As a urologist for 15 years, I often encounter people asking about circumcision and prepuce. Some parents rush to arrange circumcision for their children when they are very young; some adults fail to get treatment for various reasons, and some adults have children and grandchildren, but still have prepuce; worse, some have problems with the foreskin that lead to malignant penile cancer or cause cervical cancer in their partners, resulting in a cup.
The author participates in annual medical examinations for college entrance examinations or military conscription, and finds that the incidence of circumcision is very high, estimated at more than half.
The first thing you need to do is to find out if you need to be circumcised or not.
First let’s understand the origin of the foreskin.
The foreskin is God’s most special and precious gift to primates, especially humans, a gift that is believed to have remained on the primate body for more than 100 million years without degradation or evolution. This gift is believed to have remained in the primate body for more than 100 million years, without degeneration or evolution. However, in some races or religious cultures, this precious gift is cut off as a sacrifice during childhood or during the “rite of passage” in order to conform to their social heritage or religious rituals. This gift from God is – the foreskin! Although most physicians today acknowledge that the foreskin is a normal structure of the penis that has been preserved through millions of years of evolutionary history, they still believe that the foreskin is prone to harboring bacteria and infections, and that the secretion of foreskin tumescence can easily contribute to the occurrence of cervical cancer, so most of them recommend early circumcision. Is the foreskin really useless, as mentioned above? Or does it not have a place in the book of functions because it can only be used as a ritual totem? Or is it simply a useless structure that has not yet had time to die out completely in the evolutionary history of mankind?
Actually, no! Because up to now, it is still not an “optional” trace organ of the human body (one for the appendix and one for the third molar), which shows that it must have some function, but we have neglected it before.
Here we list the 17 functions of the foreskin, and arrange them in order of importance.
A: Sexual life a. Increase sexual pleasure. The sensation at the ligament is particularly acute.
Second, during sexual intercourse or masturbation, the skin of the inner and outer foreskin plates is in a sliding state and has a comfortable “rolling” feeling (rolling bearing).
The inner and outer plates of the foreskin slide on their own, reducing the friction on the vaginal wall and avoiding painful intercourse.
4. The abundant foreskin can stimulate the partner’s genitalia and obtain pleasure.
V. When erection occurs, it provides the skin needed for penile elongation and avoids the feeling of constriction.
The foreskin can store “pheromone” and release it during sexual arousal to fully stimulate the partner’s desire.
Seven, foreskin can store natural lubricating fluid (pre-ejaculatory fluid), released when sexually excited, play a lubricating role during sex.
Eight, the glans becomes the focus of visual stimulation during sexual arousal.
IX. To provide a temporary receptacle for semen to reduce wear and tear on the vaginal wall.
B: Protection X. Protect the glans from hyperkeratosis of the glans skin and keep it loose and moist.
XI. Protect the “thin-skinned” glans from injury.
Twelve, to protect the nerves of the glans, to avoid damage to erectile function.
Thirteen, in children, to protect the urethral opening from pollution or urethral infection.
Fourteen, foreskin secretions originally have antibacterial components, which are relatively clear on the lysozyme, which can play a role in killing and inhibiting germs.
Fifteen, to protect the non-pigmented glans from sunburn.
Sixteen, to protect the glans, which has an already insufficient blood supply, from frostbite.
C: Other xvii. Provide skin for reconstructive orthopedic surgery. (e.g. hypospadias, eyelid burns) Therefore, when circumcision is to be performed, it must be done with the concept of circumcision cosmetically, preserving as much as possible the bulbous sensory receptors, Dartos muscle, foreskin mucosa, etc., and trying to avoid premature exposure of the glans in children to avoid local skin hyperkeratosis.
In many medical opinions, such as the Australasian Society of Pediatric Surgery, the Canadian Pediatric Medical Association and pediatric urology textbooks, it is considered that the glans and prepuce mucosa of newborns is a complex fusion that is not yet mature, so it is more prudent to perform circumcision; in adolescence, it is also best to clearly inform the boys themselves, and it is best to wait until they can understand the pros and cons of circumcision before performing it. When it comes to circumcision diseases that affect the health of children, such as recurrent infections, the structure and function of the foreskin should be preserved as much as possible.
Of course, not only should the physician understand the role and function of the foreskin, but also the parents of the child or the adult patient themselves should raise their awareness of the foreskin.
The next step is to learn more about the dangers of circumcision and prepuce.
The main points are as follows.
1, if the male circumcision can not be treated in a timely manner, the head of the penis is locked by the foreskin for a long time, resulting in adolescence, resulting in penile dysplasia, resulting in penile hypospadias, will also affect normal sex life, and impotence premature ejaculation, resulting in lifelong regret.
2, circumcision and circumcision easily cause infection and accumulation of foreskin scale, long-term chronic stimulation can lead to chronic inflammatory circumcision and penile glansitis, serious and even induce cancer. If the husband is circumcised, the foreskin scale will enter the female reproductive tract during sexual intercourse and cause long-term chronic stimulation of the cervix, which may induce cervical cancer.
3. Prepuce and prepuce are likely to cause foreskin imbedding, such as forced upturning and can not be reset, in serious cases may cause glans necrosis.
Finally, the author gives a strategy: children’s prepuce is a natural state, after more than 2 weeks of age, parents should try or under the guidance of a doctor to turn the child’s foreskin, cleaning the glans and the inner plate of the foreskin, to avoid long-term accumulation of foreskin scale leading to glansitis, due to the erection and development of the penis, part of the foreskin mouth gradually become larger, and eventually form a perfect state without prepuce and prepuce. As for pediatric circumcision with recurrent infections in childhood, it is recommended that surgery be performed under general anesthesia after controlling the infection. For other children, it is recommended that they be diagnosed by a doctor at the beginning of puberty to see if they are circumcised or circumcised and receive surgery, and note that they should be differentiated from the occult penis.
Choice of circumcision modality.
There are many kinds of modern circumcision surgical methods, and the author has had a lot of experience from traditional circumcision, cuff circumcision, Korean circumcision, commercial ring circumcision, to the current circumcision using the “Wolf and Brand Circumcision Device” from more than ten years ago.
The introduced “Wolf and brand circumcision device” circumcision has been maturely applied in clinical practice with good results! This procedure has the advantages of fast surgery, less bleeding, less pain, beautiful postoperative appearance and fast recovery, etc. It is recommended.
Surgical steps.
First disinfection and local anesthesia, placement of the bell holder to protect the glans and the tether.
The extent of excision is determined and the tape is tightened.
The circumcision device is pushed in and locked in place.
With a click, the overgrown foreskin is removed in a few seconds.
Post-operative aesthetics, minimal scarring (some scars are barely visible after healing), quick recovery, less pain, and few post-operative complications such as edema and bleeding.