Synechia of the small lips in girls microbial 10. Code microbial synechia of the foreskin
Synechia - fusion of the tissues of the genital organs. In little girls, this is most often partial and complete "gluing" of the labia. In women of reproductive and menopausal age, synechia is localized in the uterine cavity and vagina. Pathology is congenital as well as acquired. Treatment of synechia in girls and adult women can be conservative or operative. Tactics are determined individually.
Synechia in the uterine cavity are connective tissue strands, they can be compared with adhesions. Synechiae look like whitish thin "threads" or dense fibrous areas. They may be asymptomatic or present with severe symptoms. The consequences for both girls and adult women are associated with menstrual dysfunction, pain, unpleasant discharge and even infertility. According to ICD-10, the condition refers to non-inflammatory diseases and is coded as N90.
Why do
Given that synechia in girls and women manifests itself differently, the factors that provoke their appearance should be considered by age group.
Girls
In the prepubertal period female body produces a small amount of estrogen. Namely, they are responsible for the development of a special secret that acts as a lubricant in the vagina and vulva. Its lack leads to adhesion of the small and large labia to each other, after which they are “soldered” in this position. In addition, synechia is a consequence of vulvitis and vulvaginitis of various nature. However, such adhesions are not formed in all girls. Rarely, synechia can be a congenital pathology. There are factors that contribute to their occurrence.
- Disorders in the digestive tract. Dysbacteriosis, helminthic invasion and other gastroenterological problems, due to which the supply is disrupted nutrients mucosa and its additional drying occurs.
- Infections. Tonsillitis, rhinitis, sinusitis (including chronic ones) are the source of infection in the body. Influenza, adenovirus diseases lead to a decrease in immunity and increase the likelihood of dysbacteriosis, vulvitis.
- Hygiene. Frequent, intense washing "to the squeak" using soap often leads to minor injuries to the thin, sensitive mucous membrane of the labia. The healing of these wounds and provokes splicing.
- Linen. Synthetic, tight underwear irritates the skin and mucous membranes, contributes to excess moisture in the crotch area. This provokes the appearance of vulvitis.
- Allergy. The reaction to various internal and external stimuli can affect the labia: their inflammation occurs and the subsequent formation of synechia.
Vulvitis in a girl may be the result of infection from her mother when using the same towels and personal hygiene products. Therefore, in the presence of synechia in a child, it is necessary to examine a woman for sexual infections.
In the reproductive period
Synechia in the uterine cavity is called Asherman's syndrome, after the doctor who first described the disease in detail. Similar adhesions can form in the vagina and cervical canal. The causes of synechia in women of childbearing age are the following factors.
- Mechanical damage. During abortions, gynecological manipulations, after childbirth, with prolonged use of the intrauterine device, after the introduction of drugs into the uterine cavity.
- Inflammation. Colpitis, endometritis.
Curettage of the uterine cavity after a frozen pregnancy often leads to the formation of adhesions. Necrotized areas of the chorion activate fibroblasts (tissue cells connecting type), which stimulates the production of collagen and the formation of synechiae.
In menopause
IN menopause in conditions of estrogen deficiency, atrophic processes occur in the genital organs. Synechia often form in the vagina and cervical canal against the background of chronic colpitis. Moreover, women may not have complaints if they do not have an active sex life.
Classification
Separation of synechia of the genital organs is carried out according to different criteria. The most common classifications are presented in the table.
Table - Classification of synechia
Criteria | Division | Characteristics |
---|---|---|
Synechia according to the type of tissue fusion | Baby | - Occur in girls before puberty; - affect the labia |
adults | Produced in the uterine cavity | |
Synechia according to the severity of fusion of the labia minora | Partial | Up to 2/3 |
Complete | Over 2/3 | |
Uterine synechia according to histological structure | Lungs | "Film", which is easily excised |
Medium | - Fibromuscular synechia; - dense, bleed when cut |
|
Expressed | - Synechia from connective tissue; - very dense; - extremely difficult to excise and do not bleed |
|
Uterine synechia by prevalence | I degree | - Small adhesions; - affect up to 25% of uterine tissues; - not in the fallopian tubes and the bottom of the organ |
II degree | - Synechia covers from 25% to 75% of the tissues of the uterus; - pipe mouths and bottom are covered |
|
III degree | - Synechia affects more than 75% of the tissues of the uterus; - there is a "sticking" of the walls |
Symptoms
In girls, the pathology can be asymptomatic in the initial stage or with a small area of union. Often, synechia is a mother's "find" when washing a girl or when treating the perineal area. In this case, the labia minora are interconnected, completely or partially blocking the entrance to the vagina.
