Recently, a friend asked Duoduo's mother, "Does the child need circumcision?" Faced with friends' questions, many mothers don't know how to answer them.
At that time, many kindergartens required children to have a physical examination before entering the park, but the physical examination doctor was careful enough. After the examination, he said that the child's foreskin is a little long, so it is best to go to a big hospital to see if it may need circumcision.
"What? Ok, want to take a knife? " Many mothers think that it is normal for children to urinate and don't think it is necessary to circumcise. As soon as I was distracted, I ignored the advice of the forensic doctor at that time. Now that Duoduo is in his teens, everything seems quite normal. Many students have had this kind of operation. According to parents, it has many advantages. Do you want to cut it or not? Duoduo's mother still dare not answer her friends casually.
Small ads are scary enough. There are even people on the internet who act as real warriors, buy tools from online platforms and do DIY circumcision ... of course, the consequences are particularly serious (please don't learn).
More than a month ago, there was a news that a boy in Hangzhou was saved for 6 days after circumcision.
80%-90% of out-patient children with phimosis do not need to be cut.
What are foreskin and phimosis? The foreskin is a double folded skin wrapped around the penis head, just like a dress on the head. Under normal circumstances, if the "clothes" are pulled down, that is, the foreskin is turned up, the urethral orifice and the whole glans can be exposed. The phimosis refers to the "neckline of clothes", that is, the foreskin mouth is small, and even if it is turned up hard, it can not be exposed or only a small part of the urethral orifice and glans can be exposed.
In the consulting room of urology department of Shanghai Children's Hospital, every day, parents bring their children to ask for circumcision, especially in winter and summer vacations, which is the "peak season" for circumcision. "From 1 year-old babies to teenagers and teenagers, children of all ages have it."
1. The child's foreskin is repeatedly inflamed, often swollen and painful, and even the foreskin is purulent; 2. Some children's parents' awareness is advanced, and they began to try to turn their foreskin regularly very early, but if they take the initiative to correct it for a long time (1-2 years), the external opening of the foreskin is still very tight and the glans penis cannot be completely exposed, so surgery can be considered. 3. Although some children can completely expose the glans penis, it is easy to be unable to reset after opening the foreskin because the foreskin is relatively narrow. The technical term is foreskin incarceration. After a long time, the genitals will obviously edema and become more difficult to reset, so emergency doctors need professional reset and even emergency surgery to remove incarceration. If this happens repeatedly, the doctor will also advise the child to do circumcision to solve the problem completely.
However, Lu Yiqing often encounters situations where the child's own conditions do not require surgery, but the parents' wishes are relatively strong.
"For example, after the child's foreskin is too long, if the foreskin is not dried every time the urine is discharged, the urine will gradually soak the surrounding skin. The skin of the foreskin and scrotum has been in a humid environment for a long time, especially in winter, when clothes are worn too much and it is airtight, eczema will appear throughout the perineum.
Children will often scratch the perineum because they will itch and feel uncomfortable, and even scratch the local skin, leading to bleeding and blood stains on their underwear.
Although this situation can be alleviated by urging children to dry the foreskin after going to the toilet every time, if children (such as kindergarten children) have poor self-care ability and can't do local hygiene, parents themselves are more willing, and they can also consider removing the long foreskin to alleviate the symptoms. "
In addition, if the child's foreskin is kicked or torn by the zipper while playing, obvious scars will be formed locally after the wound heals, and the scars can also be removed together with the redundant foreskin through plastic surgery.
"Some children may feel uncomfortable and even painful when they erect because of the narrowing of the foreskin after puberty. You can also consider foreskin surgery. " Lu Yiqing added.
Although this business is very popular, Lu Yiqing bluntly said that 80%-90% of the children with phimosis admitted to the outpatient department of the hospital did not meet the indications for circumcision, and most of them came to see the doctor because their parents were too worried and anxious.
