What is circumcision and why is it done for boys: indications for surgery and features of care after the procedure
Circumcision or circumcision of the foreskin is more often performed in childhood. Indications for surgery can be both religious customs and medical indications: phimosis, deformity of the frenum of the penis, frequent inflammation.
The procedure taking place in a medical institution requires general or local anesthesia, with all the rules being followed, complications are very rare. In our article about circumcision in boys, photos of the child's genitals will also be demonstrated: before and after circumcision, during surgery and in the postoperative period.
Child circumcision is practiced by Jews and Muslims. The procedure can be performed in a medical facility, at home, or in a temple.
The ideal age for circumcision is determined by faith. In Jews, the procedure is carried out after the infant is 8 days old, circumcision is done by a specially trained religious leader (moel).
Circumcision becomes part of the festive ceremony held in the synagogue, the cut off foreskin is kept by senior representatives of the family. The procedure is carried out without anesthesia, in rare cases, anesthetic cream can be used.
Muslims practice circumcision at an older age. Religious figures believe that a procedure performed at 3 or 4 years old allows a child to consciously come to religion and perceive circumcision not as a given, but as part of the rite.
The operation can be performed in the outpatient clinic under local or general anesthesia. If for some reason circumcision did not take place in early childhood, it can be done by adolescents.
Hygienic and medical indications
Urologists and andrologists believe that healthy children do not have indications for surgery. However, in some cases it is recommended..
- frequent inflammation of the glans penis or foreskin (balanitis and balanoposthitis),
- congenital phimosis (narrowing of the foreskin), not passing by the age of three,
- shortened frenum of the penis, which prevents the complete liberation of the head,
- excessively overgrown foreskin, completely hiding the penis, interfering with urination and hygienic procedures.
An operation for medical reasons is done at the age of 3 years. In rare cases (with pronounced congenital pathologies), it may be performed earlier..
The choice of methodology and method of anesthesia depends on the doctor and the conditions of the clinic. Circumcision is done to children only in a medical institution, this minimizes the risk of complications.
Experts recommend that parents talk to several doctors and choose the option that suits them completely.
Before surgery, it is necessary to pass a general blood test and assess the degree of coagulability.
Circumcision to children can be performed both in a hospital and in an outpatient setting. Some clinics do not have equipment for general anesthesia and can only offer local anesthesia.
Very mobile, nervous, fearful children and impressionable parents, this option may not be suitable. However, general anesthesia also has contraindications. It is not recommended for patients under 3 years of age, children with heart failure and a variety of chronic diseases.
Under the age of 2 months, surgery is performed without anesthesia. It is believed that at this age, pain receptors are undeveloped and the child does not experience severe discomfort.
It is possible to apply an anesthetic gel to the penis or an anesthetic injection, which is done at the base of the penis. Children under 10 years old are recommended general anesthesia.
It provides complete immobility of the patient, the doctor can perform the procedure more accurately. Sevoflurane, desflurane and other inhaled anesthetics are used. Children over 10 years old are circumcised under local anesthesia on an outpatient basis.
When using general anesthesia, 8 hours before the procedure, the child should not eat or drink. After the anesthesia begins to act, the doctor pushes the foreskin and cuts it off with a scalpel in a circle where the skin fold fits snugly against the head of the penis.
Sometimes the operation is carried out with a laser tool. If the frenum is not affected, there is no bleeding. With a shortened bridle, it is incised simultaneously with the removal of the foreskin, and then fixed with self-absorbable threads. Older children may have sutures; in infants, wounds are not sutured.
Some surgeons perform surgery using special clamps. They are selected depending on the weight of the patient.
The device reliably fixes a skin fold, designating a cut-off zone and ensuring smooth scalpel movement. The clamp is applied to the foreskin so that about 1 mm of free skin remains and protects the glans penis from accidental damage.
After cutting off excess skin, the device remains on the penis for about 5 minutes, and then is removed. This technique prevents bleeding and significantly reduces the duration of the operation.
You can watch the video of the operation:
The appearance of the body in the photo, before and after the procedure
What does circumcision look like in a child?
Male circumcision - before and after photos
The operation to excise the foreskin lasts no more than 60 minutes.
Photo of circumcision in children
After its completion, swelling of the penis and scrotum is possible, the skin turns red, but does not become inflamed.
Mild swelling persists for several hours or even days, then it goes away without treatment. If the child feels discomfort or pain, he is given sedatives or analgesics. To reduce edema, you can apply a cold compress.
