1.What is prepuce?
Prepuce is a condition in which the outer opening of the foreskin is too small and tightens around the head of the penis and cannot be turned outward to reveal the head of the penis. The urethral opening of prepuce is completely wrapped by the foreskin and only a small hole is exposed.
2.What is circumcision?
Circumcision is a condition where the foreskin cannot expose the head of the penis when the penis is weak, and still cannot expose the head of the penis when it is erect, but the foreskin can be turned over to expose the head of the penis.
3.What are the hazards of circumcision?
Because the head of the penis is tightly wrapped by the foreskin, the development of the penis is greatly constrained, if this restriction is not lifted in time during puberty development, the mature foreskin will be smaller than its peers; and the foreskin will secrete a lot of sebum, which is not easily discharged when the foreskin, forming foreskin scale, leading to priapism, prepuce, urinary tract infection, etc. Repeated inflammation of the foreskin can easily lead to adhesion of the penis head to the foreskin. Chronic stimulation of foreskin scale can also induce the occurrence of penile cancer and even cervical cancer in the spouse. In addition, the inability to expose the glans, which affects the erection of the penis, can also have an impact on sexual life, such as painful intercourse and premature ejaculation.
What are the causes of prepuce?
Most prepuce is physiological and is mainly related to the male growth cycle. Generally, it can heal itself after the age of 3. Acquired prepuce is mostly secondary to circumcision and injury to the foreskin and head of the penis caused by overcircumcision. The foreskin mouth has scar contracture, losing the elasticity and expansion ability of the skin, and the foreskin cannot recede upward, accompanied by narrowing of the urethra.
4.What is foreskin scale?
Foreskin is the normal anatomical structure of male external genitalia, under normal circumstances it covers the head of penis and plays a protective role. There are abundant sebaceous glands in the foreskin, which can secrete a large amount of sebum. The sebaceous secretions in the foreskin are not easily discharged due to long foreskin and circumcision, together with the cells shed on the surface of foreskin and penis head, secreted mucus, as well as bacteria and urine, forming a white film-like substance under the foreskin, called foreskin scale, which is white or yellowish flakes to the naked eye. Foreskin scale is very suitable for bacterial growth and often causes infections, which can even cause urethral stenosis, adhesion and even penile cancer in serious cases.
5.Are all children born with prepuce?
Yes. Under normal circumstances, the foreskin of infants and children have physiological natural adhesions with the head of the penis, the urethral opening is small and the glans is difficult to be exposed. As the body develops, the opening of the foreskin will gradually become larger and the foreskin will recede upward on its own to reveal the head of the penis, thus gradually separating the foreskin from the head of the penis. Generally speaking at the age of 3 most children’s foreskin can be retracted and turned up.
6.Does circumcision always need to be operated?
Not necessarily. Since prepuce can limit the development of the penis and easily hide foreskin scale, causing prepuce infection, glansitis and urinary tract infection, it is recommended that all prepuce before puberty should be treated surgically. Even if the development of the external genitalia has stopped in adults, prepuce may still cause infection and affect sexual function, so surgery is recommended. Infants and children can temporarily do without surgery, but if it causes difficulty in urination, inflammation, etc., then we should consider surgery.
7.Does circumcision need to be treated?
Circumcision does not always require surgery. It is now believed that the foreskin can play a certain protective role for the head of the penis, and is not completely useless. However, prepuce can easily hide foreskin scale and lead to infection and inflammatory adhesions, and chronic inflammatory stimulation in the foreskin is also a factor leading to penile cancer. Therefore, it is recommended that the circumcised person can turn up the foreskin and wash it every day when taking a shower, and if it can be cleaned inside the foreskin, surgery is not necessary. However, if the infection is often caused by foreskin scale, or if the foreskin is too long, resulting in glans sensitivity, causing premature ejaculation of young patients, surgery is recommended.
8.Does circumcision affect sexual function?
Yes. Because the head of the penis is tightly wrapped by the foreskin, the development of the penis is greatly constrained, affecting the development of the penis, resulting in a relatively small penis after maturity. In addition, prepuce can cause erection difficulties, painful intercourse and premature ejaculation, which will not only cause disharmony in the sexual life of the couple, but also lead to long-term psychological sexual dysfunction.
9.What are some diseases that can be easily mistaken for prepuce?
There are usually the following conditions that should be distinguished from circumcision: 1. Excessive foreskin. The biggest difference between it and prepuce is that the foreskin can be flipped open by hand to completely expose the glans; 2, occult penis. This type is most easily confused with circumcision. Occult penis often occurs in fatter children and can be combined with prepuce. The two are similar in appearance, but close examination reveals that the prepuce of occult penis is hollow and hill-like, and it is difficult to feel the body of the penis with the hand, which is often mistaken for prepuce. However, the two surgical methods are very different. If occult penis is mistaken for prepuce treatment, the result is that the problem of developmental limitation of the occult penis is not solved, but the intact foreskin is removed, thus causing great difficulties for the subsequent plastic surgery, so these two diseases should be strictly identified before performing circumcision.
