The foreskin is an integral part of the male external genitalia and has important physiological functions. The medical community has been conducting research on the function of the foreskin, and as the research progresses, there is a new understanding and appreciation of the function of the foreskin. At present, the medical profession recognizes the following functions of the foreskin: First, the foreskin covers the head of the penis and plays a protective role for the head of the penis. In primitive humans, this function appears more prominent, primitive humans due to hunting and other activities, in the deep forest often have a variety of mosquito bites, because the penis head is more sensitive, easy to stimulate the part, so because the foreskin cover, can make the crowd more convenient to complete a variety of activities. Modern humans, no longer hunting and other activities, and are covered by clothing, increasing the protection of the genitals. The foreskin as a result of millions of years of human evolution, its protective role cannot be ignored.
A man, especially before the age of seven, the foreskin is long, covering the entire head of the penis and urethral opening. By the age of about thirteen, the foreskin and glans will separate on their own, when it is easier to pull the foreskin behind the glans. As youth develops and the size of the penis increases, the foreskin will retract backwards, exposing the head of the penis and the urethral orifice outside the foreskin.
If in adulthood, the foreskin mouth is narrow, the foreskin and the head of the penis are still attached, and the foreskin cannot be turned up to reveal the urethral opening or the head of the penis, it is called prepuce in medicine.
If the foreskin can reveal the glans, but the foreskin mouth is very small, covering no urethral opening, it is called prepuce.
If there is a case of hypospadias, the foreskin can be used to repair the urethra. As the child grows older, the foreskin can be used to protect the glans and urethra from accidental injury.
Common injuries include strangulation of the foreskin by a zipper or burns, while without the foreskin, the glans and urethra would be directly injured.
Diseases of the foreskin
Circumcision can lead to premature ejaculation, circumcision, because the glans has been in the foreskin, more sensitive, in a sensitive situation, if in normal sexual intercourse, if in the warm, wet vagina, this time rapid excitement, very sensitive glans can quickly reach the ejaculation
The threshold of ejaculation is easy to appear premature or premature ejaculation, so generally speaking, patients with premature ejaculation, if it is because of long foreskin, or circumcision, we recommend doing surgery, after the surgery, because the glans is often exposed outside, often with the outside of the underwear
After the surgery, because the glans is often exposed, often rubbing and contacting with the outside underwear, it becomes less sensitive and dull, and after it is dull, it is less likely to have premature ejaculation, which is good for controlling ejaculation.
Circumcision explained
Many parents are concerned about whether the foreskin problem will affect the development of their children’s genitals. Due to the many media campaigns that flood the media, one of the most common advertising phrases is “early treatment for pediatric prepuce”. These rumors often reveal two things: first, that pediatric prepuce is a pathology that should be treated; and second, that pediatric prepuce should not only be treated, but treated early. Thus extends the conclusion that if not treated early, it will affect the development of the penis, leaving an extremely deep, if not indelible, impression on some ignorant parents. In fact, looking at the developmental process regarding the foreskin, one can answer with certainty: circumcision does not affect the development of the penis. Even those who support or advocate routine infant circumcision, as in the United States, do not cite the fact that it affects penile development as a reason for removing the foreskin.
Although there will be circumcision, just be careful to clean out the trash from the foreskin with water (warm water) on a daily basis and no inflammation will occur. By paying attention to foreskin cleanliness on a regular basis, it will not be possible for the urethra or anterior urethra to become narrow, causing difficulty in urination. It will also not damage the kidney function. By paying attention to the cleanliness of foreskin, penile cancer will not occur. Usually expose it more often and rub it with your underwear, persist, it will get better after a while, and the sensitivity of glans will be greatly reduced.
Role of foreskin
What are the roles of foreskin? The role of foreskin includes preventive function, immune protection and so on. Normally, we should pay attention to keep the hygiene of foreskin to prevent the occurrence of related diseases.
