Outside the head of the penis in men, there is a double layer of folded penile skin, which is the foreskin. When the foreskin is turned over, the glans is visible behind the glans in a ring-shaped narrowing area for the coronal groove. Generally male foreskin is long, especially before the age of 7, covering the entire head of the penis and the urethral opening. Later, with the development of youth, the volume of the penis increases, the length increases, the foreskin will recede backwards, so that the head of the penis and the urethral orifice exposed outside the foreskin. If the head of the penis is covered by the foreskin and the foreskin cannot naturally retract to expose the head of the penis, it is called redundant prepuce, and if the foreskin is too long and the tip is narrow and cannot be flipped to reveal the head of the penis behind the head, it is called phimosis.
Among adult men in China, about 29% are circumcised and 9% are circumcised. In both cases, the foreskin cavity is prone to retaining dirt that can lead to diseases such as phimosis and warts, and can even induce foreskin stones or penile cancer. And it will also hinder the development of the penis during puberty and affect the harmony of sexual life.
Diagnosis】 1. Diagnosis is mainly based on physical examination. According to whether the foreskin can be turned up to reveal the head of the penis to identify circumcision and prepuce. In severe cases of circumcision, there may also be poor urine flow, bulbous foreskin and difficulty in urination.
2, foreskin scale is common; complications of infection can be seen in the foreskin mouth redness, swelling, visible purulent discharge, penile itching pain.
【Treatment】 Circumcision should often turn up the foreskin, cleaning the penis head, coronal groove, keep the local clean, can prevent and control infection. Pediatric circumcision can be used under local anesthesia with small vascular forceps to expand the foreskin mouth, remove foreskin scale, apply antibiotic ointment to prevent re-adhesion, and often upturned.
For children with complicated penile head prepuce, apply antibiotics to control inflammation in the acute stage, and soak locally with warm water or 4% boric acid water several times a day. After the inflammation subsides, first try to separate the foreskin by hand, local cleaning treatment, consider circumcision when ineffective. If the inflammation is difficult to control, a dorsal circumcision should be performed to facilitate drainage.
The main surgical treatment is circumcision, such as cuffed circumcision, modified circumcision, and laser circumcision with external flap method. It is worth noting that circumcision is not an indication for circumcision. The indications are: ①The glans cannot be revealed after the age of 4 to 5 years. ②Recurring circumcision and even scarring narrowing of the foreskin opening. (③) The penis has a narrow ring after erection. ④Circumcision with short ties. (⑤) Those who have a history of foreskin impaction.