An open wound remains in place of a cut of the foreskin. Children rarely suture, the edges of the wound quickly tighten. If frenum plastic was performed, stitching with self-absorbable threads is done.
What does the genitals of a boy look like after circumcision? A photo
After the operation, the child is observed, after 2 hours the doctor checks the condition of the penis. There should be no blood at the cut site.
A day later, a yellowish film forms on the penis, which soon disappears. It does not bother the child and does not require removal.
Photo of the postoperative period after circumcision
If a bandage is applied to the penis, it is changed daily, pre-soaking the bandages.
Circumcision of the foreskin is a quick operation that does not cause any discomfort to the boys. It is performed under general anesthesia; complications of circumcision are extremely rare.
To eliminate the slightest risks will help a consultation with the attending physician, the use of modern anesthetics and strict hygiene in the postoperative period.
Video comment of a specialist doctor about the circumcision procedure:
What is male circumcision?
Circumcision is a surgical operation to remove the foreskin in men, boys and boys. The second name of this procedure is circumcision. It is carried out for religious reasons, medical reasons or as a sign of nationality. Circumcision is partial or complete. With partial circumcision, only areas of the extreme skin are removed.
In which countries and for what is the foreskin removed for boys?
Why is the boy circumcised?
- The foreskin is removed for children in countries where they adhere to the Muslim faith. Do the procedure for kids up to a year. Muslims believe that only after the ceremony the boy becomes a real man.
- Jews circumcise babies on the eighth day after birth. According to their beliefs, this allows the child to be reunited with God.
- Some African villages also trim the skin of the penis according to tradition.
- Jews believe that circumcision is a prerequisite for the baby to enter a religious community.
- Some men undergo surgery for aesthetic reasons. In the modern world, it is done for many men and boys for medical reasons, regardless of faith and belief.
Indications for surgery
The removal of the foreskin to the child due to his religion or nation is an internal issue of each family (see also: what to do if the child does not open the foreskin?). However, there are cases when circumcision is necessary to eliminate medical problems. Why can the boy be circumcised and what are the indications for circumcision:
- Phimosis, which does not go away by 6-7 years (more in the article: how to treat phimosis in a boy at 6 years old?). This phenomenon is the growth of the foreskin to the glans penis. In children under three years of age, the disease is physiological in nature and does not need treatment. At a later age, phimosis can lead to inflammatory processes of the head of the penis and painful sensations.
- Problems with urination. They occur when the opening of the foreskin does not coincide with the urethra and the urine is retained in the skin fold.
- Inflammation of the foreskin - balanoposthitis. There is a disease due to non-compliance with the hygiene of the genitals.
- The formation of growths and papillomas.
- Head injury. This phenomenon can occur due to physical effects on the penis.
- Skin diseases.
- The tendency to oncology. It is believed that cancer of the head of the penis occurs in uncircumcised men more often.
- Short bridle.
Circumcision is a simple but specific exercise. Doctors believe that children should be circumcised before they turn 3 years old (when they know little) or after 6 years (when they already understand everything). This will save the child from psychological trauma. At an early age, the healing process is faster. The photo-illustration schematically shows the result before and after the operation.
Contraindications to the procedure
Contraindications to circumcision:
- low pain threshold that will cause pain shock,
- inflammatory processes in the body,
- bleeding disorder,
- congenital pathologies of the penis,
You also need to consider that after removing the foreskin, hygienic problems can occur, as it creates the likelihood of inflammation in those places that protected the skin.
Methods of operation
Circumpy for medical reasons is performed on an outpatient basis and does not require a hospital stay. When circumcision is carried out for religious or national reasons (as among Muslims and Jews), the event can be implemented at home. The main conditions for removing the foreskin in boys are sterility and accuracy.
The classic way to perform the procedure is surgical circumcision. In simple words, this is a mechanical removal of the foreskin with a sharp medical instrument. The skin of the penis is pulled using special devices, cut and cut off. Sutures are placed on the edges of the wound with special absorbable threads.
Small children undergo circumcision without suturing. During circumcision, special rings or clamps are used. A small incision is made in the foreskin and the necessary device is introduced between the head of the genital organ and the skin. The top of the skin is fixed and excess flesh is removed. After 5-7 days, the latch disappears by itself. The classic surgical method uses local anesthesia.
Laser clipping is considered more gentle. The operation is performed using a laser, not a scalpel. However, it is not possible to make such a procedure in every clinic and its cost will be higher than with the classical method. Bleeding after such circumcision is very rare, and the body heals faster. Thermal laser action minimizes the need for suturing.
Laser circumcision is the most gentle circumcision method.