Synechia can form between the labia majora and labia minora. When trying to separate them, the child cries or does not allow himself to be touched at all. If the fusion has covered a significant part of the tissues, this may manifest itself with the following symptoms:
- difficulty urinating- girls refuse to go to the potty, the stream of urine can be directed upwards, as in boys, and not downwards;
- pain - the child becomes capricious, cries for unknown reasons;
- discoloration - redness, itching and peeling of the skin may appear.
In the case of an infectious-inflammatory process, purulent discharge, bright hyperemia of the vulva, and a rash can be observed.
Intrauterine synechia in women is manifested by the following symptoms:
- pain in the lower abdomen;
- scanty menstrual bleeding or amenorrhea;
- pain during menstruation.
With menopausal synechia, there is discomfort in the vagina, pain, burning, itching, soreness, especially during sexual contact.
Intrauterine synechia is an insidious violation, because it poses a threat reproductive function. But with timely and correct therapy- There is a good prognosis for recovery.
Consequences
The consequences of synechia differ in women of different ages.
Girls
In the prepubertal period, synechia does not pose a particular threat to the girl's health. They occur frequently and in most cases pass without a trace. But synechia can cause discomfort, pain and, if not corrected, provoke an infectious and inflammatory process that already requires serious treatment.
In the reproductive period
Synechia in the uterine cavity is dangerous with the following consequences.
- Hematometer. The accumulation of blood between adhesions, the difficulty of withdrawing it during menstruation can lead to infectious and inflammatory processes with spread to nearby tissues, which is dangerous not only for health, but also for the life of a woman.
- Infertility. Even isolated synechias in the region cervical canal or the mouth of the fallopian tubes can become an obstacle to spermatozoa, and fibromuscular or connective tissue act "like a spiral."
- Miscarriage. In the event of pregnancy, the risks of ectopic, non-developing pregnancy and miscarriages remain.
In menopause
Synechia in the postmenopausal period is dangerous for the development of an infectious and inflammatory process in the vagina, which can spread to the cervix and cause its dysplasia.
Women with synechia in the uterine cavity or vagina suffer from menstrual cramps and pain during intercourse. Reviews confirm this.
What examination should be done
Fusion of the labia in girls can be detected at a gynecological examination. Next, the pediatric gynecologist takes the secretions of the vestibule of the vagina for microscopic examination and bakposev. According to the results, additional treatment is prescribed.
For the diagnosis of intrauterine synechia, the following methods are used.
- Hysteroscopy. Synechia during the operation are visible as thin whitish connections of different lengths and densities. They reduce the space of the uterus, they most often do not have blood vessels.
- Metrosalpingoscopy. Allows you to set the degree of adhesive process inside the uterine cavity. And also the singleness and multiplicity of pathological fillings of the contrast between synechiae, which have different sizes and most often have a lacunar shape.
Ultrasonography in the diagnosis of synechia in most cases is not informative. Adhesions are not visible, the uterine cavity has a normal structure and shape. In some cases, during ultrasound, synechia may resemble polyps.
Treatment of synechia in girls ...
It is necessary to treat synechia depending on which parts of the genital organs and to what extent the process affected. Preference should be given traditional medicine and not folk remedies.
Asymptomatic synechia on initial stages up to 0.5 cm in length in girls often pass by themselves. However, the condition should be monitored together with a specialist in order not to miss complications and the inflammatory process.
Synechia of the labia of a larger size are treated with special ointments, due to the impact of which the tissues gradually diverge. In difficult cases, surgical separation of synechiae is used. It is painless and less traumatic, but does not protect against their re-formation. Surgical dissection of synechia is resorted to in extreme cases. For conservative treatment, the following ointments and creams are used:
- treatment - "Kontraktubeks", "Ovestin";
- prevention - baby cream or oil (after the main course of treatment).