1, prevention function
Like the eyelids protect the eyes, the foreskin protects the head of the penis, keeping it soft, moist and sensitive. It also keeps the head of the penis at a certain temperature, regulates the pH balance as well as has a cleansing effect. There are no hair follicles on the glans, areola, inner side of foreskin, labia minora and eyelids. The sebaceous glands open alone on the skin surface and discharge sebum to the skin, also known as free sebaceous glands.
2.Immune protection
The openings of all body organs are the first line of defense for the body’s immune prevention. The glands of the foreskin are capable of secreting anti-bacterial and viral proteins such as lysozyme, an enzyme also found in tears and mother’s milk. Specific epithelial cells, such as Langham’s cells, which are components of the immune system, are enriched on the outer surface of the foreskin. The plasma cells of the foreskin mucosa are capable of secreting immunoglobulins, which are antibodies that prevent infection.
For many years, we have known that Langham’s cells and dendritic cells play an important role in the immune system of the skin mucosa. Only in recent years it has been found that the mucosal immune system is used to prevent urinary tract infections by introducing antigens, i.e., by sensitizing the vaginal mucosa. The immunologically active foreskin mucosal system could theoretically also be used as a way to provide mucosal vaccines.
We already knew that Langham’s cells are capable of secreting cytokines. Only recently, it has been discovered that squamous epithelial cells can also secrete cytokines and interleukins that stimulate the immune response of T cells without Langham’s cells. Cytokines released by the foreskin mucosa and skin have not yet been carefully studied. Weiss, a foreign scholar, did not find Langham’s cells on the mucosal surface of the fetal foreskin, but they were readily identified in the mucosal epithelium of the adult foreskin.
The absence of Langham’s cells on the mucosal surface of the foreskin in newborns may be due to the fusion of the foreskin mucosa with the glandular mucosa in the sterile intrauterine environment. It is not until gradual growth, when the foreskin can retract and the mucosa comes in contact with antigens that the presence of Langham’s cells can be determined.
The role of the diversity of the subcircumcised flora has not been further investigated and studies of the immune function of the foreskin have been performed only in infants. It has been reported that circumcision removes Langan cells from the foreskin, presumably possibly reducing the risk of HIV infection.
However, there are drawbacks to this theory; even after removal of the foreskin, there is still a remnant of the penile head mucosa, and there are still Langham’s cells present in the epidermis of the penis. The prevalence of circumcision has not prevented the spread of sexually transmitted diseases, including HIV, in the United States. Langham’s cells should therefore be understood as normal mucosal immune cells and not as a disease that needs to be removed.
4. Sexual zone
The foreskin is as sensitive as the fingertips and lips. It contains an extremely rich diversity of specific nerve receptors that are more dense than any other part of the penis. These special nerve endings are able to discern kinesthetic sensations, subtle temperature changes and the layering of tissue structures.
Circumcision treatment
1, circumcision, not necessarily surgery
More and more parents have a “health consciousness”: children slightly circumcised should take advantage of the summer holidays to quickly cure! The reporter learned from many hospitals in Hangzhou, the summer heat, with children to the hospital for circumcision of a steady stream of people. The male expert said: many circumcised children simply do not need to do surgery, or can be suspended to do surgery.
2, circumcision can really cause glansitis and foreskin scale
The part of the skin of the penis that extends forward is called the foreskin. If the foreskin covers the glans but can be turned back to reveal the glans with your hand, we call it “prepuce”; if the foreskin covers the glans completely and cannot be turned out to reveal the glans, it is “prepuce”. Whether circumcised or circumcised, because the foreskin covers the glans, usually the glans and the coronal sulcus are in a dark and humid environment, one is easy to breed bacteria, causing glansitis; and the other is easy to accumulate secretions and sediments, forming foreskin scale. Long-term chronic inflammation and stimulation of foreskin scale are likely to form terrible lesions on glans skin. According to statistics, the incidence rate of penile cancer is about one in 100,000, while Jewish people are circumcised 10 days after birth, so penile cancer is very rare in this race.
3.Children with prepuce that cannot be flipped can grow up and be treated again
“For married adult men, circumcision is not only likely to cause inflammation of their own glans, but also to cause Candida infection in the female partner, resulting in vaginitis, cervicitis, and even more serious gynecological diseases.” Teenagers, on the other hand, depend on the situation and do not need to rush into surgery.