The operation at home is usually carried out by people who are specially trained in this (for example, rabbis). To carry out house circumcision, it is necessary to have sterile instruments and disinfectants and to ensure cleanliness in the place where the procedure will be carried out. However, circumcision at home increases the likelihood of postoperative complications.
Harm to the body and possible complications
The attitude of doctors to the circumcision procedure is ambiguous. Some doctors advocate mass removal of the upper skin in order to prevent diseases, while others believe that this is a useless traumatic procedure. However, all experts agree that circumstance in boys is a must when medical conditions appear (for example, with phimosis).
Adherents of circumcision argue that removing excess skin from the penis reduces the risk of diseases of the genitourinary system and viral diseases, facilitates the hygiene of the penis. Circumcision is believed to reduce the likelihood of cancer and AIDS. However, these allegations are not certain.
Removing the foreskin is considered a simple surgical operation, but it can cause harm to the human body and cause complications. Opponents of circumcision insist that the procedure leads to psychological trauma of the child, and if the technique of surgery is violated, the genitals can be damaged. Do not exclude the likelihood of death.
Circumcision can provoke the development of various complications, at least - the psychological stress of the child
Possible complications after circumcision:
- painful shock,
- wound infection
- blood poisoning,
- heavy bleeding
- organ head injury
- allergic reaction to anesthesia,
- decreased genital sensitivity
- long healing process
- severe organ swelling
- penis cosmetic defect.
Many complications appear if sanitary procedures were not followed during the procedure. Within 5-7 days after surgery, the boy may experience pain, the genitals become more sensitive, a slight swelling appears. These body reactions are the norm and, with proper care and adherence to the doctor’s recommendations, pass quickly.
How long does the healing period take and what care is needed?
After removal of the foreskin, wounds and sutures heal completely after 3-5 weeks, and the sutures are removed 9-10 days after surgery. The recovery period depends on the individual characteristics of the body. As a rule, in young children this process is faster.
After circumcision, the bandage should not be removed during the first day. From the second day you need to do daily dressings for 10 days. The first 2 days, the dressing is changed up to 6 times a day, and then 2 times a day. Toddlers have a dressing after each diaper change. It must be removed carefully. If it has dried, you can soften it with a weak solution of potassium permanganate, a decoction of chamomile or hydrogen peroxide.
Seams are treated daily with brilliant green or a solution of manganese. If blood is secreted from the wound or an anemone appears, antiseptic and anti-inflammatory drugs are treated. The doctor may advise Levomekol or Actovegin ointment (which one is better, a specialist should decide). With the appearance of pain in the genital area, painkillers are possible.
For some time after circumcision, the penis may be cyanotic or have a yellowish tint.This is normal after circumcision. The next few months, special attention should be paid to the hygiene of the penis. Puffiness helps to remove the salt bath. It is urgent to consult a doctor if the following symptoms appear:
- swelling of the penis increased and blue spots appeared
- wounds inflamed
- penile discharge
- body temperature increased
- sutures and wounds do not heal for a long time.
Where better to do circumcision?
The choice of uterus circumcision depends on why the child is circumcised. If for medical reasons, then it should be held in a hospital. Muslims are circumcised at home, and Jews perform surgery in a hospital in the presence of a rabbi and relatives of the baby. Parents themselves can decide where it is better to do this, but the conditions of the clinic minimize the risks of complications.
At present, circumcision can be done both in the municipal clinic and in a private institution. In public institutions, it is carried out in the direction of the attending physician (for example, with phimosis). The cost of the procedure is minimal or not worth the money. In private clinics, an operation can be done without a referral, but it will cost several times more.
Many people prefer private surgical centers. These clinics are equipped with laser devices, which are preferable during the operation. Whatever choice parents make, it must be borne in mind that circumcision in children should only occur if there are no contraindications.
The procedure for circumcision in boys is found among Muslims and Jews. It can be carried out not only in a medical institution, but also in a temple or even at home. Such religious intervention is necessary for religious reasons so that a person can approach the Almighty and get rid of sins.
In Jews, circumcision is performed when the child is 8 days old. Circumcision is carried out by a mohel - a religious figure specially trained for this. On this day, a festive ceremony is held in the child's family, which takes place in the synagogue. After clipping, the foreskin is deposited with senior family members. Moreover, the operation itself takes place without anesthesia, in rare cases, the use of anesthetic cream is allowed.
In Muslims, circumcision is most often carried out in the third or fourth year of a boy's life. It is believed that it was during this period that the child already consciously approaches the issue of religion and perceives the procedure as part of the sacred rite, and not as a given. Intervention is performed under medical conditions under general or local anesthesia.
