This summer, undergoing circumcision surgery seems to have become a trendy operation. To cut? Or not to cut? Today, our hospital will systematically introduce “All about Circumcision”.
1. Is the foreskin useful?
The foreskin refers to the layer of skin that covers the glans at the front end of the penis. It is like a premium leather jacket for the little fellow, tailored to fit closely, with excellent flexibility.
– The foreskin contains a large number of tactile sensory cells, making it a sensitive area;
– The foreskin protects the little fellow from harm and helps to maintain its softness, moisture, and good sensitivity;
– The gland in the foreskin secretes proteins that combat bacteria and viruses, serving as a line of defense for the body’s immune system.
2. What type of foreskin does my child have?
There are three types of foreskin.
– Normal foreskin: well-developed, no intervention needed;
– Foreskin too long: if the foreskin completely covers the urethral opening and the glans, but can be easily pulled back to fully expose the “glans,” it is considered too long;
– Phimosis: not only is the foreskin long, but it also tightly constricts the “glans” and cannot be pulled back even after manual manipulation, indicating phimosis.
In simple terms, if it can be pulled back, it is considered too long; if it cannot, it is phimosis. Having a foreskin that is too long may lead to the accumulation of smegma, causing inflammation, urinary tract infections, etc. However, having a foreskin that is too long does not necessarily mean circumcision is required.
(Image source: Internet)
3. What are the dangers of phimosis?
– Difficulty urinating: the narrow foreskin opening can cause slow urination or difficulty urinating, which may eventually affect bladder and kidney function;
– Increased risk of infection: the inability to clean smegma in a timely manner can lead to conditions like balanitis and urinary tract infections;
– Increased risk of tumors: prolonged irritation from smegma can increase the likelihood of penile tumors;
– Risk of paraphimosis: in children with phimosis, after the foreskin is pulled back to expose the “glans,” the narrow foreskin opening can easily constrict around the little fellow, leading to trapped foreskin and possible ischemia or necrosis of the “glans.”
4. Do all cases of phimosis require circumcision?
The answer is: not necessarily.
Most newborn male babies are born with phimosis, which is considered a normal physiological phenomenon and is known as physiological phimosis. With age and development, the foreskin will naturally retract, gradually loosening the foreskin opening to expose the “glans.” Typically, by the age of 3-4, about 90% of children can retract their foreskin. If a child is 3-4 years old and still cannot retract the foreskin and does not experience difficulty urinating, foreskin infections, etc., there is no need for treatment. As the child grows older, phimosis may resolve naturally. If there is a desire to retract the child’s foreskin earlier, under the guidance of a pediatric surgeon, gentle retraction during bathing can be done to clean the area effectively. It is recommended to apply a topical corticosteroid cream at the narrow foreskin opening (such as mometasone furoate cream, twice daily, for 3 weeks) or as directed by a doctor. While gentle retraction is effective, it is crucial to remember to retract only as much as is comfortable. Forcing retraction can lead to pain and potential damage, tears, or scarring of the foreskin. Besides avoiding forceful retraction, it is essential to return the foreskin to its original position after cleaning. Retracting the foreskin for cleaning purposes should be followed by repositioning to avoid complications like lymphedema and paraphimosis. Overall, with proper medication, gentle retraction, and gradual progress, the foreskin will eventually fully retract.
5. Which cases of foreskin require circumcision?
– True phimosis: severe narrowing of the foreskin opening, with the possibility of developing cicatricial phimosis;
– Recurrent paraphimosis: after the foreskin is retracted, a narrow, constricted opening forms a tight ring that tightly encircles the “little fellow.” This situation requires prompt medical attention, as improper handling can lead to necrosis of the “little fellow”;
– Foreskin too long and difficult to clean, leading to recurrent balanoposthitis and urinary tract infections.
6. When is the best time to have a circumcision?
Age is not the key factor; do not believe advertising claims that early circumcision is better! Regardless of age, if there are indications for surgery, it can be performed. However, the level of cooperation from children of different ages varies. In the absence of symptoms, domestic guidelines often recommend waiting until the child is around five to six years old before considering surgery. In general, if the child has simple foreskin lengthening and the foreskin can be easily retracted, surgery is not urgent. Most cases improve as the child grows and the foreskin lengthening issue resolves. In adolescence, if long foreskin persists, local anesthesia can still be used to perform surgery. For cases of phimosis, initial treatment with topical corticosteroid cream and gentle retraction may be attempted. If there is no improvement, surgical intervention can be considered.
7. How long does it take to recover after circumcision?
After surgical treatment, a period of rest is necessary. Around five days after surgery, the dressing covering the wound is removed. Nowadays, absorbable sutures are often used, eliminating the need for suture removal in most cases. Recovery typically takes around 14 days. If a circumcision device is used, the device will typically fall off on its own after about a month. However, the exact timeline varies from person to person, so it is important to follow the doctor’s instructions.
8. Will the “little fellow” grow longer after circumcision?
There is no evidence to suggest that circumcision leads to increased length, girth, or improved sexual performance of the “little fellow.” In fact, if too much foreskin is inadvertently removed, it could result in a tighter skin causing a reduction in size.
9. Can a simple circumcision procedure be performed on a concealed penis?
The answer is: no.
If the “little fellow” is of insufficient length and the owner is overweight, it may be a case of concealed or buried penis. In such situations, circumcision should not be performed without appropriate evaluation. Alternative interventions should be sought, and the case must be assessed by a specialist in pediatric surgery.
