Subject: The foreskin has staged functions. Author: Huang Rongyao, director of Shu Tian urology clinic.

"Is the foreskin too long? Do you want to cut it? What will happen if it is cut? " It often puzzles and puzzles many men, and it is also a problem that many parents are troubled by. Circumcision has existed for thousands of years, and it should be done frequently in the future, but it also often brings a lot of trouble to people.

If the foreskin is too narrow and forms a so-called "phimosis", the foreskin will bulge like a balloon when urinating, making urination difficult and painful, and it is more likely to cause eczema inflammation and glans urinary tract infection.

There is also a kind of "incarcerated phimosis", in which the foreskin is pulled to the glans and stuck, unable to return to its original position. At this point, venous reflux is blocked, causing local edema and even necrosis. Therefore, for children's foreskin, circumcision is the most suitable choice if there are phimosis, phimosis incarceration and repeated inflammation of the foreskin.

After puberty, taking into account sexual behavior, local hygiene after old age, local anesthesia during surgery and other factors, the treatment of foreskin is generally more active. During sexual intercourse, if the foreskin does not retreat behind the glans penis, it is easy to get hurt and bleed. The scale on the inside of the foreskin during sexual intercourse has a bad influence on the health of both men and women. The proportion of Jewish women suffering from cervical cancer is very low, and Jewish boys have been circumcised in infancy for religious reasons, which may be one of the factors.

Another problem is that the inner surface of the foreskin is easier to keep clean when young. When you are old, your eyesight is a little poor, your hands and feet are not flexible, and local hygiene may be difficult to maintain. Therefore, when you are young, if the foreskin is too long, you can consider surgical resection for treatment. If there are phimosis and incarcerated phimosis, surgery is even more needed.

After puberty, men usually use local anesthesia in circumcision. The wound is sutured with absorbable thread and will fall off in about two weeks. There will be swelling and pain in the first few days after the operation, but it will disappear on its own. You can take a bath on the third day after operation.

The possible sequela after operation is bleeding, and there is little chance of inflammation. As for the damage to the glans and urethra caused by the operation, and the difficulty of penis erection caused by short foreskin, it should be avoidable under the operation of a suitable doctor.

The foreskin is a personal thing of every man, and it also has its stage function. In childhood, if there is no inflammation or dysuria due to tension, the foreskin plays an important protective role. In adulthood, most people will retreat behind the glans penis, at least when they have an erection. Circumcision is the most basic and common operation in the field of urology.

But for every man, because of the significance of this part, Ben or his parents will go through some thoughts and struggles in their hearts before deciding to undergo surgery, so patients and doctors should deal with it with piety in order to obtain the most perfect result.

What do you know about foreskin?

This article is provided by Dr. Jiang Hansheng.

When a boy grows up, the first physical problem he faces is the cleanliness of his genitals. Among them, "Is the foreskin too long?" It is the most common problem, and there are many advertisements for fine circumcision in the workshop, which makes a big boy feel very confused. Is my foreskin too long? Is circumcision necessary?

In fact, there is only one reason for circumcision, that is, it is not easy to keep clean and hygienic. We know that there are many oil glands on the skin such as foreskin and glans penis, so they secrete so-called scales, which are white and yellow and produce a special taste. If the foreskin is too long, it often touches and rubs on the glans, plus sweat and dirt, it will produce red spots on the skin, making the skin itchy and painful, which is very uncomfortable. We call it "balanitis prepuce". Therefore, pay attention to foreskin hygiene, and the most important thing is to know how to turn the foreskin over, clean it and keep it dry. If this cleaning work is done well, no matter how long the foreskin is, there is no need for surgical removal.

Under what circumstances should I be circumcised? Here are the patients who really need surgery:

1. The complete foreskin is too long, that is, it is not easy to be turned over and cleaned when the foreskin covers the glans. The common reason is that there is a narrow foreskin ring, which is smaller than the glans, so it is impossible to cut the foreskin below the glans. If the foreskin ring is too hard, it may get stuck in the penis, pressing the venous blood flow, causing edema, pain and even dysuria at the front end of the penis. This is called "foreskin incarceration". Emergency surgery must be performed to remove the foreskin. Teenagers with this kind of foreskin incarceration had better be circumcised as soon as possible. Because it is difficult to turn it upside down and clean it, the accumulated scale and various viruses will cause symptoms and harm to local organs. Long pain is better than short pain. A simple half-hour operation will make a man feel dry and hygienic. Why not?

2. Sexually transmitted diseases often recur locally on the foreskin, such as herpes and cauliflower. These diseases are difficult to deal with, because circumcision in the dead corner of wildfire never completely consumes them, and they grow taller in the spring wind. Buried in the long foreskin is helpful for thorough treatment and permanent prevention.