Lubricate areas of large and small labia should be daily after washing. Gradually, the adhesions will separate. It is useful to supplement the treatment with sitz baths with chamomile, calendula. It is important to determine the root cause and eliminate it to prevent relapse.
… and adult patients
Synechia in the uterus is eliminated through surgical manipulation - hysteroscopic dissection. Depending on the length and density of synechia, such operations are carried out:
- endoscopic scissors;
- tongs;
- hysteroscope body;
- laser;
- hysteroresectoscope.
To control the procedure and prevent uterine perforation, a control ultrasound or laparoscopy is performed.
Spikes on 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.
According to the international classification of ICD-10, synechia 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 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:
- 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.
- 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.
- 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, 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;
- General blood test for elevated temperature to exclude systemic infection;
- Ultrasound of the penis, scrotum, Bladder, kidneys if further spread of inflammation is suspected.
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:
- Pour warm water into the bath, seat the child in the water.
- 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).
- Procedures to be performed 1-3 times a week.
- 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 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 active breeding it has infections. 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.
Synechia or adhesion of the labia minora occurs in early infancy or somewhat later, before the age of six years. Often the disease is asymptomatic and is discovered by parents during child care or by a doctor during a medical examination. Determining what synechiae look like is, in most cases, easy. This can be done by carefully examining the genitals.
The disease is prone to constant recurrence. Approximately one third of the patients note the appearance of new adhesions.
How to conduct an inspection
Before the examination, you need to thoroughly wash your hands with soap and cut your nails so as not to injure the delicate skin. Spreading the legs of the child, carefully examine the genitals. At the same time, attention is paid to the presence of a genital gap through which the vagina is visible.
If instead of a gap only a whitish strip is visible, and an attempt to push the labia minora does not bring success, there is a high probability of having synechia. In rare cases, fusion occurs and the labia majora.
Signs of pathology
Synechia of small lips may not cause discomfort to the girl. In some cases, there are problems with urination, if you want to urinate, the child begins to grunt, push hard and cry. After urination, there is a quick relief.
You can also highlight the following symptoms:
- redness of the skin in the genital area, the appearance of a rash;
- irritation of mucous membranes;
- crying indicating pain when touched while washing or bathing;
- the direction of the urine stream upwards, which is typical for boys.
Girls 1 year and older experience urine leakage even if the child is already using the potty.
How dangerous is the disease
The fusion of the labia cannot be regarded as a natural process that should not be paid attention to, but its occurrence rarely brings serious consequences for the female body.
However, the condition can contribute to the development of various infectious processes. With the progression of the disease in the future, associated with the growth of the genital organs and the incorrect formation of the perineum, the girl may have problems with conception and delivery.
The initial stage of the formation of synechia makes itself felt by swelling of the vulva, its redness, irritation, pain during urination. If you suspect a pathology, you need to take the child to the doctor.
Synechia - insidious disease prone to relapse. It is impossible to rely on their independent resolution in girls under one year old. The problem can be eliminated by puberty. With this pathology, the child should be under the supervision of a pediatric gynecologist, who determines the necessary treatment and gives recommendations for caring for the genitals.
Reasons for fusion
The reasons for the formation of synechia may be different. If they are still noticeable in a newborn, then they were most likely caused by a complicated pregnancy and intrauterine infection of the fetus.
IN preschool age Spikes in girls can appear for the following reasons:
- transferred infectious diseases of the urogenital area (cystitis,), when bacteria penetrate into the focus of inflammation, which provokes the fusion of the small lips;
- household transmission of viruses (through towels and other care items);
- improper hygiene of the genitals, the use of aggressive cosmetics that eliminate the necessary bacterial environment;
- a tendency to allergies, as a result of skin contact with the remnants of washing powder on linen, hygienic wet wipes, diapers, leading to swelling of the vulva and the further appearance of synechia;
- hormonal imbalance caused by;
- wearing underwear made of low-quality synthetic materials;
- helminthic invasions, intestinal dysbacteriosis, taking certain medications.
