In fact, I have wanted to write about pediatric circumcision for a long time. It seems that every summer there is a “circumcision season” in the pediatric surgical clinics of all hospitals, and the clinics are filled with parents who come to see their little boy’s foreskin, and the most frequently asked questions are about circumcision. As one parent said, they never used to pay attention to the foreskin of their little boy, but now almost every boy has a foreskin problem, and raising a boy is so troublesome! Thanks to the advertising campaigns of many hospitals (urology) male departments or many male hospitals, just like the “universal calcium supplement” in previous years, it seems that now the “universal circumcision”, so what is wrong with the little boys nowadays, why there is suddenly a circumcision problem? The problem? Should I be circumcised in the end? The foreskin occurs in the 8th week of embryonic life, and in the 16th week the foreskin develops to the front of the head of the penis, and the inner plate of the foreskin naturally adheres to the head of the penis,
This adhesion begins to separate at the 24th week of embryonic life. After birth, the adhesion between foreskin and penis head exists in most of the children, so newborns, infants and children with prepuce and foreskin are normal physiological phenomena, according to statistics, the foreskin of children before the age of 3 can be completely upturned only 0. 93%, and those who cannot be upturned account for 0. 93%.
According to statistics, only 0.93% of children before the age of 3 can have their foreskin completely turned up, and 64.09% cannot be turned up.
09%; if the foreskin can not be completely turned up to reveal the glans penis, it is called “prepuce”. With the development of children, generally after the age of 1 year old children will have an erection when holding urine or rising in the morning, this alternation of erection and atrophy is conducive to the expansion of the foreskin and the adhesion of the foreskin and penis head separation. It is generally believed that most foreskins can be turned up around the age of 3-5, but most cannot be completely turned up and still cover the head of the penis in its natural state, which is called “prepuce”. By puberty, most of the adhesions are absorbed and the penis suddenly grows,
Development faster than the foreskin, late puberty penis head revealed, foreskin retreat to the coronal sulcus, foreskin development is complete, the statistics is 11-18 years old completely flip 48. 33%, only 7. 66% can not flip.
Only 7. 66% cannot be upturned. The physiological function of the pediatric foreskin is not yet widely reported in the literature,
However, it is believed that the pediatric foreskin still has certain physiological functions: the head of the penis is developing, delicate and sensitive, and the foreskin wraps around the glans penis to avoid local friction and discomfort; moreover, the adhesion between the foreskin and the glans penis can prevent the local accumulation of urine and avoid the stimulation of the urethra and the head of the penis by ammonia in urine,
Thus, local ulcer formation can be avoided. The origin of circumcision is not exactly documented,
The earliest records of circumcision are found on 6000-year-old Egyptian mummies and reliefs discovered in the 19th century. It is thought that circumcision may have originated from castration, where the scalp, hands, and some of the body parts of captives were used as trophies in ancient times. There is also a theory that,
In the obscure tribal era, the main concern was to reproduce and strengthen the tribe,
Circumcision was considered to be the most effective way to improve fertility in both men and women (this is the main point of many hospitals’ propaganda, how backward and foolish it is). The development of circumcision has a lot of religious origins: Judaism stipulates that every Jewish baby boy should be circumcised with a stone knife by his family eight days after birth,
This is a sign of the covenant. Circumcision is an important part of Jewish life. Whenever a family circumcises a child, family and friends are invited to be present. Among Jews,
Circumcision is actually a sign of fulfilling the covenant with God, establishing Jewish identity, and entering into the marriage license. In Islamic rituals, the Arabic word “hetnai” is translated,
It is also known as “circumcision”. It refers to the ritual circumcision of the penis of a Muslim boy. According to a hadith transmitted by Aisha, the Prophet Muhammad considered that there are 10 events that belong to the human nature,
According to a hadith, the Prophet Muhammad believed that there were 10 things that belonged to human nature: cutting the moustache, circumcision, using a toothbrush, choking the nose, cutting the nails, washing the knuckles, plucking the armpits, shaving the pubic hair, saving water and rinsing the mouth. Muslims then observe circumcision as a “sunnah”. The Shariah requires circumcision of Muslim boys at the age of 7-8 or 12 years. Circumcision in Islam is a major life ritual. Circumcision is equivalent to Catholic and Christian baptism,
After circumcision, the young boy becomes a Muslim. When an Islamic boy is circumcised, the child’s family performs a solemn ceremony,
Neighbors and friends come to congratulate the boy. The circumcision was performed by an experienced religious person, with solemn prayers and a strict set of procedures. In the late 19th century, however, modern medicine gradually transformed circumcision from a religious ritual to a medical procedure, and it was rapidly developed as a health care procedure. At that time, it was believed that the tight wrapping of the foreskin around the glans could cause systemic diseases,
Once this pressure was relieved, some other symptoms could be relieved. Especially after the 20th century, research concluded that circumcision was effective in reducing the spread of AIDS, and doctors around the world believed that early circumcision would bring benefits. However, as the years progressed, more and more people began to oppose the procedure, and the debate has continued to this day. Should pediatric circumcision be performed and at what age? First of all, there are physiological adhesions between the glans of the penis and the foreskin in children, and most of them can be separated and absorbed without surgery during adolescence, and can heal themselves by turning over. Secondly, pediatric foreskin still has a certain physiological function, so premature surgery is not conducive to protecting the sensitive glans, increasing friction, and may even have an impact on the child’s sexual psyche, resulting in bad habits such as masturbation; there is also circumcision in infancy and early childhood,
Because of the need to separate more adhesions between the foreskin and the head of the penis, resulting in larger trauma, more postoperative secretions, covering the head of the penis to form a secretion crust, the appearance is very unsatisfactory,
The appearance is very unsatisfactory, causing mental stress to parents and even complications such as pathological adhesions and urethral stenosis. Therefore,
We believe that it is best not to perform circumcision before puberty, but after puberty (12-14 years old and above). Of course, in clinical work,
There are many children who need surgery, and the specific indications for surgery are as follows: after repeated expansion, the scar forms a fibrous stenosis ring at the outer foreskin; ‘recurrent glans penis prepuce; the above two are absolute indications. The rest ƒ after the age of 5 years, the foreskin mouth narrow, the foreskin can not retreat to reveal the glans need to grasp according to the specific circumstances and parental requirements. Of course, those with foreskin impaction need emergency surgery. If a pediatric prepuce is not operated on, does it not need to be treated? We believe that for prepuce in infancy (before the age of 3-5), if there are no symptoms such as difficulty in urination or foreskin infection, most of them do not need to be treated. For children over 4-5 years old, if there is glans penis or foreskin scale, you can use surface anesthetic ointment to apply, try gentle upturning to clean the foreskin scale, and then reset it. Most children can be cured after such treatment, as long as they can ensure upturning with consultation, as they grow older, without affecting the foreskin upturning and forming after puberty. In summary, pediatric foreskin is not as some bad media propaganda, all need surgery, and is required according to the age of the child, parental requirements, the need for specific analysis of the treatment, not a one-size-fits-all! Otherwise it will bring endless troubles and pain!