There are many ways of circumcision, such as general circumcision, laser sleeve excision, sleeve ring ligation and so on, currently more popular is the combination of Korean plastic surgery technology and the United States advanced plastic surgery equipment “American sleeve circumcision”. Regardless of the type of surgery, the overgrown inner and outer plates of the foreskin are removed under anesthesia. For children who are unable to cooperate with local anesthesia, we recommend that parents turn the child’s foreskin over and clean it frequently to prevent the formation of foreskin wax and adhesions. For children with prepuce that cannot be flipped, early balloon dilatation is feasible to expand the foreskin opening so that it can be flipped normally for cleaning, and then surgery can be performed when the child grows up. If the child has repeated infections that cause itching, rashes or even erosion of the glans, the overgrown foreskin must be surgically removed. This is because the long foreskin covers the glans and the local humidity plus the stimulation of the foreskin scale can easily breed bacteria causing glansitis.
4, teenagers should keep the local dry after showering
If you are not in a position to perform circumcision, how can you effectively prevent the formation of glansitis? The first is that the foreskin is often turned over to expose the glans; second, the foreskin is turned over and cleaned every day when you shower and keep the area dry. In this way, you can effectively prevent infection from causing glansitis. The foreskin of a circumcised patient must be surgically treated, because it covers the glans for a long time and cannot be turned out for cleaning. At the same time, after a long time, patients with foreskin will also form serious adhesions between the foreskin and the skin of the penis head.
If the foreskin is long, it covers the glans, or there is a small opening left for urination, or it can be turned up, or it can’t go down again, so we will keep a part of the coronal groove, and remove the excess part of the ring, so that the glans can be completely exposed, which is better for his urination and foreskin scale, and urination will not be easily affected, which means that he can have intercourse, because The foreskin must also stay part of the erection does not affect the foreskin short and affect the normal erection, so for patients with long foreskin, or circumcised patients, generally take the circumcision method for treatment.
5.Jumping injury
This is a type of human trauma, if riding, across a thing, causing injury to the perineum, this is called a riding injury. After a straddling injury, there is a hematoma in the perineum and blood in the urine. When blood in the urine comes out of the urethra, the urine cannot be urinated normally, the bladder is dilated, there is urine inside, and it cannot be discharged, so there is damage to the urethra, and the catheter cannot be guided out, so surgery is needed. So in cases like this, acute urethral injuries must be treated promptly and cannot wait, so straddle injuries are also a common injury among trauma. The outside of the erect penis has a white membrane, if excessive stimulation, it will cause damage to the white membrane of the penis, then it is necessary to emergency surgical treatment.
6.The suitable age for circumcision
If it is a preschooler, six or seven years old, it should be said that two-thirds, or even more, 70-80% have circumcision, why is this? The reason is that at this time, the child’s penis is not yet pubescent, they have not developed, the penis has not developed, the foreskin appears longer, but if after puberty, because of the role of youth hormones, the role of endocrine, resulting in the penis began to develop, the prostate gland increased, the penis development, the growth of pubic hair, and the appearance of the throat node, these will appear some of the original foreskin appears long, become less long, become normal. The foreskin is slowly retreating backwards, so it’s normal. But to puberty still foreskin longer, then this time you need surgery, or surgery, or to see if you can flip up, if this time can not flip up, there is a foreskin, or often infected cases need surgery, because this time when the child, pay attention to let him often wash, to prevent adhesion, many of the little boys will appear long foreskin or foreskin appeared foreskin and glans adhesion situation, I have seen many children. I myself have seen many children who have had surgery to separate their adhered foreskin, and at that time, because they did not pay attention to it, it was necessary to separate it, and if it did not separate, it would be more painful if it grew together later and needed to be separated again. So this is not to say that children, four or five years old, ten years old before the child generally we do not advocate surgery, the child’s penis has not yet developed normally, only after puberty, still circumcised or prepuce, you need surgery. However, if you don’t reach puberty, but you have a prepuce that affects urination and is already adhered to, you can also have surgery, but the long foreskin is generally not recommended for surgery before puberty.
