First of all, there are several concepts: circumcision: the foreskin opening is narrow, or the foreskin adheres to the head of the penis so that the foreskin cannot be turned up to reveal the head of the penis.
Circumcision: When the penis is not erect, the foreskin covers the entire head of the penis and the urethral opening, but the foreskin can still be turned up to reveal the head of the penis. Or when the penis is erect, the foreskin needs to be pushed by hand to fully expose the head of the penis, which is also considered to be circumcised.
In short, circumcision refers to the tightness of the foreskin opening or the adhesion of the foreskin to the head of the penis, making it impossible to turn up the foreskin. In contrast, circumcision means that the foreskin is long, but the opening is not tight and can be turned up. However, if the foreskin is too long, if the foreskin penile head inflammation occurs frequently, the repeated stimulation of inflammation may also lead to a narrow ring at the foreskin mouth.
Circumcision can be divided into congenital and acquired. Congenital prepuce is seen in every normal male newborn and infant. After a male newborn is born, there are adhesions between the inner plate of the foreskin and the head of the penis, and after a few months the adhesions are gradually absorbed and the inner plate of the foreskin can gradually separate from the head of the penis. After 3-4 years old, the prepuce accumulated between the inner plate of the foreskin and the head of the penis can make the adhesion between the inner plate of the foreskin and the head of the penis separate naturally. Congenital prepuce is a physiological phenomenon, also called “physiological prepuce”. For physiological prepuce, if there are no complications, treatment is not necessary. If there are difficulties in urination, such as thin urine line, effort to urinate, and bulging foreskin sac when urinating, you can first try to separate by hand, that is, to turn up the foreskin by hand, the technique should be gentle, not to pursue the foreskin completely turned up, can be normal urination. If the foreskin cannot be turned over after 3 years of age, it is possible to expand the foreskin by turning it over, cleaning the foreskin and applying antibiotic ointment locally to prevent re-adhesion, and after expansion, the foreskin should be turned down and reset. Frequent upturning, cleaning, put down, can make the foreskin mouth narrow ring gradually disappear. Manual expansion fails, feasible balloon expansion, is to place a special balloon into the foreskin cavity, and then inflate the balloon, is the foreskin cavity expansion. Compared to the traditional hemostatic forceps to separate and open the foreskin cavity, this method is less painful and easily accepted by the child, and is suitable for those who do not have scar contracture of the foreskin. If the foreskin scar contracture has appeared, it should not be forcibly turned up, otherwise it is easy to cause foreskin ingrowth, that is, the foreskin is turned up to the back of the head of the penis and cannot be reset. Embedded prepuce should be dealt with in time. If not dealt with in time, it can cause dry gangrene of the head of the penis over a long period of time. Most of the embedded prepuce can be reset by manipulation, if the manipulation reset fails or the embedded time is too long, surgery can be considered.
Acquired prepuce, mostly secondary to penile head circumcision, foreskin and penile head injury, due to repeated inflammatory stimulation, the foreskin mouth can have scar contracture, this contracted tissue is not elastic, no expansion ability, forming a fiber narrow ring, so that the foreskin can not be turned up, this kind of prepuce will not heal itself, serious cases will affect urination and penile development. Circumcision should be performed for acquired prepuce.
It is controversial whether circumcision should be done for long foreskin. Traditionally, it is believed that when the foreskin is too long or circumcised, the sensitive areas such as the penis head, coronary sulcus and foreskin ties receive less external stimulation and therefore are overly sensitive to sexual stimulation, which can easily lead to premature ejaculation. However, there is no sufficient evidence to confirm that those with long foreskin or circumcision are more prone to premature ejaculation, nor is there sufficient evidence to show that patients are more satisfied with their sex life after circumcision than before.
If the foreskin is too long or circumcised, it is easy for the foreskin scale to gather in the foreskin cavity, and foreskin scale has been found to have carcinogenic effects in animal tests. In some countries and regions, circumcision is performed on male newborns after birth, and penile cancer is rare in these countries and regions. In addition, some studies have found that after circumcision, the incidence of sexually transmitted diseases such as condyloma acuminata, AIDS and syphilis is reduced. The reason for this may be that keratin can resist viral infection. The head of the penis is rich in keratin and is not easily infected by viruses, while the inner plate of the foreskin and the surface tissue of the foreskin ties lack keratin and are vulnerable to viral attack. Circumcision, which cuts away the inner plate of the foreskin, thereby reducing the chance of viral infection. Therefore, circumcision has positive implications in AIDS endemic regions.