The exact origin of circumcision is not known, but it has been around in many parts of the world for at least 4,000 years. Circumcision is culturally practiced by the Egyptians, Jews, Edomites, Ammonites and Moabites in the Book of Jeremiah, and the local people take circumcision very seriously, and they often see it as one of the more important and celebrated events in their lives. For Jews and Muslims, circumcision has significant religious significance; while in some countries and regions, circumcision is a sign of a boy’s adulthood; in some families in the United States, circumcision is simply done so that the child looks the same as his circumcised father and brother ……
Some studies suggest that circumcised boys are less likely to have urinary tract infections; circumcised adult men are also relatively less likely to have sexually transmitted diseases such as HIV and less risk of penile cancer; and for women, their sexual partners are less likely to have cervical cancer if they are circumcised …… But there really isn’t enough medical evidence to suggest that every man has to be circumcised.
From a medical standpoint, circumcision of newborns is not routinely recommended. Almost 100 percent of newborn male babies are circumcised (physiologically circumcised). As the baby grows, the foreskin will gradually separate from the head of the penis, a process that takes about three years or more, so circumcision is generally not recommended before the age of three. Also, urinary tract infections generally rarely occur in male babies under the age of one. If an infant has hypospadias, it is even less likely that the foreskin will be removed after birth, as repair of hypospadias requires the use of the foreskin. Besides, caring for a circumcised penis during the neonatal period is always more tedious and difficult than caring for an uncircumcised one.
The actual foreskin is cut or not cut, not depending on the age and symptoms. Some boys before puberty, despite the obvious circumcision or circumcision, but there are no frequent clinical symptoms such as glansitis, urinary tract infections, etc. With the onset of puberty, the penis develops rapidly, the development and growth of the penis body and head exceeds the growth of the foreskin, the penis is often erect, but also the relative narrowing of the distal foreskin plays an expanding role, so that it naturally develops into a mature type of penis. However, you may need to discuss with your family and doctor about circumcision for your child when there are
1. Recurrent glans penis infections are associated with overcircumcision or circumcision, which is characterized by redness, swelling and pain at the foreskin or foreskin margin;
2, recurring urinary tract infections and circumcision or circumcision related, mainly manifested as frequent urination, urinary urgency or with urinary pain;
3. Difficulty in urination related to prepuce or prepuce, mainly manifested as difficulty in urination, bulging of foreskin in the shape of “bubbles” when urinating.
Warm tip: Parents must take their children to the urology department or male department of a regular hospital for consultation with a specialist. There is a clear genetic tendency for circumcision or prepuce, and for the critical state of prepuce before puberty, you can refer to the child’s father’s circumcision to consider whether surgery is needed.
I. Criteria for circumcision
Circumcision refers to a man’s adult life, the penis skin wrapped glans, so that the glans can not be completely exposed. This can be divided into true circumcision and pseudo-circumcision. True circumcision is the penis erection after the glans can not be fully exposed; pseudo-circumcision is usually the glans can not be fully exposed, but after the penis erection glans can be fully exposed. The foreskin is completely wrapped around the glans and the glans cannot be exposed at any time.
Second, what are the possible adverse effects of circumcision
1, may be easy to “premature ejaculation”
The most common case is when the foreskin normally covers the glans, but the glans is exposed during erection. As the glans is usually hidden under the foreskin, the friction and stimulation is less, making the nerve sensation of the glans too sensitive, when sex, the glans is exposed after erection, when the glans and vaginal friction and stimulation will trigger premature ejaculation due to the over-sensitive glans nerve, premature ejaculation caused by prepuce is generally preferred to progressive delay training method treatment, if necessary, can be combined with drug therapy.
2, may lead to “no ejaculation”
In contrast to the causes of premature ejaculation caused by circumcision, non-ejaculation may often be caused by circumcision. In this case, because the glans is excessively protected by the skin, the function of the glans rich in nerve conduction sexual stimulation and stimulation of sexual excitement disappears, and the intensity of stimulation required to stimulate ejaculation is not reached during sex, so it is easy to not ejaculate.
3, may affect the glans development
In some patients with prepuce, if there are repeated urethral infections, it is easy to cause adhesion of the foreskin and glans mucosa, affecting the normal development of the glans, and in serious cases, glans deformity may occur.
4, may affect female pregnancy
If the circumcision is left untreated for a long time, it will not only easily bring harm to men’s health, but also affect women’s health, such as causing pelvic inflammatory disease and cervical disease in women, thus reducing the chances of pregnancy.
