Medical circumcision: pros and cons of the procedure
Circumcision of the foreskin is an operation that has long been widely practiced among representatives of many nations: Jews, Egyptians, Palestinians, tribes of Africa, Australia, Indians of Central and South America and others. If in antiquity, it was mostly a religious custom or dedication to men, now it can be used not only in this capacity, but also to eliminate anatomical defects.
What is circumcision?
Circumcision or circumcision is a surgical procedure that involves removing the foreskin (prepucium, preputial sac) on the head of the penis from a male.
This procedure is carried out due to various reasons, namely:
- religious (currently used among Muslims and Jews);
- social (as a rite within a social group or community);
- medical (in the presence of congenital or acquired disorders of the structure of the genitals);
- national (to confirm the relationship to a particular people, culture).
Circumcision of the foreskin is performed on men of all ages.
Pros and cons of circumcision
The main arguments for positive effects after surgical excision are as follows:
- Elimination and prevention of infectious and inflammatory processes in the urinary tract (balanitis, balanoposthitis, cystitis, pyelonephritis). It is explained by technically simpler adherence to the rules of cleanliness and hygiene, the lack of smegma compared to uncircumcised men.
- Elimination of urination difficulties. Pathology occurs when the foreskin hangs over the urethra.
- Reducing the likelihood of cancer of the penis (with a direct relationship between low risk and early patient age).
- Reducing the risk of HIV infection, human papillomavirus, syphilis, genital herpes and other sexually transmitted diseases.
- Increase the duration of sexual intercourse.
Among the disadvantages of the method are a number of the following potential complications:
- pronounced pain syndrome;
- danger of profuse bleeding;
- traumatic injury to the glans penis and / or urinary canal during an intervention;
- penile deformity;
- infectious inflammation of the postoperative wound in case of non-compliance with the rules of asepsis and antiseptics;
- subsequent disturbances in sexual activity (loss of penis sensitivity);
- formation of hypertrophic scar.
Medically circumcised
In some cases, most often in children, circumcision of the foreskin is required in order to correct various congenital developmental abnormalities.
Strictly medical indications for the procedure are:
- congenital pathological phimosis in boys (a condition in which the process of moving away the foreskin and the exposure of the head is impossible or partially carried out);
- acquired phimosis due to trauma, prolonged action of antiseptic solutions, forced exposure of the head;
- paraphimosis - a condition in which the head of the penis is injured as a result of compression by an overly narrow preputial bag;
- frequent recurrent infections of the head and foreskin;
- violation of the urethra;
- premature ejaculation.
According to most researchers, it is inappropriate for a boy to have an operation for up to
Intervention on excision of the foreskin is not indicated for acute inflammatory lesions and ulcerations of the external genital organs, cancer, decompensated chronic diseases, blood diseases (hemophilia, idiopathic thrombocytopenic purpura), mental disorders, convulsive syndromes in history (epilepsy)
Excision of the foreskin and postoperative care
Depending on the goal, there are several types of circumcision. The basis of the separation is the amount of tissue that must be removed.
Minimum circumcision
This type of operation involves the excision of only a small part of the foreskin. At the same time, the main structure and its functional abilities are preserved. Visually, the penis is practically unchanged, and the traces of the operation are securely hidden in the skin folds.
The minimum type of circumcision is indicated when there are medical problems:
- excessive development of the foreskin;
- the presence of cicatricial lesions, narrowing of the ring prepucium.
The disadvantage of the procedure is the possibility of re-formation of a ring of scar tissue.
Partial circumcision
With partial circumcision, excision of the foreskin is performed in a slightly larger volume than with the previous procedure. However, the head remains partially covered, the external opening of the urethra becomes open. However, the skin fold around the coronary sulcus is still less along the circumference than the head itself.
The operation is also used to correct anatomical defects and is not recognized according to religious traditions.
Free circumcision
With a free (non-circular) circumcision, two-thirds of the foreskin is excised, with the result that the head becomes completely open. Sometimes, mainly with small penis sizes, it can remain covered in the area of the coronary sulcus.
This type is most common and is suitable for any purpose, including religious, social, hygienic, etc.
Extremely rare type of operation - tight circumcision - is performed only at the personal desire of the patient or in case of severe malformations. When it is removed, both the inner and outer layer of the foreskin in full. The disadvantage of the method is the excessive tightening of the skin of the penis during erection, being a source of unpleasant and even painful sensations. As a result, visually the penis may look smaller than its true size.
Before any of the above procedures, the patient undergoes standard blood tests (general, biochemical, blood clotting, viral hepatitis, syphilis, HIV infection), urine, and undergoes an instrumental examination (chest X-ray or chest x-ray, electrocardiogram). Mandatory consultation of the therapist, urologist and surgeon.
All three types of surgery are performed under local anesthesia. The surgical field is treated with antiseptic solutions. The only painful moment for the entire operation is the injection of anesthetic into the base of the penis. Then a circular (circular) incision is made around the head, the tissues of the foreskin are excreted and excised. Bleeding vessels coagulate.
During the procedure, the surgeon necessarily takes into account the need to maintain a few millimeters of the inner part of the foreskin, in order to avoid excessive skin tension during erection in the future. According to the testimony, the manipulation is accompanied by plastic surgery on the frenum of the penis. Stitches are made of durable non-absorbable material. The postoperative wound is closed with a sterile dressing and additionally fixed to the patient’s body. The whole procedure takes
In clinics with modern high-quality equipment, it is possible to remove a preputial sac with a laser or special electric knife. They are distinguished by low invasiveness, faster healing, a good cosmetological effect, and the absence of the possibility of bleeding.
Surgery to circumcise the foreskin should be carried out only with the full consent of the patient or, in the case of a minority, his parents. The operated man should be familiar with all the shortcomings and possible consequences.
Postoperative care
Surgical excision of the foreskin is an outpatient procedure and does not require hospitalization. On the day of surgery, the patient goes home. On the following day, it is recommended to visit your attending physician to monitor the correctness of healing and the presence / absence of complications.
The stitches are removed for
Among the main recommendations in the postoperative period are the following:
- regular dressing change, at least once a day;
- avoidance of thermal procedures, hypothermia, heavy physical exertion;
- temporary cancellation of sports activities;
- sexual rest for 2-3 weeks (prevention of seam divergence);
- wearing loose linen made of natural cotton fabric;
- on the 3-4th day it is allowed to wash the penis with caution with warm soapy water;
- the use of ointments containing antibacterial drugs, or accelerating the regeneration of the wound as prescribed by a doctor.
If a man is worried about pronounced pain syndrome, the doctor prescribes painkillers (analgesics, nonsteroidal anti-inflammatory drugs).
In the event of redness in the postoperative wound, swelling or severe pain should immediately consult a specialist because of the possible development of infectious complications.
In addition to infections, after surgery, bleeding may open, pain and tactile sensitivity of the penis skin may be disturbed, and external defects may appear, requiring repeated surgery.
