Male genital deformity and disease treatment of 1 – circumcision, prepuce

In our work in male or urology clinics, we often encounter male patients with congenital or acquired genital malformations or disorders. Male genital malformations and diseases are absolutely 100% harmful to patients and their families. Congenital male genital malformations not only affect the normal development of the genital organs during childhood growth and development, but patients are also subjected to psychological stress that others cannot imagine, greatly affecting their psychological health. These genital malformations and diseases will affect the fertility and sexual function of patients in adulthood, leading to male infertility and affecting normal married life, which not only brings psychological burden to men, but also destabilizes marriages and families.  Although there are many types of male genital malformations and diseases, with the current development of clinical technology, most of them can be treated well if they are detected in time. In particular, congenital male genital malformations should be diagnosed and surgically corrected early in childhood to allow normal genital development and avoid years of psychological baggage. However, often due to the lack of knowledge in this area and the special nature of the reproductive system, people are too shy to mention or afraid to go to the hospital for examination, resulting in some patients miss the best time for treatment and can only regret their lives.  In order to facilitate the understanding and consultation of patients and their families, a brief introduction to male genital abnormalities and diseases such as circumcision, prepuce, occult penis, webbed penis, penile scrotal transposition, penile curvature, cryptorchidism and varicocele is given in the form of illustrations and easy-to-understand language.  1.What is foreskin?  The foreskin is a component of male external genitalia and refers to the skin of the penis folded into a double layer at the head of the penis. In infancy, the foreskin is long and wraps around the penis so that the head of the penis and the urethral opening cannot be revealed. As we grow older, the penis and foreskin gradually develop, and by the time we reach puberty, the foreskin retracts backwards to fully reveal the head of the penis in adulthood. But about 30% of adults, the foreskin still completely cover the head of the penis.  2.What is circumcision and prepuce?  (1) Prepuce refers to the foreskin mouth is too small, so that the foreskin can not be turned up to reveal the glans, can be divided into two types. One is congenital prepuce, mainly seen in infants and young children, can be normal physiological, with the development of penis enlargement, foreskin under the constant accumulation of foreskin scale and intermittent penile erection to gradually separate the foreskin and penis head, so infants and young children unless there is a needle point-like foreskin mouth affect urination or infection, generally do not need surgery. Acquired prepuce is mainly seen in adult males who have long term infection in the foreskin cavity resulting in a small foreskin opening, which requires timely surgical treatment.  (2) Excessive foreskin means that the foreskin covers the entire glans, but the opening of the foreskin is not small and can be turned up to reveal the glans. This disease is related to genetics and can be divided into true circumcision and pseudo-circumcision. The real circumcision is that the glans cannot be fully exposed even after the penis is erect; the pseudo-circumcision is that the glans cannot be fully exposed normally, but after the penis is erect the glans can be fully exposed.  3.What are the hazards of circumcision and prepuce? What should be done?  (1) Adult circumcision or prepuce causes discomfort during sexual intercourse.  (2) It is easy to accumulate foreskin scale, which leads to recurrent episodes of glansitis, glans adhesion and urinary tract infection, and even induces penile cancer. At the same time, the stimulation of foreskin scale during sex makes cervicitis, cervical erosion and even cervical cancer occur in women.  (3) If the foreskin is forcibly turned up during sexual intercourse or masturbation, it will easily cause tearing of the ligament, and the narrow foreskin mouth will be tightened on the head of the penis or the coronal sulcus, which will obstruct the blood flow back to the distal end of the foreskin and the head of the penis, resulting in swelling of these parts and the formation of foreskin imbrication. There is severe local pain, redness and swelling of the head of the penis, and edema of the foreskin after foreskin imbrication. The longer the imbedded time, the more serious the swelling, if not treated in time, the foreskin and penis head will occur ischemia, necrosis.  (4) Although for the non-inflammatory prepuce, often turn up the foreskin cleaning and do not need surgery, but adult prepuce and prepuce should be early surgical treatment; such as the occurrence of prepuce embedded, first use the manual reset after surgery to remove the foreskin, such as prepuce embedded for a long time, the manual reset can not recover, should be as soon as possible surgical reset; for the combination of hypospadias, painful erection, dorsal skin deformity of the penis, webbing or For patients with combined hypospadias, painful erection, dorsal penile skin deformity, webbed or occult penis and small penis, circumcision is not suitable for routine circumcision.  4.What do patients need to pay attention to after circumcision and circumcision?  (1) Take oral antibiotics for 2-3 days after surgery to prevent infection; (2) Remove the penile incision dressing after 2-3 days and change the medication once; after that, change the medication once every 2-3 days according to the local situation; (3) Avoid showering for 1 week and sexual life (including sexual intercourse and masturbation) for one month; (4) If there is more than bleeding or swelling after surgery, go to the hospital for examination in time; (5) Don’t perform Red light, microwave, ultra-short wave and other treatments to avoid causing penile necrosis.