10.What is foreskin impaction?
If the foreskin is forcibly turned up, not recovered in time or difficult to recover, so that the narrow foreskin mouth tightly in the coronal groove of the penis, this situation is called foreskin imbedded. The foreskin embedded will cause blood return obstruction and local edema, bruising, should be properly handled in a timely manner.
11.What should I do if my child’s foreskin is ingrown?
As the foreskin embedded will cause poor blood flow, resulting in foreskin edema, bruising, should be promptly reset by hand. If it is difficult, you can apply paraffin oil or petroleum jelly to the foreskin and coronal sulcus. If the reset fails, please immediately go to the hospital emergency dorsal circumcision or circumcision of the foreskin.
How to reset the foreskin?
The foreskin embedded often occurs in sexual life or other circumstances, the foreskin forcibly turned up, at this time should first use one hand to hold the head of the penis coronal groove foreskin edema 1-2 minutes, so that edema gradually subsided. Then use the left thumb and index finger pinch the head of the penis while pulling outward, and then use the right hand to pull the foreskin ring in the coronal groove backward, so that the foreskin folds flatten, then let go of the left hand, the right hand moderate force to push the narrow part of the foreskin to the head of the glans, so that the glans retracts into the foreskin, if the reset fails, should promptly seek medical attention.
12.What should I pay attention to in infants and children with prepuce?
Since the majority of newborns are born with the foreskin and the head of the penis fused, a physiological prepuce is formed. At this time, the foreskin only has a narrow small opening, and some are even pinhole-like. We parents should pay attention to the development of children’s external genitalia, if the foreskin still has not naturally retracted after the age of 3, and the foreskin and glans are often infected and inflamed; or there are difficulties in urination, surgery should be considered; if the above circumstances do not exist, the hand flip method can be tried to treat the prepuce, but for some children with adhesions, it is not advocated to forcibly flip the foreskin, because there is the possibility of re-adhesion or secondary prepuce.
13.What is the hand flip method for the treatment of prepuce?
Hand flip method for treatment of prepuce is to pull the foreskin upward when bathing the child, rinse the head of the penis with warm water, and then try to flip the foreskin upward with slight force, so as not to cry, clean the foreskin scale, and finally restore the foreskin. Pay attention to gentle operation, step by step, not overly eager to turn the foreskin up. Persist for a period of time, the narrow mouth of the foreskin will gradually expand, after this method of treatment can gradually cure the prepuce.
14.Sometimes you can feel a small hard lump on the penis of infants and children, what is it?
This kind of hard lump on the penis is commonly found in the following cases.
(1) Foreskin scale. The most common, because infants and children are very common prepuce, sebaceous glands secreted by the foreskin is not easy to discharge, easy to accumulate in the foreskin and form a small hard lump.
(2) Cysts of the foreskin or urethra, the difference with prepuce is that prepuce can be pushed, while cysts are fixed in position and can slowly increase in size.
(3) tumor, this kind is less common, it is characterized by hard to the touch, the mass is difficult to push, and can increase rapidly within a short period of time.
15.When children pee, a big bag will bulge in front of the penis, why is this?
Some infants and young children with prepuce have pinhole-like urethral orifice, when urinating, urine is blocked through the narrow foreskin, urine is scattered in a rosette-like manner, urine will bulge a small bag at the foreskin mouth, this type of prepuce is difficult to urinate, if the situation gradually worsens or often causes infection, surgery is recommended.
16.Does prepuce affect fertility?
Generally speaking, adult patients with prepuce can also complete ejaculation and have no effect on fertility. However, circumcision can have an impact on sexual life.
17.Is there any relationship between long foreskin or prepuce and the occurrence of penile cancer?
Yes. The accumulation of foreskin scale by circumcision or prepuce can induce penile cancer through long-term chronic stimulation. Those with long foreskin should turn it up and wash it every day to keep it clean; surgery for prepuce in childhood is beneficial to prevent penile cancer.
Can I use alcohol to disinfect my foreskin or prepuce?
The foreskin scale is very suitable for bacterial growth and often causes infections, so it needs to be cleaned frequently, but care should be taken to clean with water as much as possible to avoid stimulating the glans or changing the local flora with alcohol and other disinfectant solutions, and the glans is generally more sensitive, so scrubbing with disinfectant solutions often causes discomfort.
18.What is the best age to operate on circumcision and prepuce in children?
Strictly speaking, there is no specific time limit for surgery for circumcision and prepuce. If the circumcised person cleans his foreskin every day and pays attention to cleanliness and hygiene, he can be operated without surgery. Those with foreskin need early surgery, which is generally considered better at the age of 7-10. If children with prepuce often have difficulty urinating and have recurrent infections, they should be treated regardless of their age.
19.What are the common types of surgery for prepuce?
There are mainly the following surgical methods applied in clinical practice.