3. If the foreskin is too long to affect sexual life, you should also consider foreskin surgery. Many men's foreskins are particularly prone to dermatitis. After contact with women, the other person's body fluids or lubricants on condoms cause itchy skin and allergic rashes. In addition, some men have chapped foreskin during sex, which causes great pain. In addition, the hygiene of male foreskin is more closely related to the health of female genitalia. Many women complain that excessive secretion, urethral discomfort, and even local itching are all caused by their partners' sexual life, which is probably related to long foreskin and poor hygiene habits. Women's cervicitis, cervical erosion and cervical cancer have been proved to be closely related to the hygiene of male foreskin and herpes virus hidden in foreskin, so men should not only consider their own comfort but also their partners' health care needs before they can have surgery once and for all.

4. After foreskin surgery, the appearance of male penis usually changes in a benign way. We should not believe some exaggerated false advertisements, saying that circumcision can promote the development of penis and enhance sexual function. This is groundless. Many male friends have too long foreskin, which will make the penis look ugly. After the operation, the glans penis will reappear in broad daylight, which really enhances the self-confidence of men. As for the sensitive glans after operation, premature ejaculation may occur in the short term, however, in the long run.

Case:

A 27-year-old man suffered from delayed healing and even ulcer after undergoing circumcision. I wanted to wait and see, maybe it will be fine in a few days. How do I know that day by day, a month has passed, and the skin still hasn't grown out, and it is still festering. Because the wound has collapsed, it must be treated first, and the dressing should be changed every day (at least for one week) until the wound is clean, and then the plastic surgery of skin grafting and skin replacement should be done.

Excessive prepuce refers to the situation that the glans of male genitalia is completely covered by prepuce. When the glans is completely covered by excessive prepuce and cannot be exposed, it is called phimosis. Most newborn boys will have phimosis, when the foreskin and glans are closely combined. After the age of five, most boys' foreskins can be pushed open to reveal the glans. In adult men, infection and inflammation may make the surrounding foreskin adhere to form phimosis.

Too long foreskin may increase the chance of children suffering from urinary tract infection, and may also cause infection and inflammation of local foreskin and glans penis. In adults, too long foreskin may be related to the spread of sexually transmitted diseases and the occurrence of penile cancer. Jews have to undergo circumcision because of their religious beliefs, so the low incidence of cervical cancer among Jewish women may also be related to this. Therefore, too long foreskin will have some effects on health and deserve attention. In addition, local cleaning is an important key to prevent foreskin diseases. When the foreskin is too long, it should be cleaned every day, but if it can't be opened, there is no need to force it. If the child can observe for a period of time, if it is after puberty, it is one of the situations that need surgery.

Not all men should be circumcised. People in some regions or races will have all men circumcised for some reason (such as religion or rite of passage), but from a purely medical point of view, the reasons for circumcision are as follows:

Adult phimosis, penis erection still can't show glans. ※.

Because the foreskin is too long, the local hygiene becomes worse. ※.

Because the foreskin is too long, repeated infections occur in some areas, and even the foreskin adheres to the glans penis. ※.

The opening of phimosis is too small, resulting in small urine flow. ※.

Generally speaking, patients should consider foreskin surgery without general anesthesia after puberty. However, if the boy is complicated with repeated inflammation or even urinary tract infection because of the long foreskin, he should be treated surgically as soon as possible and circumcised. Whether newborn boys should be circumcised or not is controversial, so we should consider it carefully and not make a hasty decision. If the baby has hypospadias, don't circumcise it, because the repair of hypospadias needs foreskin.

During prepuce surgery, the doctor will give appropriate anesthesia according to the patient's condition. In order to avoid vomiting caused by patients' inadaptability to narcotic drugs, they should be fasted for four to six hours before operation. After the operation, after the anesthetic effect subsides, the wound will have slight pain and swelling, so take the medicine regularly. Generally, the symptoms will subside after three days, and the wound will heal in seven to ten days. Before the wound heals, follow the doctor's advice and follow up regularly. In addition, the injured part should be kept clean and dry after operation. Please be careful not to wet the gauze when urinating. If the gauze is soaked by urine, you can take it off first and then go back to the clinic to change the medicine.

After operation, patients can still do their daily work without hospitalization, except for children under general anesthesia who need short-term hospitalization observation for nursing and safety reasons. Teenagers and adult patients will have swelling, pain and bleeding caused by penile erection after operation. If there is slight bleeding, they only need local cold compress and pressing to stop bleeding. If there is serious bleeding, they should go back to the hospital immediately. Because the wound is stitched with absorbable suture, there is no need to remove the suture after the wound heals. If necessary, the wound can be soaked in clean warm water to promote the suture to fall off. One month after operation, the patient can resume sexual life without affecting sexual function.

The foreskin operation can be said to be the most common operation in urology, and it is also a so-called "minor operation". Although it is a common minor operation, it is not without major problems. There have been babies whose glans were cut off because of circumcision. As for the situation of the young patients mentioned above, it may be because of the nursing problems during or after the operation, which led to a period of mental and physical pain. Fortunately, it was handled well in the end, otherwise it would leave some regrets. Therefore, doctors and patients should be cautious about the treatment of foreskin.