menorrhagia or metrorrhagia:

N92.5 Other specified forms of irregular menstruation

N92.6 Irregular menses, unspecified

Excludes: irregular menstruation due to:

Shortened intervals or profuse bleeding (N92.1)

N93 Other abnormal bleeding from uterus and vagina

Excludes: neonatal bleeding from the vagina (P54.6)

N93.0 Postcoital or contact bleeding

N93.8 Other specified anomalous bleeding from uterus and vagina

Dysfunctional or functional uterine or vaginal bleeding NOS

N93.9 Abnormal uterine and vaginal bleeding, unspecified

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

N94.0 Pain in the middle of the menstrual cycle

Excludes: psychogenic dyspareunia (F52.6)

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 involving female genital organs and menstrual cycle

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

N95 Menopausal and other perimenopausal disorders

Excl.: profuse bleeding in premenopausal period (N92.4)

premature menopause NOS (E28.3)

N95.0 Postmenopausal bleeding

N95.1 Menopause and climacteric condition of woman

Symptoms associated with menopause such as hot flashes, insomnia, headaches, impaired attention

Excl.: associated with induced menopause (N95.3)

N95.2 Postmenopausal atrophic vaginitis Senile (atrophic) vaginitis

Excludes: associated with induced menopause (N95.3)

N95.3 Conditions associated with induced menopause. Syndrome after artificial menopause

N95.8 Other specified disorders of menopause and perimenopause

N95.9 Menopausal and perimenopausal disorders, unspecified

N96 Recurrent miscarriage

Examination or provision of medical care outside the period of pregnancy. Relative infertility

Excludes: current pregnancy (O26.2)

N97 Female infertility

Includes: inability to conceive

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 anomaly of the uterus

Oocyte 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 ovum 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 URINARY 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 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 Vaginal prolapse after hysterectomy

N99.4 Postoperative adhesions in pelvis

N99.5 Dysfunction of external stoma, urinary tract

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

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

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Synechia in girls - a condition in which the labia minora are fused with each other or with the labia majora.

It is observed in little girls due to anatomical features and hormonal levels: low level estrogen in combination with sensitive, vulnerable skin of the genital organs creates conditions for sticking together, and allergies, uncomfortable underwear give rise to pathology.

General information about the violation

What do synechias look like in a girl? A photo:

Most often small labia stick together, fusion of small and large labia is less common. In 3-10% of girls from one to two years old, this pathology was diagnosed.

The fusion process lasts in different ways: the pathology can develop in a few days, or it can slowly progress for months.

Synechia does not carry a significant danger, may not be accompanied by severe symptoms, but can progress without treatment, which will lead to the development of complications that will make the girl's future life more difficult.

Reasons for the appearance

Factors that lead to sticking include:

Also, fusion can develop against the background, enterobiasis,.

At newborns In girls, adhesions are extremely rare, as the concentration of estrogen received from the mother is increased in their blood.

But gradually their level drops, and the risk of sticking increases.

The most common pathology is diagnosed in girls from six months to six or eight years, further, the likelihood of occurrence decreases, as the skin and mucous membranes of the genital organs become stronger, become more resistant to damage.

Why is there a delay in menstruation in adolescents? Learn about it from ours.

Symptoms and stages

Features of symptoms depend on the degree of fusion of the labia.

1. I degree. The length of the fusion does not exceed 5 mm, urination is not difficult, there is no pain. Synechia of the initial stage is easily cured by conservative methods and does not lead to complications.
2. II degree. The length of the union exceeds 5 mm, problems with urination and moderate soreness are possible.

If the pathology is not treated at this stage, the child may need surgery.

3. III degree. Complete adhesion of the labia, urination is extremely difficult, the child feels pain, the release of natural secretions is also difficult, which leads to the development of inflammatory reactions.

The main signs of synechia:

Complications

If the pathology was diagnosed on early stages and the girl received treatment, the likelihood of complications is minimal.

Complications of synechia:

• fused labia do not allow natural secretions to come out, which contributes to the development of severe vulvovaginitis;
• if the treatment was started late, the girl has an increased risk of violations in the process of future pregnancies;
• the long course of the pathology adversely affects the process of formation of the genital organs: they can be deformed.

Diagnostics

Diagnosis of synechia is not difficult: pediatrician or pediatric gynecologist determine the disease at the first examination.

The gynecologist may also use a vulvoscope during the examination to take a closer look at the external genitalia.

Further diagnostics is aimed at identifying the causes of the pathology. The following diagnostic measures:

• taking a smear for microscopic and bacteriological examination;
• PRC-diagnostics;
• linked immunosorbent assay;
• allergy tests;
• clinical analysis of blood and urine;
• determination of the concentration of glucose in the blood;
• analysis of feces.

It may also be required consultation from an allergist and other specialists, depending on the symptoms.

Methods of treatment

If the pathology is extremely mild, the attending physician may decide do not start treatment. He will give the parents of the child a number of recommendations, and periodically the girl will need to undergo preventive examinations.

