The circumcision refers to the narrowing of the foreskin opening, so that the foreskin cannot be turned upward to reveal the head of the penis. The prepuce is divided into congenital and acquired, which can also be called physiological prepuce and pathological prepuce.
Congenital prepuce: Every normal boy is born with congenital prepuce, and there is a physiological adhesion between the foreskin and the head of the penis plus a narrow foreskin opening, so the foreskin cannot be turned up to reveal the head of the penis. Strictly speaking, congenital prepuce is not a disease, but a physiological phenomenon. If a boy is not born with a prepuce, the head of the penis is not normal, but may be a congenital malformation, such as hypospadias, urethral cleft, etc. Physiological prepuce from a few months after birth with the absorption of adhesions, the foreskin and the head of the penis separated, the foreskin mouth gradually expanded gradually self-healing. After the age of 3, 90% of children’s prepuce heals itself. after the age of 17, only less than 1% have prepuce. Most of the physiological prepuce can heal by itself.
Acquired prepuce: congenital prepuce can lead to infection, resulting in penis head circumcision, and if the penis head circumcision repeatedly becomes chronic inflammation, the foreskin mouth loses the elasticity and expansion ability of the skin, forming scar contracture, and the foreskin cannot be turned up, this kind of prepuce is acquired prepuce, often accompanied by urethral stenosis. Scar contracture after trauma to the foreskin can also lead to acquired prepuce.
Treatment principles. For prepuce under 5 years old without difficulty in urination, no infection, and not serious foreskin scale, no treatment is necessary. For symptomatic prepuce, we can try to enlarge the foreskin opening first. The foreskin can be turned up repeatedly on a trial basis in the hospital to expand the foreskin opening, reveal the head of the penis, remove the foreskin scale, apply antibiotic ointment or liquid paraffin to lubricate it, and then restore the foreskin. Parents continue to use the method of treatment at home, most children can be cured as they grow older.
Circumcision is suitable for: ① Acquired prepuce with fibrous stenosis ring; ② Recurrent episodes of penile head circumcision; ③ After the age of 5-6 years, severe narrowing of the foreskin mouth, the foreskin can not retract and reveal the head of the penis, and conservative treatment is not satisfactory. The first two of them are absolute indications for surgery.