As the holidays approach, the more children in our pediatric urology clinic consult whether their foreskin needs to be removed, the more children up, so what kind of foreskin needs to be surgically removed? What are the issues that need to be taken into account for circumcision surgery?
What is circumcision?
Excessive foreskin means that although the foreskin can be turned over to reveal the head of the penis, the foreskin is too long and the front of the foreskin is “bird’s beak” or “teapot mouth-like”.
What is circumcision?
Circumcision is defined as a small opening in the foreskin that prevents the foreskin from being flipped over to reveal the head of the penis. However, this definition is often only suitable for children and adults after puberty. For children, the glans cannot be exposed because of the adhesion between the foreskin and the glans, so it cannot be diagnosed as prepuce yet. Therefore, the diagnosis of prepuce in children should not only have the characteristic of the head of the penis not being exposed, but also the key is the presence of a clear narrowing ring of the foreskin when the foreskin is turned over. Patients who cannot be diagnosed as circumcised because of foreskin adhesions only need a simple separation of the foreskin adhesions in the outpatient clinic and do not need to undergo surgery.
What is meant by acquired prepuce?
Because it is not easy to clean the prepuce and foreskin, secretions accumulate under the skin, which can form foreskin scale and often stimulate the mucous membrane, which can cause foreskin inflammation of the penis head. Repeated inflammation makes the foreskin mouth have scar contracture formation, forming a fiber narrowing ring – “scar prepuce”, which is also known as acquired prepuce. This condition affects urination and penile development and must be operated on as soon as possible.
What is occult penis?
It is often diagnosed by non-specialist doctors as circumcision because of the concealed penis and the accompanying prepuce, which can cause serious consequences, so here is a special emphasis. The following characteristics of the occult penis: 1. The penis body is hidden under the skin, so the appearance of the penis is short. 2.
The foreskin looks like a bird’s beak wrapped around the penis and is not attached to the penis body. Holding the penis with your hand while pushing back the surrounding skin can reveal a normal penis body.
3, urination or penis erection when the penis body can be stretched out, then the length is about the same as normal.
4, many obese children because of the lower abdomen, especially in front of the pubic bone fat accumulation, the penis can be hidden shape.
Because the mechanism of occult penis pathogenesis is the abnormal attachment of the penis body, which is obviously different from the general circumcision, and can obviously affect the development of the penis body and the child’s psychosexual development, so the penile plastic surgery is performed, and because of the special nature of this surgery, it must be performed by a pediatric urologist.
What are the dangers of circumcision and phimosis?
Because of the circumcision and prepuce cleaning is not easy, secretions accumulate under the skin, can form a foreskin scale, if not timely cleaning, in early childhood can cause the head of the penis foreskin inflammation. Repeated inflammation can lead to scarring circumcision. Circumcision and prepuce often develop into adult circumcision or even circumcision after adulthood. Adult circumcision can easily cause penile cancer and lead to consequences such as vaginitis, cervical erosion and cervical cancer in women.
What is the most appropriate age for circumcision?
Regarding the choice of age of surgery, about 25% of men worldwide are circumcised due to religious, cultural, medical and parental decisions, and circumcision is more commonly performed in newborns abroad. In China, due to the relative lag in health education and traditional beliefs, circumcision is mostly chosen in the preschool years.
Diagnosis takes into account the characteristics of infants and children – physiological prepuce and glans cannot be exposed, so we generally diagnose whether it is prepuce or circumcision at around 3 years old to avoid over-diagnosis and unnecessary surgery. Therefore, 3-6 years old is the best age to decide if circumcision is necessary. Because the foreskin has a clear genetic tendency so for the critical state of prepuce or circumcision, the decision can be made by referring to the child’s father’s circumcision.
What exactly are the indications for circumcision?
1. Circumcision.
2. Overcircumcision.
3. There is an obvious circumcision after penile head infection.
4. Scar circumcision (acquired circumcision).
5. There are recurrent urinary tract infections, frequent urination, enuresis boys, circumcision can significantly reduce or eliminate the incidence of the above diseases.
What kind of care is needed for foreskin that does not require surgery?
For “circumcision” without a constricting ring, repeated gentle hand strokes to expand the foreskin opening and cleaning of the penis head and foreskin are sufficient. For children with a slightly longer foreskin, the foreskin must be turned over and cleaned every day, just as a child’s little buttocks must be cleaned every day. Another thing to remind parents is to avoid frequent cleaning with disinfectant when there is no inflammation.
There are many methods of circumcision, so what is the most ideal method at the moment?
There are conventional circumcision, laser surgery, etc. Our pediatric surgery department uses circumcision. The foreskin anastomosis used is made of nano-materials, and the entire operation takes only 5-10 minutes. No sutures are needed during the operation, and the ring falls off on its own, with a beautiful appearance close to natural development.