It’s that time of the year when summer comes and it’s time for hordes of parents to bring their boys to the hospital to have their little kiddos checked. So whether the child needs to be circumcised or not, the following are some of the common doubts of parents that I have summarized in my clinical work, I hope they will be helpful to parents.
First, what is circumcision?
When children are born, 96% of male babies have prepuce, which means that the foreskin tightly wraps around the head of the penis (glans) and cannot be turned over, which is normal. As the child gets older, the foreskin opening will gradually loosen, but the age span for loosening is relatively large, usually from 2 to 12 years old.
Do I need to turn the foreskin over for cleaning?
Newborns and infants (up to 1 year old) only need to wash their penis during bath time, and do not need to clean the inside of the foreskin.
After the age of 1, if the child’s foreskin opening is small or even pinpointed, the foreskin can be dilated under the guidance of a doctor for the purpose of early resolution of the prepuce and easy cleaning of the foreskin glans. It is important to remember to restore the foreskin position after turning it over for cleaning, otherwise it may cause impaction, leading to swelling of the glans and foreskin. Foreskin imbedded is an emergency situation and needs to be sent to the hospital immediately for emergency treatment.
Third, the foreskin can not be turned, there is foreskin scale how to do?
Circumcision is a white lump of mud formed under the foreskin by shed skin cells and oil secreted by the foreskin glands. When the foreskin can not be opened, the foreskin scale can not be cleaned, try not to forcibly open the foreskin to remove the foreskin scale, otherwise it may lead to the foreskin tear bleeding, children severe pain, urination difficulties, etc.
Normally, foreskin scale is harmless and does not irritate the glans. Sometimes the foreskin scale can form a mass under the foreskin, which helps to separate the foreskin from the glans and does not need to be treated. After the foreskin is gradually turned over, the foreskin scale will fall off on its own
4. Do all boys need to be circumcised?
Not necessarily. The foreskin has the role of protecting the head of the penis, maintaining sensitivity, preventing dryness, and blocking contaminated urethra, and does not necessarily need to be circumcised. If there are no pathological factors in the child’s foreskin, surgery can be dispensed with, as long as the foreskin glans is kept clean under the guidance of the parents.
Circumcision can reduce urinary tract infections in children, reduce the risk of penile cancer, and reduce the risk of contracting HIV and sexually transmitted diseases. However, the incidence of the above diseases is low in the population. With good vulvar hygiene, men can greatly reduce the incidence of the above diseases and do not necessarily need to be circumcised.
V. Under what circumstances is circumcision recommended?
Circumcision is recommended in the following cases.
1, recurrent or more serious glans penis.
2, dry occlusive glansitis.
3, significant narrowing ring at the foreskin opening.
4, pinpoint prepuce.
5, standardized foreskin expansion under the guidance of a physician for more than 2 months with no obvious effect.
6, those who cannot guarantee lifelong glans prepuce cleanliness.
7, pathological prepuce (secondary prepuce).
8, repeated urinary tract infections.
Six, what are the risks of circumcision?
What are the risks of circumcision? There may be pain, urinary retention, bleeding, edema, infection and splitting in the short term after surgery, and there may be shortened foreskin, narrowed urethra and scarring in the long term. But the probability of these complications is relatively small.
Seven, when is it better to do circumcision?
Generally after 3-5 years old, before the penis develops, the child is more obedient and less likely to resist during this period, and the erect penis is not much different from the usual one, which makes the incision less likely to bleed and facilitates wound healing.
The circumcision incision is small, and there is no obvious relationship with the weather, so the surgery is suitable all year round.
What are the main surgical methods of circumcision?
The specific surgical method needs to be determined according to the specific situation of each hospital.
The first one, the traditional full manual suture method, suitable for all ages, using absorbable threads thinner than hair suture, no need to remove stitches, but the method requires high skills of the operator, the advantage is short healing time and fast recovery (about 1-2 weeks).
The second, circumcision ring ligature method, the price is more expensive, the hospital needs to take a ring home, 2 weeks if not off, need the doctor’s help to remove, more inconvenient; after surgery some children foreskin edema is more obvious.
The third type, circumcision nailer, the price is more expensive than the second type of ring sleeve, the operation time is also short healing period to about 3 weeks, some people off the nail delay need to manually remove the nail.
Nine, how to care after circumcision?
1.After waking up from anesthesia (4-6 hours after surgery), you can eat; you can leave the hospital the day after surgery.
2.There may be slight incision pain within 2 days after surgery, which can be solved by giving ibuprofen for oral pain relief in general.
3.Patients with prepuce may have yellowish-white ooze (not pus) from glans within 7-10 days after surgery, which requires daily disinfectant solution.
4, cleaning the trauma, and can wear medical “foreskin underwear” to prevent adhesion of foreskin and clothing, wearing appropriate loose and breathable pants, walking freely.
5, 3 days after surgery should not take a bath, three days later can be a daily shower, after the shower with disinfectant cleaning wound; pay attention to prevent constipation, violent cough, so as not to appear the incision swelling pain bleeding.
6.Some children have obvious morning erection of the penis after surgery, which leads to bleeding of the incision. It is necessary to divert the attention of the child as soon as possible, keep in touch with the doctor if necessary, and take oral medication to prevent bleeding of the erection of the penis.
7.After the operation, generally 1 week, 2 weeks, 1 month follow-up, if there is obvious redness, swelling, pain instead of intensifying, inability to urinate, bleeding, pus flowing from the wound and other abnormal conditions, then you should immediately follow-up.
8.After circumcision, within 2 weeks, there will be foreskin edema, line knot, ooze, blood scab and other conditions, affecting the aesthetics, generally 2 weeks after the foreskin appearance becomes better.