If the illness continues progress, it will be revealed in time. Most often, synechiae are treated conservatively. The following medicines are used:

If the diagnosis showed that the occurrence of synechia is associated with allergic reactions, the child is protected from the allergen and prescribed antihistamines(Diprazin, Bravegil).

When diseases of the genital organs are detected, they are prescribed medical preparations: antimicrobial agents, antibiotics (only with bacterial damage), antimycotics (if fungi were found in the smear). The most commonly prescribed drugs are Viferon, Erythromycin, Sumamed.

Traditional medicine also offers its own methods of treating synechia, but it is important for parents who decide to try them to consult with the child's doctor and not to abandon the methods of treatment adopted traditional medicine, otherwise you can start the disease.

In addition, many folk methods can seriously harm the child: cause an allergic reaction, chemical burns.

Examples of folk methods of treatment:

• herbal baths with chamomile, string, calendula;
• lubrication of the fusion area with a small amount of potato juice applied to a cotton swab.

If the disease is in an extremely advanced state, and conservative methods have not been effective, it is shown surgical intervention which is performed under local anesthesia or under acute anesthesia.

To prevent re-union, after surgery, you need to treat the labia with a hormonal ointment.

Komarovsky's opinion

Dr. Komarovsky reports:

• synechia are not a disease, they should be considered an age feature;
• they are extremely low degree expressions are found in most of the little girls, the danger is only pronounced contractions, which are rarely observed;
• if, in the presence of adhesions, the child has no discomfort, and urination is not difficult, they should not be treated.;
• surgical intervention is carried out if the use of ointments was not effective;
• should always be used during surgery anesthesia.

Forecast and prevention

In most cases, synechiae are successfully cured, and if parents carefully follow the recommendations of doctors after treatment, chance of recurrence is extremely low.

Preventive measures:

• you should use less wet wipes, detergents with fragrances;
• to wash children, it is enough to use water, you can also use special children's products;
• do not use ordinary soap and other products that are not intended for washing;
• avoid swimming in polluted rivers, lakes, do not allow a girl without underwear to sit on the floor, on sand or earth;
• it is also important to choose comfortable underwear made from natural fabrics, devoid of coarse seams and prickly lace;
• washing should be carried out in the morning, evening and after each act of defecation.

It is important to regularly examine the child's genitals. If redness, rash, abnormal discharge, signs of fusion are observed in the perineum, you should go to the hospital.

Doctor Komarovsky about synechia in girls in this video:

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CLASS XIV. DISEASES OF THE URINARY SYSTEM (N00-N99)

This class contains the following blocks:
N00-N08 Glomerular diseases
N10-N16 Tubulointerstitial kidney disease
N17-N19 kidney 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 Diseases of the mammary gland
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 lesions of the kidneys 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* Bladder disorders in diseases classified elsewhere
N37* Disorders of the ureter in diseases classified elsewhere
N51* Disorders 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 if renal failure is present ( N17-N19) use two's complement code.

Excludes: hypertension with primary renal involvement ( I12. -)

Rubrics N00-N07 the following fourth digits classifying morphological changes may be used. Subcategories.0-.8 should not be used unless specific investigations (eg biopsy or autopsy of the kidneys) have been performed to identify the lesions. Three-digit rubrics are based on clinical syndromes.

0 Minor glomerular disorders. Minimum 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 Dense sludge disease. Membranoproliferative glomerulonephritis (type 2)
.7 Diffuse crescentic glomerulonephritis. Extracapillary glomerulonephritis
.8 Other changes. Proliferative glomerulonephritis NOS
.9 unspecified change

N00 Acute nephritic syndrome

Included: acute:
glomerular disease
glomerulonephritis
nephritis
kidney 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

Includes: hematuria:
benign (familial) (children's)
with a morphological lesion specified in c.0-.8
Excludes: hematuria NOS ( R31)

N03 Chronic nephritic syndrome

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

N04 Nephrotic syndrome

Includes: congenital nephrotic syndrome
lipoid nephrosis

N05 Nephritic syndrome, unspecified

Includes: glomerular disease)
glomerulonephritis) NOS
jade)
nephropathy NOS and renal disease NOS with morphological lesion specified in c.0-.8
Excludes: nephropathy NOS of unknown cause ( N28.9)
kidney 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
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

Excludes: Alport syndrome ( Q87.8)
hereditary amyloid nephropathy ( E85.0)
syndrome (absence) (underdevelopment) of the nail-patella ( 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-ureteral
inflection) (connections
obstruction) (pelvic segment of the ureter
structure) (ureter
Excludes: calculous pyelonephritis ( N20.9)
obstructive uropathy ( N13. -)
N11.8 Other chronic tubulointerstitial nephritis
Non-obstructive chronic pyelonephritis NOS
N11.9 Chronic tubulointerstitial nephritis, unspecified
Chronic:
interstitial nephritis NOS
pyelitis NOS
pyelonephritis NOS

N12 Tubulointerstitial 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 ureteropelvic junction obstruction
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 by a stone
Excluded: with infection ( N13.6)
N13.3 Other and unspecified hydronephrosis
Excludes: with infection ( N13.6)
N13.4 Hydroureter
Excluded: with infection ( N13.6)
N13.5 Kinking and stricture of the ureter without hydronephrosis
Excludes: with infection ( N13.6)
N13.6 pyonephrosis
Conditions listed under headings N13.0-N13.5, with infection. Obstructive uropathy with infection
If it is necessary to identify the infectious agent, use an additional code ( B95-B97).
N13.7 Uropathy due to vesicoureteral reflux
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

Use an additional external cause code (class XX) if necessary to identify the toxic substance.