(1) Traditional circumcision: It is the most common surgical method with good healing and fast recovery, but the disadvantage is that it needs to be performed under anesthesia. The disadvantage is that it needs to be performed under anesthesia. Generally, children under five years old have difficulty cooperating under local anesthesia and are changed to general anesthesia.
(2) Circumcision with a circumcision device: This method is easy to operate and does not require sutures, but it is necessary to pay attention to the foreskin with the ring to dry with a hair dryer after bathing to avoid infection. This method is more suitable for children.
(3) Laser cuff circumcision: less bleeding during the operation, avoiding excessive ligation of blood vessels that lead to subcutaneous foreign body residue and postoperative thread reaction; clear intraoperative vision, neat cutting edge and beautiful postoperative healing. However, the operation is complicated and takes a long time. The high temperature generated by the laser burns the tissue, which prolongs the healing time of the tissue, and the wound may not heal, become infected and split after surgery.
(4) Simple dilation method: Less frequently used. The narrow foreskin opening is dilated by using vascular forceps to hold open and enlarge the narrow foreskin opening. The same needs to be performed under anesthesia, the operation time is short, the damage is small, but after the operation is easy to edema, the foreskin mouth still has the possibility of retraction or adhesion.
What tests are needed before circumcision?
Before circumcision, a routine male examination should be performed to clarify the diagnosis. In addition, routine urine tests should be performed if necessary to avoid secondary infections after surgery, and in addition, for patients with a history of abnormal coagulation, coagulation should be checked.
20.What do I need to pay attention to before circumcision surgery?
If there is inflammation or infection in the foreskin before the circumcision surgery, it may cause complications such as non-healing of the wound or aggravation of infection after the surgery, so it is not recommended to perform the surgery at this time. It is best to treat anti-infection first and then perform the surgery after the inflammation is controlled or subsides. The external genitalia and foreskin should be washed frequently a few days before surgery to maintain cleanliness and hygiene, which can reduce the occurrence of postoperative infection. In addition, it is best to wear loose underwear on the day of surgery, keep a good attitude and don’t be too nervous.
21.What are the possible complications after circumcision surgery?
At present, the main surgical methods for the treatment of circumcision are traditional circumcision, circumcision ring ligation and laser cuff circumcision, each of which has its own advantages and disadvantages. Circumcision is a minor urological procedure and complications are uncommon. The reasons for their occurrence may be related to the surgical operation or improper postoperative care, etc. The main complications of traditional circumcision include pain, bleeding, infection or wound dehiscence, foreskin edema; excessive circumcision can lead to altered sensation or loss of sensation; uneven incision and downward curvature of the penis caused by too short a tether; intraoperative accidents can also lead to glans or penile injury. The main complications of circumcision ring circumcision are: long wound healing time, significant pain when removing the ring; postoperative infection, postoperative slippage and bleeding of the ring, wound dehiscence, foreskin edema, and misalignment of the tether. The main complications of laser cuff circumcision are: postoperative wound bleeding, postoperative infection, wound dehiscence, etc.
22.Can the problem of premature ejaculation be improved after circumcision?
Some of the circumcised or circumcised patients have keratinized the skin at the glans after circumcision, which reduces the sensitivity and helps to improve premature ejaculation.
23.Why do some penises swell up after circumcision?
If you find that your penis is swollen after circumcision, the most common condition in this case is foreskin edema. The main reasons for this are the large incision during surgery and the premature release of the bandage after surgery. If this happens, do not worry too much, available gauze elastic bandage pressure bandage, to be slowly absorbed edema can be.
24.What are the precautions after circumcision?
If it is a traditional circumcision, the blood flow of the glans should be observed after the operation, if it is purple, it means that the bandage is too tight, it can be suitable to unwind a little, but it should not be too loose. In case of circumcision, attention should be paid to the position for any misalignment, blow dry after bathing and keep dry and clean. It is best to rest 1-2 days after surgery and try to walk less to prevent bleeding from post-operative activities; in addition to oral antibiotics after surgery, you can also take drugs to prevent erection and pain relief (such as hexestrol tablets 1mg three times a day to inhibit post-operative erection and reduce post-operative pain and wound dehiscence, but should not be used for a long time, generally taken until 3 days after surgery; Fenbid once a day to reduce post-operative pain); post-operative diet Try to eat light food, less spicy, stimulating food; generally change the medicine once after 3 days, twice a week; after surgery, try to think less or contact pornographic, obscene magazines, Internet pictures and videos, avoid causing penile erection to avoid wound collapse. The time of sexual life should be about one month after the wound is completely healed, and it is better to have loose and breathable underwear on weekdays, if there is serious edema or heavy bleeding, you should immediately go to the hospital for treatment.
25.Do I need to take an IV after circumcision?
Intravenous infusion therapy is commonly known as “drip”, which is a systemic medicine. After circumcision, you only need to keep dry and clean and take oral antibiotics to prevent infection, there is no need for infusion therapy.