The boy’s “penis” is a big problem, “penis” out of the question, will affect the happiness of the man’s life.
The “penis” is a very sophisticated and complex organ, for men, it shoulders the dual function of urination and fertility, “penis” consists of penis body, penis head and foreskin, the head of the penis wrapped by the foreskin, we observe the penis When we observe the penis, we need to pay attention to several points: 1. If the testicles do not completely descend into the scrotum after 2 years old, active surgery is needed because the spermatogenic function of cryptorchidism over 2 years old will be affected.
2. Whether the “glans” can be exposed. When the foreskin wraps the head of the penis, due to the narrowing of the outer foreskin, urine is easily left in the head of the penis and foreskin cavity, and pathogens around the outer urethra increase, causing urinary tract infections. Children who are not circumcised are 10 to 20 times more likely to become infected than those who are circumcised. If circumcision is still present during adolescence, long-term inflammatory irritation may lead to occlusive dry glansitis, which can occur in up to 40% of cases. Dry glans can cause stricture of the external urethral opening, requiring an external urethrotomy, which may require repeated urethral dilatation or, in severe cases, urethroplasty or alternative surgery. Circumcision in young adults can be more conducive to sexually transmitted infections during sexual activity. Removing the foreskin can reduce the chances of sexually transmitted infections and reduce the transmission of the acromegaly virus (HPV), mycoplasma, and chlamydia; the latest research shows that circumcision can prevent the transmission of HIV (HIV) by up to 60% and is known as a surgical vaccine to prevent AIDS! For the elderly, circumcision and phimosis can cause penile cancer, which is life-threatening. Penile cancer occurs almost exclusively in uncircumcised men, and circumcision is an important risk factor for penile cancer. 3. Is the “penis” in good shape? Abnormally shaped “penis” usually has congenital malformation and needs to be treated. There are many reasons why penises are particularly small and need to be treated differently. In obese children, the abundant suprapubic fat can bury the penis, but if the penis is lifted the length is not significantly different from that of a normal child. A webbed penis is one in which the scrotal skin extends to the ventral side of the penis and fuses with the penile skin, and the penis has a triangular appearance. Small penis is a normal penis appearance, the size is smaller than the normal average of more than 2.5 standard deviations, usually full-term newborns penis size is greater than 47.5px, before the age of 11 years old children penis is greater than 95px or more is normal. Hypospadias and supraurethral cleft is a deformity that guides the opening of the urine not in the middle of the head of the penis, but below or above the head of the penis, usually combined with penile curvature deformity, and requires surgery.
Pediatric prepuce and phimosis are the most common problems, how is prepuce treated?
Usually, pediatric prepuce is self-healing. Before the age of 3, the head of the penis is usually not exposed; after the age of 3, the head of the penis is gradually revealed; from the age of 3 to 7, about 42% of children can reveal part of the penis, and after the age of 11, the majority of the head of the penis can be fully revealed. If the head of the penis cannot be exposed after the penis starts to develop or if the following conditions occur, treatment is needed: (1) repeated urinary tract infections, (2) repeated glansitis of the foreskin, (3) inflammatory narrowing of the external foreskin, or (4) difficulty in urination due to circumcision. Treatment options include medication and surgery. The first choice of drug treatment, can be localized corticosteroid cream (such as 0, 1% flouroxyprednisolone) for 6 weeks, 3 ~ 4 times a day, recurrence rate of about 20%, if the foreskin recurrence, can be used again a course of treatment. If medication is not effective, surgical circumcision can be used.
Circumcision is very popular in developed countries, and the proportion of male circumcision is very high. 70% of men in the United States are circumcised, about 80% of men in Korea are circumcised, and less than 20% of men in China are circumcised. There are many methods of circumcision, but there are only two: traditional circumcision with knife and stitch and circumcision with instruments. A large number of studies have been analyzed to prove that: compared with traditional circumcision, pediatric circumcision ring lassoing has a shorter operation time, less intraoperative bleeding, less postoperative infection and better postoperative appearance. Among the circumcision rings, the Chinese commercial ring is the most thoroughly researched. After inspection and evaluation by several relevant international institutions and the World Health Organization, the Chinese commercial ring has been written into the World Health Organization (WHO) Circumcision Guidelines. It has also become the preferred circumcision device for the Gates Foundation’s project to support the expansion of circumcision services to prevent HIV infection in areas with a high prevalence of HIV in Africa.
In our clinical practice, we found that the application of the Chinese commercial ring for circumcision of children is simple, with less intraoperative and postoperative pain, shorter operative time, fewer complications, and aesthetic appearance. However, children with occult penis, micropenis, hypospadias, supraurethral cleft and other penile deformities are not suitable for circumcision and need to be treated with corresponding plastic surgery.
In summary: 1. The potential benefits of circumcision are to reduce the risk of urinary tract infections in newborns, prevent penile cancer, priapism, and possibly prevent sexually transmitted diseases. 2. 90% of uncircumcised children can be self-healed by the age of 11.
3. Topical application of corticosteroid cream can loosen 70%~80% of the prepuce, but the cream is not tender to make the foreskin adhesions separate.
4. Children with occult penis, webbed penis, huge foreskin, hypospadias, supra-urethral cleft, recurved penis deformity or small penis should not be circumcised.
5. The incidence of complications of circumcision is 0.2%~3%, including early bleeding, wound infection, foreskin edema, penile adhesions, excision of too much or too little foreskin accompanied by secondary circumcision of the concealed or retracted penis, and narrowing of the urethral opening.