N14.0 Nephropathy caused by analgesics
N14.1 Nephropathy caused by other drugs, medicines 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 kidney diseases

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

N16* Tubulointerstitial disorders of the kidneys in diseases classified elsewhere

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

RENAL INSUFFICIENCY (N17-N19)

If it is necessary to identify the external agent, an additional external cause 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)
postpartum ( O90.4)
prerenal uremia ( R39.2)
kidney 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 kidney 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
Excludes: renal failure with hypertension ( I12.0)
uremia of the newborn P96.0)

URINAL STONE DISEASE (N20-N23)

N20 Kidney and ureter stones

Excludes: with hydronephrosis ( N13.2)

N20.0 Kidney stones. Nephrolithiasis NOS. Stones or stones in the kidney. Coral stones. kidney stone
N20.1 Stones of the ureter. Stone in the ureter
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. Stones in the bladder diverticulum. bladder stone
Excludes: staghorn calculi ( N20.0)
N21.1 Stones in the urethra
N21.8 Other stones in the lower urinary tract
N21.9 Stones in lower urinary tract, unspecified

N22* Stones of the urinary tract in diseases classified elsewhere

N22.0* Urinary stones in schistosomiasis [bilharzia] ( 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 under headings E70-E90

N25.0 Renal osteodystrophy. Azotemic osteodystrophy. Tubular disorders associated with phosphate loss
Renal(th):
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 Dysfunction of the renal tubules, refined

N26 Shriveled 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 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

Excludes: 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
Excludes: Goldblatt's kidney ( I70.1)
renal artery (extrarenal part):
atherosclerosis ( I70.1)
congenital stenosis ( Q27.1)
N28.1 Acquired kidney cyst. Cyst (multiple) (single) kidney acquired
Excludes: cystic kidney disease (congenital) ( Q61. -)
N28.8 Other specified diseases of the kidneys and ureter. kidney hypertrophy. Megaloureter. Nephroptosis
pyelitis)
Pyeloureteritis (cystic)
ureteritis)
ureterocele
N28.9 Diseases of the kidney and ureter, unspecified. Nephropathy NOS. Renal disease NOS
Excludes: nephropathy NOS and renal disorders NOS with morphological lesions specified in .0-.8 ( N05. -)

N29* Other disorders of 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.
Excluded: 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 Trigonite. Urethrotrigonitis
N30.4 Radiation cystitis
N30.8 other cystitis. Bladder abscess
N30.9 Cystitis, unspecified

N31 Neuromuscular dysfunction of bladder, 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)
specified ( 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 disturbances) (sensory disturbances)
autonomous
non-reflex
N31.8 Other neuromuscular bladder dysfunctions
N31.9 Neuromuscular dysfunction of bladder, unspecified

N32 Other disorders of bladder

Excludes: bladder stone ( N21.0)
cystocele ( N81.1)
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. Vesicocolonic fistula
N32.2 Vesical fistula, not elsewhere classified
Excludes: fistula between bladder and female genital tract ( N82.0-N82.1)
N32.3 Bladder diverticulum. Bladder diverticulitis
Excludes: bladder diverticulum stone N21.0)
N32.4 Bladder rupture non-traumatic
N32.8 Other specified lesions of the bladder
Bladder:
calcified
wrinkled
N32.9 Bladder disorder, unspecified

N33* Bladder disorders in diseases classified elsewhere

N33.0* Tuberculous cystitis ( A18.1+)
N33.8* Bladder disorders in other diseases classified elsewhere
Bladder lesions in schistosomiasis [bilharzia] ( B65. -+)

N34 Urethritis and urethral syndrome

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

N34.0 urethral abscess
Abscess:
Cooper's glands
Littre's glands
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 stricture of the urethra
Urethral stricture:
postpartum
traumatic
N35.1 Postinfectious stricture of the urethra, not elsewhere classified
N35.8 Other urethral stricture
N35.9 Urethral stricture, unspecified. Outer opening NOS

N36 Other disorders of urethra

N36.0 Urethral fistula. False urethral fistula
Fistula:
urethroperineal
urethrorectal
urinary NOS
Excludes: 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. Prolapse of the urethra. Urertocele in men
Excludes: female urethrocele N81.0)
N36.8 Other specified diseases of the urethra
N36.9 Disease of urethra, unspecified