Why do parents care so much about this skin? He observed that some parents may be influenced by advertisements and false propaganda from various channels, as well as the experiences of colleagues and classmates around them, and follow the trend to circumcise their children; Another part of parents found that their children's life, study and social activities were affected by perineal discomfort, and felt that circumcision could obviously alleviate the symptoms;
There are also some parents with the highest proportion who believe that circumcision is helpful to the development of children's genitals, hoping that it will be bigger and more "beautiful". "Of course, this view is not correct. In fact, circumcision does not help children's reproductive development. " Lu Yiqing stressed.
What should be cut must be cut.
Because there are many parents who bring their children to consult circumcision, in order to ensure that children who really need circumcision are treated, children's hospitals are very strict about the indications of circumcision. Even so, the annual circumcision in urology department of children's hospital is still in short supply, and many children who need surgery can only wait in line.
Lv Yiqing often tells his parents that if it is not necessary, it is best not to circumcise their children. "If you can solve the problem by improving local hygiene and changing behavior, don't have surgery."
The reason for Dr. Lu's pain is simple. Although circumcision is a very simple operation, it usually takes about 10 minutes to complete, and the slowest one takes more than half an hour. But it is always an experience of injury and discomfort for children. It takes 7-65,438+00 days to treat the wound at home after operation, which is also a burden for parents.
In addition, parents are more concerned and worried about the way of surgical anesthesia. Children's hospital foreskin surgery is general anesthesia.
Why do you have to have general anesthesia? Because: 1. General anesthesia is actually the safest and controllable anesthesia method from a medical point of view; 2. Children with local anesthesia may not cooperate with the operation because of fear, excitement and other emotions, polluting the wound and increasing the risk of infection, and the child is awake during the whole operation, which is also a very bad experience for psychology; 3. Because the operation time is very short, there is basically no problem of "affecting intelligence and memory" that parents are most worried about, so there is no need to worry about the impact of general anesthesia.
There was once a little boy whose foreskin was repeatedly inflamed, and the glans penis and foreskin kept oozing, causing serious adhesion. Eventually, even the opening of the foreskin becomes like a needle tip. Every time a child urinates, he has to overcome great pain to slowly drip the urine out.
"The glans penis and foreskin are like two pieces of paper, and the inflammatory exudate is like glue. A lot of glue was repeatedly applied between two pieces of paper and stuck together. In this case, an operation will be performed to separate the two. First, the difficulty will increase during the operation, and the glans wound will be bigger after the operation; On the other hand, even after the operation, some functions of the child may still be affected. For example, repeated inflammation in the past may cause balanitis sicca obliterans, and then urethral stricture may affect urination, or bacteria retrograde into the urethra during chronic prepuce balanitis may cause chronic urinary tract infection. "
Lv Yiqing said that parents should consider circumcision as soon as possible if they find that their children have severe foreskin inflammation, especially after repeated inflammation or urinary tract infection.
Children will have a recovery period of 7~ 10 days after operation. Lu Yiqing will advise parents to let their children wear loose pants during this period. "For example, beach pants and pajamas, under the premise that the glans has no obvious seepage, encourage children to have slight contact and friction between the glans and pants, so that children can adapt as soon as possible, which will help accelerate recovery." You can take a bath every day for about three days after operation, and then use a fan or hair dryer to dry the local skin after washing the wound secretions, which can also maintain local hygiene and reduce discomfort.
"Newborns within 6 months may have a high probability of infection because of the unstable immune system. If the foreskin of two or three years old is not hygienic, it is more likely to have a peak of infection; Later, in adolescence, because of the increase of local secretions, including sweat gland hair, bacteria are easy to multiply and there will be a peak. If there is inflammation, we suggest an operation as soon as possible. However, if there is no discomfort, we generally recommend that parents and children try to flip the foreskin for about one minute every day at home (the specific method can come to the hospital for consultation). If done well, about 60% to 70% of children can solve their own problems. " Lu Yiqing said.
The picture comes from the network.
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