Circumcision refers to the narrow opening of the foreskin. The foreskin cannot be turned up to reveal the head of the penis. Congenital prepuce can be seen in every normal baby boy. When a child is born, the foreskin and the head of the penis adhere to each other and after a few months, the adhesions are gradually absorbed and the foreskin is separated from the head of the penis. As the penis and the head of the penis grow with age, the penis becomes erect, causing the foreskin to retract upward and the foreskin to flip out to reveal the head of the penis. Circumcision is a normal phenomenon and not a pathological manifestation in children, and less than 1% of them still have prepuce after puberty.
Clinical manifestations
1, the foreskin of the narrow mouth, urine line when urinating thin and foreskin puffed up in a ball shape, long-term urinary difficulties can cause complications such as prolapse.
2, urine accumulation in the foreskin stimulates the foreskin and penile head, prompting it to produce secretions and epidermal shedding, the formation of excessive foreskin scale, the accumulation of foreskin scale is milky white tofu slag-like, from the foreskin mouth discharge or in the form of lumps accumulated in the coronal groove of the penis head, across the foreskin visible white lumps.
3, circumcision complication foreskin penile head inflammation, can appear painful urination. The foreskin is congested and edematous, and there is purulent secretion overflowing from the foreskin mouth.
4.Severe narrow obstruction of the foreskin mouth can make the internal pressure of the urinary tract rise, which can even lead to kidney function damage.
5.Tight prepuce can make the penis development delayed.
Diagnostic points]
Diagnosis is not difficult, check the size of the foreskin opening, try to turn up the foreskin, pay attention to the presence of prepuce and other complications.
Treatment principles and programs
1, congenital prepuce in early childhood, can repeatedly try to turn up the foreskin to expand the foreskin mouth.
When the foreskin is turned up to reveal the head of the penis, remove the foreskin scale, apply antibiotic ointment-type drugs if necessary, and then reset the foreskin. Pay attention to the prevention of re-adhesion of the foreskin penis head and foreskin inlay. The method of repeatedly turning up the foreskin in this way can make most children with prepuce reach cure.
There is also a method of foreskin expansion, so that doctors use vascular cyanosis to prop open the foreskin mouth.
2, a few children must be circumcised, its indications are as follows.
(1) Fibrosis of the foreskin mouth, loss of elasticity, foreskin can not be turned up.
(2) recurrent episodes of prepuce penile head infection.
(3) Narrow foreskin opening after 5 years of age, foreskin cannot be turned up to reveal the head of the penis.
(4) the foreskin and the head of the penis are severely adhered, and the foreskin cannot be successfully separated by hand, so circumcision is feasible.
3.Circumcision precautions
(1) Anesthesia: Penile root block anesthesia, general anesthesia, basic plus local anesthesia, epidural anesthesia, etc. should be chosen according to the age of the child.
(2) Pay attention to whether there are adhesions between the inner plate of foreskin and the head of penis. When separating the adhesions, hold the inner foreskin plate close to the head of the penis to protect it more.
(3) The amount of foreskin removal should be appropriate, avoiding too much or too little.
(4) Do not keep too much at the ventral prepuce tether to avoid local brittle swelling after surgery. The statement that cutting off the foreskin tether will affect erectile function in the early years is incorrect.
(5) When suturing the incision, the ventral and dorsal sides should be standardized and sutured correctly to avoid penile torsion.
(6) The bleeding must be properly stopped, especially at the circumcision. If there is postoperative bleeding, deal with it promptly.