N37* Urethral disorders 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

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

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

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
Adenoma of the median lobe (prostate)
Obstruction of prostate duct NOS
Excludes: benign tumors other than adenoma, fibroma
and prostate fibroids D29.1)

N41 Inflammatory diseases of the prostate

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 Prostatocystitis
N41.8 Other inflammatory diseases of the prostate
N41.9 Inflammatory disease of the prostate gland, unspecified. Prostatitis NOS

N42 Other diseases of the prostate

N42.0 Prostate stones. prostatic stone
N42.1 Stagnation and hemorrhage in the prostate gland
N42.2 prostate atrophy
N42.8 Other specified diseases of the prostate
N42.9 Prostate disease, unspecified

N43 Hydrocele and spermatocele

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

N43.0 Hydrocele encysted
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 testis
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 disorders of the penis

N48.0 Leukoplakia of the penis. 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) cavernous body and penis
cellulite)
Cavernitis of the penis
If it is necessary to identify the infectious agent, use an additional code ( B95-B97).
N48.3 Priapism. painful erection
N48.4 Impotence of organic origin
Use an additional code if necessary to identify the cause.
Excludes: psychogenic impotence ( F52.2)
N48.5 ulcer of the penis
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 the 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 reproductive organs
N49.9 Inflammatory diseases of unspecified male genital organ
Abscess)
Furuncle) unspecified male
carbuncle) penis
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) male reproductive organs
thrombosis)
N50.8 Other specific diseases of the male genital organs
atrophy)
Hypertrophy) seminal vesicle, spermatic cord,
Edema - testicles [except for atrophy], vaginal ulcer - vulva and vas deferens
Chylocele vaginalis (nonfilarial) NOS
Fistula urethroscrotal
Structure:
spermatic cord
vaginal membrane
vas deferens
N50.9 Disease of the male genital organs, unspecified

N51* Disorders of the 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+)
tuberculosis ( A18.1+)
N51.1* Affections of the testis and its appendages in diseases classified elsewhere
Chlamydial:
epididymitis ( A56.1+)
orchitis ( A56.1+)
Gonococcal:
epididymitis ( A54.2+)
orsite ( A54.2+)
mumps orchitis ( B26.0+)
Tuberculosis:

• epididymis ( A18.1+)

• testicles ( A18.1+)

N51.2* Balanitis in diseases classified elsewhere
Balanitis:
amoebic ( A06.8+)
candidiasis ( B37.4+)
N51.8* Other disorders of the male genital organs in diseases classified elsewhere
Filarious chylocele of the vaginal membrane ( B74. -+)
Herpes infection of the male genital organs A60.0+)
Tuberculosis of the seminal vesicles ( A18.1+)

BREAST DISEASES (N60-N64)

Excludes: breast disease associated with childbearing ( O91-O92)

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

N61 Inflammatory diseases of the mammary gland

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

N62 Breast hypertrophy

Gynecomastia
Breast hypertrophy:
NOS
massive puberty

N63 Mass in mammary gland, unspecified

Nodule(s) in breast NOS

N64 Other disorders of breast

N64.0 Fissure and fistula of the nipple
N64.1 Fatty necrosis of the mammary gland. Fat necrosis (segmental) of the breast
N64.2 Atrophy of the mammary gland
N64.3 Galactorrhea not associated with childbearing
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-lactational)
N64.9 Breast disease, unspecified

INFLAMMATORY DISEASES OF THE FEMALE PELVIC ORGANS (N70-N77)

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

N70 Salpingitis and oophoritis

Included: abscess:
fallopian tube
ovary
tubo-ovarian
pyosalpinx
salpingoophoritis
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 uterus other than 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 cervix

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

N73 Other inflammatory diseases of female pelvic organs

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

N73.0 Acute parametritis and pelvic cellulitis
Abscess:
broad ligament ) specified as
parametria) acute
Pelvic phlegmon in women)
N73.1 Chronic parametritis and pelvic cellulitis
N73.0, specified as chronic
N73.2 Parametritis and pelvic phlegmon, unspecified
Any state in a 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
Excludes: pelvic peritoneal adhesions in women postoperative ( N99.4)
N73.8 Other specified inflammatory diseases of female pelvic organs
N73.9 Inflammatory diseases of female pelvic organs, unspecified
Infectious or inflammatory diseases of female pelvic organs NOS

N74* Inflammatory diseases of the female pelvic organs 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* Pelvic inflammatory disease in other diseases classified elsewhere

N75 Diseases of Bartholin's gland

N75.0 Bartholin gland cyst
N75.1 Bartholin gland abscess
N75.8 Other diseases of the Bartholin's gland. Bartholinitis
N75.9 Bartholin gland disease, unspecified

N76 Other inflammatory diseases of the 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. Vulvit NOS
N76.3 Subacute and chronic vulvitis
N76.4 Abscess of the vulva. Furuncle of the vulva
N76.5 Vaginal ulceration
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 THE FEMALE GENITAL ORGANS (N80-N98)

