Circumcision, called circumcision in Western and Muslim countries, is the most common and simplest minor surgery in urology and male medicine. Its purpose is to remove an excessively long part of the inner and outer plates of the foreskin to reveal the glans, which is good for urination, for keeping the glans locally clean, for sexual life after marriage, and for the reproductive health of the sexual partner.
History of circumcision
Circumcision rituals have been practiced in West Africa for more than five thousand years. It has also been practiced in the Middle East for at least 3,000 years. On the tomb murals of the Ankhmahor pharaohs in Ancient Egypt in 2300 B.C., there are paintings of early men being forced to be circumcised to voluntarily accepting it and the evolution of circumcision tools from bone knives to iron knives. Jesus was born on December 25, 0001 A.D. and was circumcised (circumcised) on the 8th day of his life (January 1). Muhammad, the Messenger of God in Islam, was circumcised at birth. Circumcision was mandatory for boys in Islamic countries and became an Islamic institution of life for all Muslims. circumcision was used to represent a medical culture in the United States and Canada in the late 19th and early 20th centuries. By the early 1970s, about 40 percent of newborns in Canada and 80 percent in the United States were circumcised. Currently, about one quarter of men worldwide are circumcised, mostly in the United States, Canada, Islamic countries in the Middle East and Asia, and most African countries. Routine neonatal circumcision has become the norm in the United States, Canada, Australia and other countries; in Korea, circumcision is routinely performed at puberty, and the rate of circumcision is high in some developed countries, with the United States topping the list of developed countries with 84% to 89% circumcision. In Asia, Korea has the highest circumcision rate, close to that of the United States, at about 84%.
Benefits of circumcision
Circumcision is medically considered to be a routine procedure beneficial for sexual physiological hygiene and disease prevention. Circumcision can provide lifelong medical benefits. Circumcision can be beneficial to both the man himself and his married partner.
For the male.
(1) Eliminate the risk of circumcision; as the foreskin wraps around the glans for a long time, the humidity and temperature inside the foreskin increase, bacteria can easily grow and multiply and inflammation can occur, and over time, adhesions of the foreskin and glans can form (adhesive prepuce) and the formation of foreskin scale.
(2) Three-fold reduction in the risk of skin infection of the penis.
(3) A tenfold reduction in the risk of urinary tract infections in infants and children
(4) a more than twenty-fold reduction in the risk of developing penile cancer
(5) a twofold reduction in the risk of prostate cancer
(6) a 60 percent reduction in the chance of contracting HIV through sexual intercourse
(7) Substantial protection against other sexually transmitted diseases, such as papillomavirus, syphilis, and soft chancre, as well
(8) Sexual function is as good or better than that of uncircumcised individuals.
(9) Circumcision of soldiers in the military helps with combat effectiveness.
For women.
(1) Decreased incidence of vaginal infections with anaerobic bacteria, gram-negative bacilli, streptococci and mycoplasma, and a significant reduction in bacterial vaginal syndrome.
(2) a five-fold reduction in the risk of cervical cancer caused by human papillomavirus and chlamydia infection in female sexual partners
(3) Most women prefer the appearance of the circumcised penis and are more willing to engage in sexual activity with it.
Risks of Circumcision
Although circumcision is the simplest of minor procedures, there are some risks if it is not performed properly. A 1989 survey by the American Academy of Pediatrics reported that the incidence of post-circumcision comorbidities was about 0.2% to 0.6%, the most common being bleeding and local infection. It was reported that
(1) Mild bleeding may occur in one out of 500 circumcisions. This bleeding can be stopped by applying pressure and occasionally requires suturing or reoperation (1/1000). The need for antibiotics due to infection is approximately 1/4000, although local infection can occur and is likely to be part of the normal healing process.
(2) Serious complications requiring hospitalization due to circumcision are rare, about 1/5000.
(3) There have been no reports of penile amputation or death due to circumcision performed by regular physicians.
Method of circumcision
During the surgery, the inner and outer plates of the excess foreskin of the penis are cut off – hemostasis – suturing the skin edge, and the sutures are removed in a week or so, or the absorbable sutures fall off automatically or are absorbed, which is the classical circumcision surgery. The surgical methods are hemostatic forceps method, cuff excision method, dorsal cut method, etc. All the above operations require the operator to master certain surgical techniques. The methods of hemostasis during surgery are ligation hemostasis, electrocoagulation hemostasis, laser knife hemostasis, etc. Wire ligation hemostasis can lead to painful nodules because of its non-absorption. Electrocoagulation or laser knife hemostasis can lead to occlusion of capillaries around the hemostasis and affect the local skin healing. With the advancement and innovation of human technology, circumcision devices were invented, which are divided into multiple reuse circumcision devices and disposable circumcision devices. There is a risk of cross-infection with multiple reuse circumcision devices. Among the disposable circumcisers there are products from Korea, Malaysia, Germany and China. Under local anesthesia, the inner and outer rings of the circumciser are placed between the inner and outer plates of the foreskin to be removed, and mechanical force is used to gradually allow the foreskin tissue between the two rings to heal while ischemia and necrosis, without damaging the foreskin tie, no bleeding, no sutures, short operation time, no antibiotics, shower during the ring, few postoperative complications, and circumcision can be completed in about a week. The scab will fall off in 10-14 days after surgery, and the incision will heal in a linear fashion, which is very beautiful. The disposable circumcision device is in line with the principle of minimally invasive surgery, disposable use avoids cross-infection, and can be suitable for young children, adults and the elderly.