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What you need to know about circumcision( circumcision)?

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In urological practice, circumcision is considered almost the most common operation on the male penis. According to medical statistics, circumcision is considered a worldwide trend: thus, about half of all men in Canada underwent circumcision. In the US, this number is even higher and reaches 80%.Traditionally, Israel and the Muslim countries are leaders( there are no reliable data on the Russian Federation and the CIS countries).Accordingly, the primary role is played not by religious but by other causes. In what cases do they resort to surgical intervention and why do circumcision at all? Circumcision in men

Contents

  • 1 What is circumcision?
  • 2 Indications for
  • 3 The use and harm of circumcision
  • 4 Preparation for intervention
  • 5 Technique for conducting
  • 6 Post-operative care
  • 7 Probable complications
  • 8 Contraindications
  • 9 Frequently asked questions
    • 9.1 Circumstances: pros and cons
    • 9.2 Do I have to do with phimosis?
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    • 9.3 Does the head bruise after? Does
    • 9.4 cause an erectile dysfunction?
    • 9.5 Is there a scar?
    • 9.6 When can sexual activity be renewed?
    • 9.7 Does the risk of infection increase?
    • 9.8 Does the risk of cancer increase? Is it true that the penis is getting smaller?

What is circumcision?

Circumcision is an operation for the partial or complete excision and removal of the prepuce. The question of the necessity of carrying out this surgical manipulation is very extensive. So, most often it is used to solve the following problems:

  • Elimination of health problems. In some diseases, alternatives to circumcision simply do not exist.
  • Identification of belonging to a social group( Jewish ethnos, etc.).
  • Legend of the Religious Worldview.
The described manipulation is considered a relatively easy intervention, therefore it is conducted on an outpatient basis under local anesthesia.

Indications for

If you do not take into account religious and other socially-determined factors, circumcision is in most cases carried out for purely medical reasons. Among the diseases:

  • Phimosis. He accounts for almost half of all clinical cases requiring surgery. Phimosis is understood as a condition in which a man is unable to expose the glans penis due to the lack of elasticity of the prepuce. In medical science, four stages of the disease are distinguished. On the first head is exposed even in a state of erection, but with some discomfort. The second involves the possibility of opening the anatomical structure with only great effort, but it is still possible. On the third head is not exposed, even with a non-erect penis. The fourth one implies the fusion of the flesh with the head and the occurrence of problems with urination, when urine comes out drop by drop. The first two stages are considered relative indications for surgical intervention. The third and fourth stages are absolute. In conditions of developed phimosis sex life becomes impossible, as well as normal conception. In addition, there is a risk of head injury, followed by the formation of paraphimosis and gangrene of the penis. This is extremely dangerous.
  • Papillomatosis. The human papillomavirus manifests itself extremely variably. Genital warts occur most often in the male genital area. They have a high oncogenic potential and are often malignant, that is, they turn into malignant cells. Papillomas are localized in hard-to-reach places: the head suffers. The formations radially cover the base of the head, forming a kind of similarity to the crown. To access tumorous structures, circumcision is required. Especially the process is complicated if there is a history of phimosis in the advanced stages.
  • Full or partial rupture of the bridle. Short bridle. All these conditions presuppose excision of the prepuce with the subsequent plasty of this epithelial tissue flap. Circumcision is performed to prevent further trauma and easier access to the anatomical structure.
  • The operation can be performed for preventive purposes. For example, to prevent premature ejaculation. After the intervention, the tissues of the head are coarsened, the receptors become less sensitive.
  • Paraphimosis. Infringement of the glans penis. The basis for immediate operation. In this case, every minute counts.
  • Inflammatory diseases of the penis.
The list of indications is incomplete. In all doubtful cases, the urologist has every right to recommend to the patient the conduct of circumcision.

The use and harm of circumcision

The average person without any special medical knowledge does not understand very well what the benefits and disadvantages of circumcision are.

Pros :

  • The appearance of the opportunity to lead a full sexual life( in the advanced stages of phimosis).
  • Facilitating personal hygiene.
  • Prevention of penile cancer.

Cons .In fact, it is only one: a decrease in the sensitivity of the glans penis. As a result, the duration of sexual intercourse increases, but satisfaction from intimate contact is much less.

Preparation for intervention

Preparation is typical for any intervention on the external genitalia. First of all, you need to see a surgeon-urologist. The doctor will conduct a primary examination of the genitals, determine the nature of the upcoming intervention, its scope. After that, an anamnesis is collected. Some diseases can significantly affect the technique of anesthesia and surgical intervention( for example, if there is an allergy to lidocaine, anesthesia with another drug is indicated).

The next stage is the conduct of laboratory tests:

  • of a general blood test. Any actively active inflammatory processes make the operation impossible. Typical signs of inflammation: leukocytosis, increased ESR( ESR).
  • General analysis of urine. It is also performed to detect infectious and inflammatory lesions of urinary structures. Typical indicators of malfunctions with the excretory system are: leukocytosis, proteinuria, hematuria, etc.
In all described cases, treatment of primary inflammatory pathology is indicated. Only then can we talk about circumcision.

Further it is necessary: ​​

  • Conduct a blood clotting test.
  • Take a smear from the urethra to determine the presence or absence of pathogens of sexually transmitted infections.
  • Undergo a biochemical blood test.

The specified activities are sufficient for preparation. In general, we are talking about low-traumatic and relatively easy intervention. Psychological preparation of the patient plays an important role. The doctor is obliged to tell the person about the forthcoming operation, its duration, technique, probable sensations.

