What is non-surgical minimally invasive treatment for pediatric circumcision disorders?

       The incidence of foreskin disorders among students is as high as 28-89%, with the incidence of foreskin adhesions at the age of 6-8 being about 21.2%, at the age of 9-11 being about 16.4%, and at the age of 12-14 being about 11.8%. When the inner plate of foreskin is adhered, the glans cannot be exposed, which hinders the normal development of the penis.  The local secretion formed by the foreskin scale can not be discharged, because of local stimulation often cause penile erection, urethral redness, frequent urination, urinary tract infection and other complications, long-term stimulation may induce penile cancer.  With the gradual understanding of foreskin development pattern and foreskin function, more and more clinical attention has been paid to the non-surgical treatment of foreskin adhesions. The recurrence of some cases is due to the incomplete separation of adhesions and edema or the child’s lack of cooperation. Therefore, complete anesthesia, thorough stripping and convenient postoperative care are the keys to improve the cure rate of non-surgical treatment.  At present, most of the domestic circumcision separation does not apply anesthesia. For lighter adhesions and older patients, they can still tolerate the pain of separation, but after surgery, local edema is often obvious, and the child’s fear is heavy and it is difficult to continue to cooperate with treatment, resulting in foreskin inlay or recurrence of adhesions.  In such cases, some people in China use surface anesthesia (lidocaine, cocaine or (and) bupivacaine, sometimes in combination with paraffin oil), and the more commonly used abroad is EMLA gel, and even the application of penile root block anesthesia, epidural anesthesia or intravenous general anesthesia.  Lidocaine gum paste is now widely used in painless gastroscopy, abortion and otorhinolaryngology surgery. Its scientificity, safety and practicality have been clinically proven. At present, it has been successfully carried out in our department without 1 complication.