N80 Endometriosis

N80.0 Endometriosis of the uterus. Adenomyosis
N80.1 ovarian endometriosis
N80.2 Fallopian tube endometriosis
N80.3 Endometriosis of the pelvic peritoneum
N80.4 Endometriosis of the rectovaginal septum and vagina
N80.5 intestinal endometriosis
N80.6 Skin scar endometriosis
N80.8 Other endometriosis
N80.9 Endometriosis, unspecified

N81 Female genital prolapse

Excludes: genital prolapse 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

Excludes: urethrocele with:
cystocele ( N81.1)
uterine prolapse ( N81.2-N81.4)
N81.1 Cystocele. Cystocele with urethrocele. Prolapse of wall (anterior) of vagina NOS
Excludes: cystotele with uterine prolapse ( N81.2-N81.4)
N81.2 Incomplete prolapse of the uterus and vagina. Cervical prolapse NOS
Vaginal prolapse:
first degree
second degree
N81.3 Complete prolapse of the uterus and vagina. Prosidence (uterus) NOS. Third degree uterine prolapse
N81.4 Prolapse of uterus and vagina, unspecified. Uterine prolapse NOS
N81.5 Vaginal enterocele
Excludes: enterocele with uterine prolapse ( N81.2-N81.4)
N81.6 Rectocele. Prolapse of the posterior wall of the vagina
Excludes: rectal prolapse ( K62.3)
rectocele with uterine prolapse N81.2-N81.4)
N81.8 Other forms of female genital prolapse. Insufficiency of the pelvic floor muscles
old ruptured pelvic floor muscles
N81.9 Prolapse of female genital organs, unspecified

N82 Fistulas involving female genital organs

Excludes: vesico-intestinal fistula ( N32.1)

N82.0 Vesico-vaginal fistula
N82.1 Other fistulas of the female urinary tract
Fistulas:
cervical-vesical
ureterovaginal
urethrovaginal
uteroureteral
utero-vesical
N82.2 Fistula vaginal-intestinal
N82.3 Fistula vaginal-colonic. Rectovaginal fistula
N82.4 Other enterogenital fistulas in women. Intestinal fistula
N82.5 Fistulas genital-skin in women

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

N83 Non-inflammatory 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 (of the ovary)
N83.1 Yellow 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, ovarian stalk, and fallopian tube
Twisting:
additional pipe
morgagni cysts
N83.6 Hematosalpinx
Excludes: hematosalpinx with:
hematocolpos ( N89.7)
hematometer ( N85.7)
N83.7 Hematoma of the broad ligament of the uterus
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 Non-inflammatory disease of ovary, fallopian tube and broad ligament of uterus, unspecified

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 Vulvar polyp. Polyp of the labia
N84.8 Polyp of other parts of the female genital organs
N84.9 Polyp of female genital organs, unspecified

N85 Other non-inflammatory diseases of uterus, excluding cervix

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

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

N85.0 Glandular hyperplasia of the endometrium
Hyperplasia of the endometrium:
NOS
cystic
glandular cystic
polypoid
N85.1 Adenomatous hyperplasia of the endometrium. Atypical endometrial hyperplasia (adenomatous)
N85.2 Uterine hypertrophy. Large or enlarged uterus
Excludes: postpartum uterine hypertrophy ( O90.8)
N85.3 Subinvolution of the uterus
Excludes: postpartum uterine subinvolution ( O90.8)
N85.4 Incorrect position of the uterus
anteversion)
Retroflection) of the uterus
retroversion)
Excludes: as a complication of pregnancy, childbirth or postpartum period ( O34.5, O65.5)
N85.5 Eversion of the uterus
O71.2)
postpartum uterine prolapse N71.2)
N85.6 Intrauterine synechia
N85.7 Hematometer. Hematosalpinx with hematometra
Excludes: hematometra with hematocolpos ( N89.7)
N85.8 Other specified inflammatory diseases of the uterus. Acquired uterine atrophy. Uterine fibrosis NOS
N85.9 Non-inflammatory disease of the uterus, unspecified. Uterine lesions NOS

N86 Erosion and ectropion of the cervix

Decubital (trophic) ulcer)
Eversion) of the cervix
Excludes: with cervicitis ( N72)

N87 Cervical dysplasia

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

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

N88 Other noninflammatory diseases of cervix

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

N88.0 Leukoplakia of the cervix
N88.1 Old ruptures of the cervix. Adhesions of the cervix
O71.3)
N88.2 Stricture and stenosis of the cervix
Excluded: as a complication of childbirth ( O65.5)
N88.3 Cervical insufficiency
Evaluation and care for (suspected) isthmic-cervical insufficiency outside of pregnancy
Excludes: complicating the condition of the fetus and newborn ( P01.0)
complicating pregnancy O34.3)
N88.4 Hypertrophic elongation of the cervix
N88.8 Other specified non-inflammatory diseases of the cervix
Excludes: current obstetric injury ( O71.3)
N88.9 Non-inflammatory disease of the cervix, unspecified