Treatment
Synechias are incomplete and complete. If the fusion has occurred in a small area of the labia minora, the problem can be solved by observing the rules of hygiene and care. A great danger is the complete fusion of the labia minora, which can be cured only with a timely visit to the doctor.
Before determining treatment, the patient is prescribed general analyzes blood and urine, take a smear for bacterial culture from the vagina or tests for latent infections.
If synechia is caused by an allergy, consultation of an allergist is required.
Local therapy
In the treatment, ointments and creams containing.
- Ovestin
A hormonal agent used in various diseases associated with a lack of estrogen. The main active ingredient is estriol.
Treatment with Ovestin is carried out for 20 days, then a short break of 10 days is taken. After a break, the course is repeated. Ovestin is recommended for use no more than 1 time per day. It is better to treat synechia before the child goes to bed. If the baby sleeps in a diaper, it should not be worn until the cream is completely absorbed.
In some cases, negative reactions are possible: itching in the vagina, mucus secretion, skin rashes. With caution, the cream is prescribed to patients with bronchial asthma, epilepsy, liver disease.
The ointment is applied in a thin layer. Processing is carried out with careful rubbing movements. You can not put pressure on the genitals or try to separate the synechia on your own. It is strictly forbidden to use for this purpose various improvised means that can serve as a source of infection.
- Contractubex
The cream is often prescribed for synechia in girls. Optimal combination active substances(onion extract, sodium heparin, allantoin) has a bactericidal effect, anti-inflammatory effect, heals wound surfaces.
The product is applied to the spliced area twice a day with a thin layer. A greater effect can be achieved by combining this drug with Traumeel S or Bepanthen. The course of treatment is 20 days, then after a pause it is repeated. Since synechia is a recurrent phenomenon, Contractubex can also be used for prophylactic purposes.
The drug has practically no contraindications. The only obstacle to its use is increased intolerance or sensitivity to individual components.
- Bepanthen
Ointment or cream Bepanten is effective if the disease is complicated by inflammation. Bepanten eliminates sores, cracks, erosion of delicate skin. Its use prevents the development of infection.
Bepanthen belongs to safe drugs, it is suitable for both newborn girls and older children. Processing is carried out after washing and thoroughly drying the genitals.
Baths with the addition of chamomile, calendula, oak bark will help prevent relapse. In the treatment of synechia in girls at home, oils are used plant origin(sea buckthorn, peach, almond, grape seeds).
Surgery
How to treat a complete fusion if conservative treatment did not give the expected results? In this case, a dissection is performed. The operation is performed under local anesthesia. The procedure is not dangerous, does not cause discomfort and bleeding in the girl.
The duration of the operation is only a few minutes. After the procedure, the wound is processed antiseptic solution and in 15-20 minutes the girl can go home with her mother.
After surgical separation of synechiae, regular treatment of the genital organs is necessary for some time. To do this, use both creams and ointments, and vegetable oils. Ordinary baby cream will do. Soothing baths based on decoctions of chamomile, calendula, sage, string are prescribed.
It will be necessary to treat small lips with a cream for at least a month. In the future, this procedure is carried out 1 time per week for the purpose of prevention.
Massage
This procedure belongs to the auxiliary methods of treatment of synechia. Massage is done after applying the ointment. After waiting a minute or two until the cream-gel begins to be absorbed, they begin to massage the glued labia. The movements should be smooth, cautious, but slightly pressing.
With incomplete fusion, you can try to gently separate the lips, but you can not overdo it. It is undesirable to make sudden movements, especially when trying to separate glued lips, as movements can cause injury or psychological discomfort to the child.
The following home remedy has worked well. A cotton pad soaked in potato juice is wiped over the site of the lesion, trying to slightly stretch the labia in different directions. The procedure must be regular. Thus, with incomplete fusion, with the help of a kind of massage, surgical separation can be avoided.
Prevention of synechia in girls
Unfortunately, the phenomenon of synechiae is prone to multiple "returns" even after surgical separation. The problem is solved only with the onset of puberty. Preventive measures, compliance with the rules of hygiene and daily routine will help to significantly reduce the risk of relapse. So, prevention includes the following rules:
- You need to wash the child with ordinary tap water without the use of soap and other cosmetics that dry out the vaginal mucosa and wash out the beneficial microflora.