Third, who should be circumcised
The indications for circumcision include long foreskin, recurrent circumcision, tightly adhered prepuce, narrow foreskin opening and foreskin cyst. In particular, patients with recurrent inflammation of the foreskin, foreskin cysts and tightly adherent prepuce with foreskin stenosis should be treated with early surgery regardless of their age.
Four, the type of circumcision
Circumcision is one of the most common surgeries in urology. The common surgical methods are traditional circumcision, cutter circumcision, ligature ring excision, etc. The advantages of circumcision are neatly cut edges, minimal bleeding, and fast healing; several surgical methods have their advantages and disadvantages, and as long as the doctor performing the surgery is skilled, which method can be used.
V. Pre-operative preparation for circumcision
1. Examination. Generally speaking, circumcision (foreskin can not be turned up), tight foreskin mouth, recurring circumcision, affect sexual life need timely surgery. Children before puberty (11-13 years old) do not need premature surgery as long as it does not prevent urination. However, if it is clear that the foreskin is affecting urination and development, surgery should be performed in a timely manner.
2.Select the surgery method. The most commonly used circumcision procedures are circumcision and anastomotic circumcision.
3. Make an appointment for surgery and laboratory tests. General circumcision requires an appointment in advance, which should be decided according to your schedule (such as using summer and winter vacations, golden weeks or long holidays). It is required to make preoperative safety tests such as coagulation, blood transfusion and blood routine, liver function, kidney function, chest X-ray and electrocardiogram.
4.Take a leave of absence. After circumcision, you have to rest at home for 1 to 2 days and limit your activities, which needs to be arranged before surgery.
5.Preparation of skin. Pre-operative shaving of the pubic hair is required in advance.
6.Psychological preparation. Circumcision is generally an outpatient procedure with local anesthesia, and the pain is not obvious. Individuals may feel more pain. Most of the post-operative pain is not obvious, and generally do not need to use painkillers.
7. Cost. The country has clear regulations on circumcision fees (including surgery, laboratory fees and medicine), so you can rest assured that you will be treated.
8, transportation. It is best to take a car or taxi, avoid riding a bicycle or driving.
9, follow-up. After the surgery, you need to take medication on time, timely follow-up medication changes, and observe the wound healing.
Six, circumcision after precautions
1, under normal circumstances, after surgery in the operating room rest area observation half an hour, if there is no special discomfort, that can leave the hospital. Avoid standing and sitting for a long time after going home to avoid swelling of the penis head and poor wound healing due to poor local blood circulation.
2. Postoperative incisional bleeding: It is most common 24 hours after surgery. If the bleeding is not large, for example, the bleeding only stains part of the gauze, it can be treated without special treatment and can often stop bleeding by itself. If more bleeding from the incision occurs, or if fresh blood is found to drip out from the gauze, you should go to the hospital as soon as possible.
3. Sexual stimulation and holding urine should be avoided within one week after surgery to avoid erection, incision cracking, bleeding and infection, and sexual life is prohibited within 40 days after surgery. If an erection occurs, you should take deep breaths, relax and divert your attention. But experts suggest that the wound will heal in different times depending on individual circumstances.
4, due to the good blood supply to the penis, the ability to resist infection is relatively strong, ordinary circumcision after the general oral antibiotics for three days can be. Dressings are changed on the third and fifth day after regular surgery.
5.After surgery, it is advisable to wear loose, breathable, cotton underwear to reduce the friction of the penis head.
6.Within 2 weeks after surgery, avoid alcohol and spicy and stimulating food.
7, the wound heals in about a week, but after healing, such as strenuous exercise or trauma may still be cracked. After circumcision sutures generally do not need to be removed, sutures will automatically fall off in about 4 weeks after surgery, such as sutures at the redness and swelling oozing or more than 4 weeks still not fall off can go to the hospital to review the removal of sutures.
8. Mild edema of the glans within 3 to 4 days after surgery is a normal phenomenon, which is due to local inflammatory edema and requires no special treatment.
9, surgery generally does not affect urination, some of the younger children due to penile pain reluctance to urinate, should be comforted or urged to urinate; postoperative wound healing before urination to avoid wetting the gauze dressing, disposable paper cups available to go to the bottom after covering the local protection of the vulva, urination before the body tilt (or bend forward), so that the urethral orifice facing down, to reduce urine soaked dressing, urination ends with paper towels to wipe the urethral opening urine, to avoid urine soaking the dressing. Due to postoperative wound pressure dressing, postoperative urinary disorder, urinary bifurcation, urinary dripping phenomenon is normal and can be relieved after postoperative medication change. Those who really cannot urinate need to return to the hospital for treatment.