Circumcision in children is a common disease. Starting from boys, the role of the foreskin begins to be tightly wrapped around the glans, which has a protective effect. Gradually, with frequent erection of the penis, the foreskin is turned back and the glans is exposed after puberty, which is a normal process. If the foreskin still covers the glans and urethra, it is prone to abnormalities. Some data show that Israel, where circumcision is routinely done after birth because of religious and ethnic customs, has a low incidence of penile and cervical cancer compared to other countries that do not have the procedure. The foreskin harbors dirt, which also tends to increase the spread of STDs. In the United States in the 1990s, the circumcision rate for newborns was 64%.
In addition, recent studies have shown that because of the long-term coverage of the foreskin, the glans mucosa is more red and sensitive, and men have significantly shorter sex than those who have been operated on and uncircumcised. For children, circumcision will affect the growth and development of the penis, in adolescence because the head of the penis is tightly wrapped by the foreskin, the lack of space necessary for growth, do not get the due stimulation of the outside world, the development of the head of the penis is greatly constrained, resulting in the development of mature sex organs, the circumference of the crown of the head of the penis is significantly smaller and circumcision is often local inflammation. At present, there are more surgical methods, the traditional surgical methods are derived from the idea of cutting, suturing, or gluing. There are flaws such as the need for open sutures, drug changes, easy infection of the incision, and irregularity of the foreskin edge after surgery. Laser cutting belongs to physical excision, and there is no superiority to draw on. High-frequency electric knife excision is basically similar to laser, except that electrocoagulation can stop bleeding without the use of thread sutures to stop bleeding and can reduce foreign body irritation. However, there are still some people who form scar due to cutting sutures and always feel uncomfortable with a prong at the edge of the foreskin, especially keloid. Bonding is easy to operate but prone to aseptic inflammation and discomfort in the child. In addition, the literature reports that possible complications of circumcision include: bleeding; infection; painful intercourse; tethering injury; penile body injury; and even complications leading to death. While the use of a ring ligature is still essentially a circumcision, unlike traditional circumcision, the ring ligature is less invasive, simpler, and faster, and the overgrown excess foreskin falls off naturally because there is no blood supply. After surgery, it does not affect normal physiological activities (you can bathe and urinate normally) because urine is discharged from the middle hole of the ring sleeve. It is easy to move freely without restriction and is quite convenient to take care of. The incision after surgery is neat and beautiful. It is easy to be accepted by patients and is worth promoting and applying at the grassroots level. The treatment method: The patented product of Shanghai Servcorp Medical Equipment Co. The device consists of two parts: a special elastic thread and a plastic ring made of hard plastic and a ring handle. Except for fully cooperating adults, children were anesthetized with intravenous ketamine. After measuring the size of the penis with a disposable ring gauge before surgery, different types of plastic rings are selected. After routine disinfection, the head of the penis was turned out, the plastic ring was inserted into the head of the penis, and the foreskin was pulled downward with hemostatic forceps so that the plastic ring was placed between the inner plate of the foreskin and the head of the penis. Then the foreskin is fixed with the ring handle on the outer plate, and the ring handle is removed after the ring is ligated with pressure around the surface of the foreskin with an elastic thread for 2 to 3 turns, and the overgrown foreskin is cut off to expose the urethra. In patients with prepuce, first cut 1 to 2 CI|1 from the dorsal side of the foreskin, turn out the head of the penis, separate the adhesions, remove the prepuce, and then place the ring.
Patiently and carefully adjust the length of the inner and outer foreskin plates of the ring and make the elastic lines overlap in the same plane to facilitate the healing of the ring after the wound is dislodged, so that the front and back are symmetrical and beautiful. After the operation, the ligature should be applied with dilute iodophor solution twice a day.
There are many surgical methods to treat circumcision and phimosis. In conventional surgical treatment, bleeding often occurs due to improper operation or inexperience of the operator, and the appearance is unsightly. There is little or no bleeding during the operation. ②Small surgical scar, beautiful appearance: ③No painful blood and stitch removal after surgery. This surgical method basically achieves the purpose of minimally invasive treatment of prepuce and circumcision and is worth promoting. When the operation is performed, we should pay attention to the following: ① Children’s foreskin is less elastic, so it is not easy to put in a slightly larger model, so choose a smaller model of the ring according to the measurement. (2) The elastic thread should be used with even force to avoid dislodging the ring and postoperative pain. The inner and outer plates of the foreskin should be removed. It is not advisable to cut off too much to avoid the consequences such as edema of the inner plate, downward curvature of the penis head and appearance. In this group, two cases of obvious postoperative pain and one case of edema of the inner plate occurred at the beginning of the method, due to the inexperience of the operator.