Excludes: carcinoma in situ of vagina ( D07.2), inflammation of the vagina ( N76. -), senile (atrophic) vaginitis ( N95.2)
whites with trichomoniasis ( A59.0)
N89.0 Mild dysplasia of the vagina. Intraepithelial neoplasia of the vagina I degree
N89.1 Moderate vaginal dysplasia. Vaginal intraepithelial neoplasia II degree
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 Leukoplakia of the vagina
N89.5 Stricture and atresia of the vagina
Vaginal:
adhesions
stenosis
Excludes: postoperative adhesions of the vagina ( N99.2)
N89.6 Thick hymen. Rigid hymen. Tight virgin ring
Excluded: hymen overgrown ( Q52.3)
N89.7 Hematocolpos. Hematocolpos with hematometra or with hematosalpinx
N89.8 Other non-inflammatory diseases of the vagina. Beli NOS. Old rupture of the vagina. Vaginal ulcer
Excludes: current obstetric injury ( O70. — , O71.4,O71.7-O71.8)
an old tear involving the pelvic floor muscles ( N81.8)
N89.9 Non-inflammatory disease of the vagina, unspecified

N90 Other non-inflammatory diseases of 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 dysplasia of the vulva. Vulvar intraepithelial neoplasia 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 vulvar intraepithelial neoplasia with or without mention
about pronounced dysplasia ( D07.1)
N90.3 Vulvar dysplasia, unspecified
N90.4 Leukoplakia of the vulva
dystrophy)
kraurosis) vulva
N90.5 Atrophy of the vulva. Stenosis of the vulva
N90.6 Hypertrophy of the vulva. Hypertrophy of the labia
N90.7 Vulvar cyst
N90.8 Other specified non-inflammatory diseases of the vulva and perineum. Spikes of the vulva. Clitoral hypertrophy
N90.9 Noninflammatory disease of vulva and perineum, unspecified

N91 Absence of menstruation, scanty and infrequent menstruation

Excludes: ovarian dysfunction ( E28. -)

N91.0 primary amenorrhea. Menstrual disorders during puberty
N91.1 Secondary amenorrhea. Missing periods in women who have had them before
N91.2 Amenorrhea, unspecified. Absence of menses NOS
N91.3 Primary oligomenorrhea. Scanty or infrequent periods from the beginning of their appearance
N91.4 Secondary oligomenorrhea. Scanty or infrequent periods in women with previously normal periods
N91.5 Oligomenorrhea, unspecified. Hypomenorrhea NOS

N92 Abundant, frequent and irregular menstruation

Excludes: bleeding after menopause ( N95.0)

N92.0 Abundant and frequent menstruation with a regular cycle
Periodically profuse menstruation NOS. Menorrhagia NOS. Polymenorrhea
N92.1 Abundant and frequent menstruation with an irregular cycle
Irregular bleeding in 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. Pubertal menorrhagia. Pubertal 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 menstruation, unspecified
Irregular:
bleeding NOS
menstrual cycles NOS
Excludes: irregular menstruation due to:
long intervals or scant bleeding ( N91.3-N91.5)
shortened intervals or heavy bleeding ( N92.1)

N93 Other abnormal bleeding from uterus and vagina

Excludes: neonatal bleeding from the vagina ( P54.6)
false menstruation ( P54.6)

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

N94 Pain and other conditions associated with the female genital organs and the 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 the female genital organs and the menstrual cycle
N94.9 Conditions related to the female genital organs and the menstrual cycle, unspecified

N95 Menopausal and other perimenopausal disorders

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

N95.0 Postmenopausal bleeding
N95.3)
N95.1 Menopause and menopause in women
Symptoms associated with menopause such as hot flashes, insomnia, headaches, impaired attention
Excludes: associated with artificial menopause ( N95.3)
N95.2 Postmenopausal atrophic vaginitis. Senile (atrophic) vaginitis
Excluded: associated with induced menopause ( N95.3)
N95.3 Conditions associated with artificially induced menopause. Syndrome after artificial menopause
N95.8 Other specified menopausal and perimenopausal disorders
N95.9 Menopausal and perimenopausal disorders, unspecified

N96 Recurrent miscarriage

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

N97 Female infertility

Includes: inability to conceive
female sterility NOS
Excludes: relative infertility ( N96)

N97.0 Female infertility associated with the absence 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 anomaly of the uterus
Oocyte 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 an attempt to implant a fertilized egg after in vitro
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 URINARY 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 pathological fracture M80.1)
conditions associated with artificially induced menopause ( N95.3)

N99.0 Postoperative renal failure
N99.1 Postoperative stricture of the urethra. Urethral stricture after catheterization
N99.2 Postoperative adhesions of the vagina
N99.3 Vaginal prolapse after hysterectomy
N99.4 Postoperative adhesions in the pelvis
N99.5 Dysfunction of the external stoma of the urinary tract
N99.8 Other disorders of the genitourinary system after medical procedures. Residual ovary syndrome
N99.9 Disturbance of the genitourinary system after medical procedures, unspecified

The head of the penis 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 with the foreskin which are called synechia. In adult men, this is considered a serious illness. Let's consider what they are synechia in boys what to do with them, how to treat them.