Technique for carrying out

Circumcision - the course of the operation

Circumvention technique

It would be more correct to talk about techniques. There are several intervention options:

  • Low intervention. Assumes removal of the lower and inner part of the prepuce. The postoperative suture is localized in the region of the coronal sulcus.
  • High circumcision. It involves the removal of most of the prepuce with the formation of a clear radial suture.
  • Full circumcision. She's tight. Assumes a complete total removal of the foreskin. It is most often performed with papillomatosis, severe forms of phimosis. The most radical intervention.
  • Partial circumcision. The most gentle method of intervention. During the operation, only a part of the prepuce is excised. The head is partially bare. However, this method is not always justified: it is effective only for mild forms of phimosis without adhesions.

Other operations are variations of the described techniques. Classical is considered complete circumcision with total excision of the foreskin. Technique of manipulation is as follows:

  • The doctor marks a place for the future cut with a special marker.
  • A ring is applied to the base of the penis. Manipulation is performed on the erect body.
  • In the skin of the foreskin, an injection of an anesthetic is made( not into the penis itself, but only into the foreskin).
  • Then the tissues are pulled by medical clips.
  • With a surgical scissors, a longitudinal incision is made up to the base of the head.
  • Then the tissue is excised in a circle with a scalpel, scissors or an electrocoagulator.
  • Finally, the seams are superimposed. Usually bouncy.

The whole operation takes about 30-40 minutes. Since manipulation is considered simple, even inexperienced surgeons can conduct it. However, it is strongly recommended that you carefully choose a clinic and a doctor. Surgical intervention, however simple, remains a surgical intervention.

Post-operative care

Care is also quite standard.

  • Once or twice a day you need to do dressings. If the operation was performed in a hospital, the nurse will help. For outpatient care, you need to contact a surgeon in the clinic. In the first few days, sterile dressings are applied three times a day.
  • Duration of dressings - ten days. Then you should leave the postoperative wound open. It is enough to process seams with hydrogen peroxide twice a day.
  • In case of suppuration it is recommended to use specialized ointments: Levomecol, etc. Or classical antiseptics, like furatsilina.
  • For a period of up to four weeks, you must give up sex. Sutures can disperse.
  • In order to exclude secondary infection and inflammation, antibiotics of a wide spectrum of action are indicated.

If manipulation was performed using self-resorbable seams, you do not need to do anything. Otherwise, the final stage of postoperative care is the removal of sutures. A man should be ready for minor pain and discomfort sensations: an erection at night and in the morning is preserved.

Possible complications of

Complications are extremely rare. The probability is no more than 0.5%.Nevertheless, one must be fully armed. What are the possible consequences:

  • Infection of a postoperative wound. The most common complication. If this happens, you should immediately contact your doctor or surgeon at the polyclinic. Suppuration is fraught with necrosis, divergence of seams, sepsis, etc. It is not worth it to solve the problem by your own forces.
  • Pain syndrome. A constant companion of a man who has gone through circumcision. This is quite normal phenomenon, you just have to endure it.
  • Puffiness of the penis. Should not cause concern.
  • Hematoma. It is also considered a conditionally normal phenomenon. Stenosis of the urethra. Refers to late complications. It is extremely rare. Also requires urgent consultation of a urologist.

Other complications arise at the stage of surgery and are associated with the unprofessionalism of the surgeon. This: the destruction of the penis, necrosis of the head, partial amputation of the head, etc. Therefore, it is so important to carefully approach the choice of the treating specialist.

Contraindications

  • Paraphimosis in advanced stage.
  • Cancer of the penis and male genital area.
  • Hemophilia.
  • Ulcers localized in the genital area.
  • Anatomical disorders.
  • Infectious diseases of the male sexual sphere( until complete cure).

Frequently Asked Questions

Circulation: Pros and Cons

This question has already been addressed. Undoubted advantages will be an increase in the duration of sexual intercourse, ease of intimate hygiene, cancer prevention. From the minuses - the weakening of sensitivity in sexual contact.

Do I have to do it with phimosis?

No, phimosis does not always require an operative correction. In the first two stages of conducting or not performing an operation - this issue remains at the discretion of the patient. The third and fourth stages are really treated only through circumcision.

Does the head grind after?

Grabs and very significantly. This leads to an extension of the sexual intercourse, although the sensitivity decreases proportionally. By the way, that's why some men knowingly, without medical grounds, that they are called "fall under the knife".Is it true what causes erectile dysfunction?

This is just a replicated myth in the network. There is no scientific evidence.

Is there a scar?

In general, the technique itself does not involve the formation of a postoperative scar. Scars can remain if the surgical procedure is not properly performed.

When can I resume sexual activity?

Four weeks after the intervention, you can return to a full sexual life. For this period it is recommended to give up sexual intercourse and masturbation.

Does the risk of infection increase?

On the contrary, it reduces. Since there is simply nowhere to stagnate the infectious agent, in addition, hygiene becomes easier.

Does the risk of cancer increase?

No. According to the studies, circumcised men are practically not prone to penile cancer. Conversely, the risks are minimized. Is it true that the penis is getting smaller?

The operation does not affect the anatomy of the penis. The visually trimmed organ may look shorter, but objectively, there is no change.

Circumcision is an uncomplicated operation, but in some cases necessary. Despite all the arguments "for", it is not recommended to conduct it without sufficient medical grounds.

See also: Importance of personal hygiene for men's health

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