A long foreskin in men may increase the chance of urinary tract infections in children and may cause localized infections of the foreskin and glans. Therefore, overly long foreskin may have some health effects that deserve attention. In addition, good local cleaning is an important key to prevent foreskin disease, when the foreskin is too long, remember to turn the foreskin over every day to clean.
7, not all men should be circumcised
Not all men should be circumcised, some regions or races of people, for some reason such as religion, or rites of passage, will allow all men to undergo circumcision, but from a purely medical point of view, the need for circumcision for the following reasons.
Adult circumcision, where the penis remains unable to reveal the glans during erection.
Ingrown prepuce, which is a urological emergency.
A condition in which the foreskin is too long, resulting in poor hygiene and cleanliness of the area.
Recurring infections and even adhesions between the foreskin and the glans are caused by overcircumcision.
The opening of the foreskin is too small, resulting in a small urine flow.
8.Surgery time
Generally speaking, circumcision should be performed around puberty without the need for general anesthesia. However, if a young boy has recurrent inflammation or even urinary tract infection due to circumcision or overcircumcision, he should be operated early to remove the foreskin. Whether or not a newborn baby boy should be circumcised should be considered carefully due to the controversy and should not be decided hastily.
Precautions before and after circumcision
During circumcision, the physician will give appropriate anesthesia depending on the patient’s condition. In order to avoid vomiting caused by the patient’s discomfort with anesthetic drugs, the patient should fast for four to six hours before the surgery. Before the wound heals, you should follow the physician’s instructions and return to the clinic regularly for follow-up examinations. In addition, the wound should be kept clean and dry after surgery. Please be careful not to wet the gauze when urinating, and if the gauze is soaked with urine, remove the gauze first and then return to the clinic for a medication change.
The circumcision is one of the smallest urological procedures, but this surgery is related to the man’s lifelong “sexual well-being”, some patients for the sake of cheap, mistakenly believe in the advertising illegal propaganda, choose a variety of illegal small clinics, small hospitals to do circumcision, often leading to irreparable consequences. The new website has repeatedly reported: “man circumcision failed, the root of life was cut only a centimeter”, “teenage circumcision error caused penile necrosis”. In front of the bloody tragedy, the hospital advocates: circumcision small surgery should also choose the laminar flow operating room.
After surgery, except for children under general anesthesia who need to be hospitalized for a short period of time for observation in order to take care of safety concerns, patients in general can still perform their daily tasks without hospitalization. Adolescent and adult patients may experience swelling and bleeding due to penile erection after the surgery. If the bleeding is minor, only local cold compresses and pressure are needed to stop the bleeding.
The patient can resume sexual life only one month after the surgery.
Related reminders
1.The procedure takes about 20-30 minutes and does not require hospitalization.
2.After the surgery, the wound will be slightly painful and swollen, so you should take painkillers regularly and it will heal in about 7-10 days.
3.Before the wound heals, you should return to the clinic regularly for follow-up and review.
4.The postoperative wound should be kept clean and dry, and be careful not to wet the gauze when urinating.
5.The wound is closed with absorbable sutures, so there is no need to remove the sutures.
6.If there is erection of the penis, please use one hand to protect the wound and one hand to squeeze the glans with force to let the penis subside naturally to avoid the wound from cracking.
7.If the wound is swollen and bleeding, you can apply cold compresses and pressure to stop the bleeding; if the bleeding is serious, you should go back to the hospital immediately.
8.Prepare several pairs of underwear for changing (or buy no-rinse pants), because the tissue fluid will ooze out and dirty the underwear during the recovery period.
9, during the recovery period, it is best to avoid “sex”, otherwise the natural physiological reaction will make you suffer a lot! And one month after the surgery, patients can resume sexual life.
10.Cautiously choose a qualified physician to perform the surgery, because the physician’s skills will affect the post-operative appearance and the recovery process.