What it is

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

Synechia of the foreskin, ICD code 10– N48: Other disorders of the penis. This condition of the penis occurs in almost all children. This innate feature is designed to prevent pathogens from entering under the foreskin, as well as to prevent injury to the head.

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

If the foreskin is attached to the head in an adult male, surgery is necessary, since this condition can lead to unpleasant consequences from the genitourinary system.

Important to remember! In no case should you breed synechia in boys and adult men! This can lead to serious injury, resulting in problems with the process of excretion of urine, and in adulthood - erectile dysfunction.

Causes of synechia

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

1. The development of viruses and infections. The entry of pathogenic microorganisms into the organs of the genitourinary system is the most common reason that a boy the foreskin has grown to the head penis. Inflammatory processes that are observed due to the active activity of pathogens cause the formation of adhesions. Therefore, when the slightest signs of inflammation appear on the genitals, you should immediately consult a doctor. It is possible to prevent infection from entering the organs of the genitourinary system by observing the personal hygiene of the baby.
2. Allergy related diseases. 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 detect or prevent inflammatory processes of an allergic nature in the genital area in a timely manner.
3. Complications during pregnancy. Every mother who bears 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 synechia in the baby, which will have to be eliminated exclusively by the surgical method. Almost every pregnant woman carefully monitors her health, so adhesions for this reason appear in a child in extremely rare cases.
4. Injury to the penis. Every boy is born with a closed glans penis. Active attempts to retract the foreskin on your own can damage the penis. This is in most cases the reason why foreskin attached to baby's head.
5. Getting burned. Such damage can be caused by irradiation, radiation, contact with caustic chemicals on the genitals, thermal exposure. As a result, scars are formed, which lead to the appearance of large adhesions. It is impossible to 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 stagnation 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 synechia that is not associated with inflammatory processes, then they separate over time. Incomplete fusion of the head and foreskin with adhesions does not cause discomfort or problems with urination.

If the boy has the foreskin is fused with the head as a result of inflammation, it 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 at the top of the penis;
• pain, burning and other uncomfortable sensations at the time of urination;
• sharp pain in the penis even at rest;
• excessive discharge with particles of pus;
• problems with the excretion of urine, the liquid comes out in small quantities, drop by drop.

Synechia in men characterized by pain during erection, as well as at the time of sexual contact. Young people in most cases refuse sexual activity until full recovery.

Diagnosis of the disease

discover synechia of the penis simple enough. The specialist only needs to conduct a visual examination of the penis. The doctor should be contacted when synechia of the foreskin in boys did not separate until the age of three.

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

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 be taken at elevated body temperature to exclude the development of infectious diseases.
3. Ultrasound diagnostics of the genitourinary system. The penis, scrotum, bladder, kidneys are examined. Ultrasound examination is performed in cases where there is a suspicion of the rapid spread of inflammatory processes.

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

Treatment of synechia in boys

If observed synechia in boys, what to do In this case, let's take a closer look. 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 carry out up to 6-7 years. For this, it is necessary to carry out such manipulations:

• put the child in a bath with warm water;
• 30-40 minutes after steaming should be carried out separation of synechiae in a boy without stopping contact with water;
• slowly and carefully pull back the foreskin, trying to expose the head of the 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.

Medical therapy

If a synechia of the foreskin in boys cause inflammatory processes home treatment required through the use of medications. For this, creams and ointments of the glucocorticosteroid group are used. Hormonal drugs help to eliminate such unpleasant symptoms as swelling, redness, cracks on 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 local drugs in this group are Hydrocortisone ointment and Contractubex.

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 the specialist.

Surgical intervention

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

• sudden causeless erections, characteristic of boys during puberty;
• inflammation of the prepuce;
• secretion of sebaceous enzymes.

But without surgery and other treatments, only minor adhesions can be eliminated. Synechia of a large size require more radical actions aimed at their elimination.

Large synechia that cause regular inflammatory processes must be removed with the help of surgery. It is usually performed under local anesthesia and does not require special preparation.

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 being made. This type of surgical intervention allows you to get rid of not only synechia, but also physiological or pathological phimosis.

In the postoperative period, it is necessary to carefully monitor the hygiene of the penis. It is necessary to wash 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 for 1 week after surgery.

If the rehabilitation period of the boy is delayed, then for a complete 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 blockage of the urethra. As a result of this, the boy experiences severe pain, burning sensation and pain in the process of excreting urine. He also has a constant feeling of not emptying the 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 synechia do not allow sufficient hygiene of the penis. The danger of balanoposthitis lies in the fact that after a certain period of time it is converted 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. Erections and sex cause pain.