- Do not get carried away with bubble baths, if you can not completely refuse them, add it just before the end of the bath.
- The choice of underwear should be made in favor of natural cotton models. Only in such panties the skin will breathe freely. You also need to make sure that the underwear does not squeeze or rub the skin, as this can provoke an inflammatory process.
- Timely detect and treat infectious and viral diseases. In most cases, synechia occurs as a result of incorrectly and incompletely treated diseases.
- Regular visits to the pediatric gynecologist. Such a recommendation often causes bewilderment in a mother who believes that a little girl has nothing to do in a female doctor's office. However, doctors advise visiting a gynecologist already at preschool age.
- Timely replacement of diapers, in some cases, their use will have to be abandoned, it is better to wash children's things for preschoolers separately from the clothes of adult family members.
- Choose on sale detergents and cosmetics, toilet paper and other care products without artificial colors and fragrances.
- Prophylactic use of estrogen ointments by those girls who have previously been diagnosed with genital fusion. The dosage and duration of treatment is determined by the doctor!
- Pregnant women in the third trimester actively deal with manifestations (protein in the urine, edema, increased arterial pressure), since these symptoms lead to complications during childbirth and the appearance of pathologies in the newborn.
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* Stones urinary tract 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 characters classifying morphological changes may be used. Subcategories.0-.8 should not be used unless specific investigations have been performed to identify the lesions (eg, biopsy or autopsy of the kidneys). 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 others medicines, 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 classified elsewhere
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 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 kidney 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)
STONE STONES (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: from 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
Excluded: 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 corresponding external factor(class XX) use 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 postpartum period (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
Excluded: benign tumors, except 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 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
parametrium) 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
vagina-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 III degree 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 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:
prolonged intervals or scanty 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
Excluded: 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 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 rendering medical care outside 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. Related to congenital anomaly 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
- 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 disease. 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 has grown 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:
- 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.
- 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 early inflammatory processes allergic nature in the genital area.
- 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.
- 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.
- 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 of 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 head of the penis, top part the organ looks larger than the lower one;
- 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:
- General urine analysis. It is necessary to exclude the development of a disease such as urethritis. Because the symptoms are similar.
- General blood analysis. It is required to be taken at elevated body temperature to exclude the development of infectious diseases.
- 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 spikes are too big size the patient is sent for surgery.
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 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. 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 surgical intervention. 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 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. medicinal herbs such as calendula, chamomile, mint. It is necessary to carry out such procedures for 1 week after surgery.
If rehabilitation period the boy is tightened, then for full recovery he is assigned 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:
- 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 has a constant feeling of not emptying the bladder.
- 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.
- 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:
- 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.
- 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.
- 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.
- 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 the dangerous consequences of pathological synechia in the future.
International Classification of Diseases
International statistical classification diseases (abbreviated ICD) - 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. The ICD is a normative document that ensures 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 abnormalities(Q00-Q99)
illnesses endocrine system, eating disorders and metabolic disorders (E00-E90)
injury, poisoning and certain other consequences of exposure to 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)
Use an additional code if necessary to identify an external cause (Class XX) or in the presence of renal failure (N17-N19).
Excludes: hypertension with primary renal involvement (I12.-)
With rubrics N00-N07, the following fourth digits classifying morphological changes may be used. Subcategories.0-.8 should not be used unless specific investigations have been performed to identify lesions (e.g. kidney biopsy or autopsy). Three-character 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 disorders 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 renal 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)
STONE STONES (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
Use an additional code if necessary to identify the infectious agent (B95-B97) or the relevant extrinsic agent (Class XX).
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 spinal cord injury (G95.8)
neurogenic bladder associated with cauda equina syndrome (G83.4)
N31.0 Uninhibited bladder, not elsewhere classified
N31.1 Reflex bladder, not elsewhere classified
N31.2 Neurogenic 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 > of the 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 of the 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 Vulvar polyp. 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 during 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 of female genital organs and menstruation
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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