Circumcision, prostatitis, sexual dysfunction, and infertility are common diseases in urological male clinics. Through the experience of seeing the clinic, the author found that there are certain misconceptions and blind spots about each disease in the country. The author has always wanted to help these patients by explaining them, but it is difficult to do so in practice because of the workload, differences in the educational level of patients, and differences in the trust between doctors and patients.
In ancient times, the foreskin had the role of protecting the head of the penis, but as evolution evolved, the foreskin became redundant and harmful. According to statistics, an average of 25 men are circumcised every minute in the world today. About 1.2 million newborns are circumcised each year in the United States, and the numbers are increasing. In the Middle East about 100,000 Jews and 10 million Muslims are circumcised each year, and in Africa about 9 million each year. Talking with physicians in the Yili region of Xinjiang, China, we found that most of the local population had been circumcised by age 9. Of course, there are significant cultural differences between the Han Chinese regions of China and these regions. However, the significance of performing circumcision should be more than just because of the vastly different cultures.
Currently, the WHO calls for the primary importance of circumcision to be HIV prevention. Because the inner plate of the foreskin is the gateway to HIV, it contains immune cells that become “Trojan horses” once infected with HIV. Foreign studies have shown that circumcision can reduce the risk of HIV infection by about 56C75%. The protection is even better if condoms are used in combination with circumcision.
A long foreskin makes the coronal sulcus of the penis an excellent “hiding place” for pathogenic bacteria, and the foreskin secretion in the coronal sulcus is also a good “breeding ground” for pathogenic bacteria. Therefore, circumcision can facilitate the growth of pathogens such as syphilis spirochetes and herpes simplex virus type II. Repeated glans penis, urinary tract infection, vaginitis, cervical cancer, mycoplasma infection, chlamydia infection are closely related to male circumcision, and circumcision is also associated with penile cancer and prostate cancer as we age.
Currently, 80% of outpatients are circumcised because of glansitis, but there are still a large number of patients who believe that there is no harm in keeping it clean. In fact, there are definitely benefits to keeping clean, but this only treats the symptoms, not the root cause, and cleaning is less effective in protecting against some pathogenic infections. In terms of protection against disease, circumcision can be a once-and-for-all solution.
In other cases, if the prepuce is still present during adolescence, it may affect penile development and require circumcision. In adults, circumcision may also delay ejaculation and improve sexual life because it reduces the sensitivity of the penis head. Finally, circumcision is also early. The author has seen patients with long-term circumcision, where the head of the penis is severely adhered to the inner plate of the foreskin, which cannot be peeled off surgically and seriously affects the appearance after surgery, and such patients are at high risk of penile cancer.
The author has already discussed prostatitis in the previous article. The main symptoms of chronic prostatitis include discomfort in urination, frequent urination, incomplete urination and “white drip” after defecation and urination, as well as some digestive symptoms of change in bowel habits are not uncommon, such as frequent exhaustion and thinning of stool.
The pathogens that cause prostatitis include bacteria, fungi, mycoplasma, chlamydia, virus and so on. Therefore impure sex, excessive intercourse/masturbation, and circumcision are all important factors.
The course of treatment for prostatitis should be at least 4-12 weeks, and the treatment should be symptomatic and comprehensive. Patients should also communicate with their treating physician at the appropriate time during treatment, and the frequency should be once a week.