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 pinching of the head, smegma accumulates, which has carcinogenic properties. It is extremely difficult to get rid of such a pathology. 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 penis in boys. It consists of the following activities:

1. Daily washing of the head of the penis under running water. For this procedure, it is better to use warm boiled water. It is also useful to wash the genitals in a decoction of medicinal herbs. To do this, brew 1 tsp in 1 cup of boiling water. dried chamomile, calendula, mint or St. John's wort.
2. Do not try to retract the foreskin yourself if this causes difficulty. This can lead to injury to the penis, the formation of cracks, which are accompanied by discomfort.
3. Change diapers promptly. Prolonged stay of the 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 in the hot season, it is better to refuse them for this period. Since the baby sweats, resulting in a favorable environment for the active development of pathogenic microorganisms.
4. Choose the right underwear. Children's underpants should be made only from natural materials. Synthetics can cause allergic reactions. Also, do not forget about choosing the right size panties for your baby. They should not rub or squeeze the genitals.

Compliance with these rules will help parents avoid complications that cause synechia. Even if the boy has adhesions under the foreskin, proper care of the penis will help prevent their transformation 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. Appeal to a specialist requires their presence after the age of three. But this is also no reason to panic. Up to 7 years, you can do without surgery. If adhesions cause swelling, redness or inflammation, it is better to consult a surgeon. At an early age, the healing process of postoperative wounds will not take much time. But the operation in this case will save the boy from the dangerous consequences of pathological synechia 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 synechia on the skin of the penis, inflammation will not slow down to appear, because the soil for the reproduction of bacteria is the most suitable. There is a way out - there are modern methods of treating synechia that can be used at any age.

What is synechia?

Adhesions, or synechia - a condition when the male penis reveals areas of fusion of the foreskin and head. Spikes, with their strong severity, do not allow the head to be exposed and continue from the urethral opening to the coronal groove.

Adhesions are not always considered a pathology. In boys, they are normal at birth to protect the head from infection and damage. Later, by the age of 3, synechiae gradually begin to dissolve, and the head gradually moves forward 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 of ICD-10, synechia have code No. 47 (excessive foreskin, phimosis and paraphimosis).

In the photo, the development of the foreskin in boys

Causes of the problem

The causes of physiological synechia 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 a partial exposure of the head by the age of 3, and a complete exposure by the age of 7, while in others the problem persists even by adolescence?

The reasons may be the following:

1. Injuries, carrying out 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 places of growth of the foreskin. Also, scars can form during circumcision, dissection of the foreskin, and most often they persist until adulthood.
2. Transferred infections. If a child or an adult has had tuberculosis, syphilis, a number of other pathologies, the process may end in the appearance of adhesions.
3. Burns after irradiation, radiation, chemicals, thermal burns. In this case, the synechiae are large and difficult to treat.

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

Clinical picture

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

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

Synechia in adult men looks similar, and traumatic adhesions can be thick, irregularly shaped, resembling scars.

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

• swelling of the upper part of the penis;
• Redness of the head;
• Cutting, burning during urination;
• Soreness even at rest, sometimes sharp;
• Discharge with pus;
• Urine drop by drop.

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

Diagnostic Measures

If by the age of 3 the boy has not begun the process of separation of adhesions, you should go to a pediatric urologist. In this case, treatment is not carried out, but the doctor will assess the severity of the situation and give a forecast for an independent resolution of the problem.

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

• General urinalysis to exclude urethritis;
• Complete blood count at elevated temperature to rule out systemic infection;
• Ultrasound of the penis, scrotum, bladder, kidneys with suspicion of further spread of inflammation.

How to treat?

By 6-7 years, in the absence of improvement, the urologist will recommend the separation of synechia at home. The method is the following:

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 back the skin of the foreskin, making attempts to expose the head).
3. Procedures to be performed 1-3 times a week.
4. The process of separation of adhesions can take 3-5 months.

In most cases, you can get rid of trouble in this way. In the absence of results, the urologist will perform the procedure in the medical room. A special cream is applied to the skin, an hour later (after the adhesion has softened), synechia is rapidly diluted.

An indication for the surgical separation of synechia is age over 12 years (in adults, the problem is treated only with the help of surgery), the presence of cicatricial phimosis, and the presence of frequent inflammatory reactions. Synechia is usually operated under local anesthesia, occasionally under general anesthesia.

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

If a man or boy has an active inflammatory process, disconnection 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 (with severe inflammation). In severe 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 swelling, pain, the transition of pathology into a chronic relapsing form.

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

Prevention

Measures to prevent synechia are regular hygiene of the genital organs in children, prevention of injuries to the foreskin, 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 boy of 10 years old, asked by the author Anna Soldatova the best answer is You can contact any pediatric clinic. Where do you live? In Moscow, I will tell you more precisely.

2 answers

Hello! Here is a selection of topics with answers to your question: synechia of the foreskin in a 10-year-old boy

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 an injury. and you understand. what will happen if nothing is done? ! And self-opening leads to scars, adhesions, and this aggravates the situation. All boys from one year old should be observed by a specialist every year.

Answer from latka
I generally 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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