Circumcision is a surgical procedure primarily used to remove excess foreskin tissue in males. This procedure is commonly performed to treat phimosis, recurrent inflammation, or for personal hygiene reasons, and can also be part of religious or cultural traditions. The goal of the surgery is to improve physiological function, reduce the risk of infections, or address issues such as difficulty urinating caused by an overly long foreskin.
The surgical methods vary depending on the patient's age and medical needs, including traditional surgery, foreskin retractors, or laser surgery. The procedure typically lasts about 30 minutes to an hour and is usually performed under local anesthesia; children or special cases may require general anesthesia.
Traditional surgery involves using a scalpel or electrocautery to remove redundant foreskin, requiring suturing of the wound, suitable for complex cases. Foreskin retractors utilize metal or plastic rings to fix the excision area, reducing bleeding and accelerating healing, suitable for mild cases. Laser surgery uses high-energy light beams to cut tissue, allowing precise hemostasis but at a higher cost.
The mechanism of the surgery involves removing excess foreskin tissue, eliminating smegma accumulation between the foreskin and glans, and reducing bacterial growth environments. After removal, the glans is directly exposed, decreasing the risk of local infection and improving physical obstacles during urination or erection.
Main indications include phimosis (inability to fully retract the foreskin), recurrent foreskin inflammation, urethral stenosis, or difficulty urinating due to a long foreskin. Additionally, patients with recurrent urinary tract infections, sexual dysfunction, or psychological distress may be recommended for surgery after evaluation by a physician.
In specific situations, such as high HIV risk areas or religious rituals, circumcision is also considered a preventive measure. However, caution should be exercised in non-medical necessary cases, weighing benefits and risks.
The surgery is usually performed in outpatient clinics or day surgery centers. Adult patients receive local anesthesia, after which the surgeon marks the excision area and removes tissue; infants or children may require general anesthesia to ensure cooperation. Postoperative care involves covering the wound with gauze and regular dressing changes.
The recovery period is approximately 1-2 weeks, during which strenuous activities should be avoided initially. The surgeon will adjust the suture removal timing (usually 7-10 days) based on the patient's age and wound healing. Postoperative care includes daily cleaning and the use of antibiotic ointments to reduce infection risk.
Long-term benefits include improved personal hygiene and reduced sexual dysfunction caused by foreskin issues. The permanent nature of the surgery provides a long-term solution but should be evaluated in the context of the patient's overall health.
Short-term risks include postoperative pain, bleeding, or infection, with about 5-10% of patients experiencing mild inflammation. Rare cases may involve allergic reactions or anesthesia complications, requiring close monitoring.
Preoperative assessment should include coagulation function, diabetes control, and medication use (such as anticoagulants). Contraindications include active infections, blood disorders, or uncontrolled diabetes. Anticoagulants should be paused before and after surgery, and blood sugar levels should be controlled.
Postoperative care requires strict adherence to instructions, avoiding premature sexual activity or vigorous activities. Signs of complications such as redness, swelling, abnormal discharge, or fever should prompt immediate medical attention.
Patients should inform their doctor about current medications, especially anticoagulants (e.g., aspirin) or immunosuppressants, which may increase bleeding risks. Coordination with other urological surgeries (such as urethroplasty) may be necessary.
Postoperative antibiotic use should avoid interactions with other drugs. When treating sexually transmitted infections concurrently, medication plans may need adjustment.
Most studies show that circumcision can reduce the incidence of balanitis by 70-90% and significantly improve urination difficulties. The World Health Organization (WHO) recommends promoting this surgery in high HIV prevalence areas to reduce infection risks.
Long-term follow-up indicates high satisfaction rates of over 85%, but outcomes vary depending on individual anatomy. Some patients may require secondary revision surgeries to adjust the excision range.
Non-surgical options include topical antibiotics, corticosteroid ointments to control inflammation, or using foreskin stretching devices to improve elasticity. Conservative treatments are suitable for mild symptoms or young children.
In some cases, regular cleaning and behavioral modifications can delay the need for surgery. However, recurrent infections or anatomical issues often require surgical correction, and alternative options should be evaluated on a case-by-case basis by a physician.
It is recommended to undergo a detailed physical examination to confirm no active infections or other complications. Inform the doctor of any drug allergies or bleeding disorders. Fasting and water abstinence should start 8 hours before surgery, and personal hygiene should be maintained as instructed to reduce infection risk.
How can postoperative pain and swelling be alleviated?Pain relief can be achieved with prescribed analgesics such as NSAIDs, and cold compresses with a clean cloth can help reduce swelling. Avoid excessive activity or prolonged sitting, and wear loose underwear to minimize friction.
Will bathing or water contact affect the wound?Water contact should be avoided within 24 hours post-surgery. Afterward, gentle showering is permissible, but the wound should be cleaned carefully and dried immediately. Use the prescribed antibiotic ointment and change sterile dressings daily, observing for signs of redness, swelling, or discharge.
When can daily activities and exercise resume?Light activities like walking can usually resume after one week, but heavy lifting or cycling should be avoided for at least three weeks. Sexual activity and vigorous exercise should wait until complete healing, typically 4 to 6 weeks, following the physician's personalized instructions.
What are the complication rates and common issues post-surgery?Modern circumcision has a complication rate below 5%, with possible short-term swelling, itching, or minor bleeding. Rarely, infections or hematomas may occur. If persistent redness, pus, or severe pain develops, immediate medical attention is necessary. Regular follow-up can effectively reduce risks.
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