Circumcision means that the foreskin covers the urethral opening but can be turned up to reveal the urethral opening and the head of the penis, but is often accompanied by a prepuce. The prepuce is the narrowing of the foreskin or the adhesion of the foreskin to the head of the penis so that the foreskin cannot be turned up to reveal the urethral opening and the head of the penis.
Congenital prepuce in infancy can be treated without complications, and the majority of congenital prepuce do not need surgery. If there is difficulty in urination, manual expansion can be given. For children with foreskin inflammation, local application of topical medication in the acute stage, after the inflammation subsides, you can also try to separate and expand the foreskin by hand, and consider circumcision when it is not effective. All acquired circumcision needs to be operated.
Does circumcision require surgery? The common view of doctors has always been that circumcision can directly lead to penile cancer and is also prone to recurrent infections, so all circumcisions need to be operated. However, with the in-depth clinical research, it was found that the chance of simple long foreskin causing penile cancer is very, very low. Therefore, the current view is that if there is no recurrent inflammation, surgery is not necessary; it is enough to pay attention to cleanliness and hygiene and wash the secretions in the penile prepuce cavity frequently. If the circumcised person has recurrent glansitis of the foreskin, it is best to undergo surgery after controlling the acute inflammation. It is believed that circumcision can help reduce the chance of HIV-1 infection from the point of view of preventing sexually transmitted diseases such as AIDS, therefore, circumcision of circumcised people has its positive significance in AIDS endemic regions. There is also the possibility of surgically removing the foreskin for the purpose of religious “circumcision”.
In case of foreskin impaction, emergency treatment is required, most of which can be reset by manipulation. If the manual reset fails or if the imbedded time is long, a dorsal circumcision should be made; if the imbedded foreskin has broken or the situation allows, emergency circumcision can be performed.
If the foreskin is forcibly turned up and not reset in time, the narrow foreskin mouth can be tightened on the penis, hindering the blood flow back to the distal end of the foreskin and the head of the penis, resulting in swelling in these areas.
This situation is called foreskin imbedded. The circumcision is mostly caused by sexual intercourse or masturbation, and in serious cases, necrosis of the penis head may occur. If the foreskin is embedded, we must deal with it urgently, most of them can be reset by manipulation. If the manual reset fails or is embedded for a long time, the dorsal circumcision of the foreskin should be done; if the embedded foreskin has broken down or the situation allows, emergency circumcision can be performed.