In Muslims, circumcision is also possible in adolescence, if for some reason it was not done in early childhood.
For medical reasons, the procedure is recommended at the age of 3 years. Sometimes the operation is performed in infancy, if already at birth there is a pronounced pathology of the genitourinary system. Surgery is also recommended if the child:
- regular inflammation of the glans penis occurs
- diagnosed with congenital balanoposthitis or balanitis,
- there is a narrowing of the foreskin, which has not passed until 3 years,
- the frenulum of the penis is shortened, which prevents the complete liberation of the head,
- the foreskin has grown excessively, which leads to difficulty in the process of urination.
Circumcision should be performed by an experienced physician in a medical setting. The choice of anesthesia and method of exposure depends entirely on the conditions of the medical institution and the opinion of the treating specialist.
In the next video, the famous pediatrician, Evgeny Komarovsky, talks about the modern medical vision of this issue:
The doctor tells about why the foreskin is needed, and why it is so important not to cut it off without strict indications, in the following video:
At what age do circumcisions do?
Scientists believe that the most favorable moment for circumcision is the age of 8 to 9 weeks. At this time, the child still does not understand the essence of what is happening, so the operation is easier for him to carry.
For an older child, such an intervention can leave a negative impression on his whole future life. In addition, the child may have an insult to the parents for making such a decision for him.
If circumcision was not performed before 3 years, it is worthwhile to postpone the operation until the age of eight. At this age, the boy can already easily explain why this manipulation is needed and what it is impossible to do without it.
Sometimes in the case of physiological phimosis, doctors postpone surgery in infancy, since as the child grows older, the problem may disappear on its own. Only with cicatricial form of phimosis, the operation should be carried out immediately.
The operation is recommended in early childhood and because the nerve receptors of the genital organ are not yet so sensitive. In adolescence, the operation will cause serious discomfort, therefore, it is performed only under general anesthesia. Also, a similar procedure can lead to the development of psychological trauma in a young man.
After the intervention of the boy’s genitals
To avoid various complications after surgery, it is worth providing the patient comfort and peace, as well as wound care. The surface should be treated every day at least 6 times a day.
Before manipulation, you must always wash your hands thoroughly and put on sterile medical gloves, and moisten the bandage with hydrogen peroxide. The wound itself is recommended to be washed with a solution of potassium permanganate. Levomekol or Tetracycline ointment will help speed up member healing.
You can not treat the genital organ with cotton, as its villi can get into the wound and lead to a purulent process.
Together with drug exposure, special underwear will help speed up the patient’s recovery. It can be bought at the pharmacy. These are underpants that have a dense frame insert that protects the genital organ from infection or injury. Also, underwear does not allow the child to touch the seams. Panties are made from cotton fabric. When buying, pay attention to the size of the goods.
Bathing during rehabilitation should be replaced by wiping the affected area with wet wipes with an antibacterial effect. This treatment is necessary after each urination.
With a favorable outcome of the operation and proper wound care during the rehabilitation period, the child's sutures are removed already for 7-10 days. By this time, the dressing process ends. Further treatment tactics are determined by the attending physician. But the main condition for a quick recovery and recovery is still genital hygiene.
After the operation to excise the foreskin, the patient may experience aching pain in the genital area, increased sensitivity of nerve endings in the intimate area and severe swelling. If complications were avoided and the operation was successful, then every day the discomfort should worry less and disappear completely in a week.
To reduce pain during the rehabilitation period, a specialist can prescribe painkillers, and to reduce swelling, salt baths and lotions from chamomile infusion.
Seek help from a doctor urgently if the patient is concerned:
- a prolonged increase in body temperature - above 37 degrees,
- purulent inflammatory process,
- severe swelling of the penis
- member curvature,
- weakening the sensitivity of the penis,
- opened bleeding in the intimate area,
- recently appeared cyanotic shade of the penis.
This condition requires immediate consultation with a specialist, as it can lead to tissue necrosis. In this case, self-medication and attempts to improve the condition with traditional medicine are strictly excluded. Only a doctor can choose the truly correct tactics of treatment with medication antibacterial drugs.
Circumcision of the foreskin is a fairly quick and simple operation that will not cause the child much discomfort, but will only improve his state of health. Elimination of the risk of complications will help consultation with an experienced doctor, the use of modern medications and compliance with hygiene rules in the postoperative period.
Do boys need circumcision
The mandatory procedure is considered only for health problems and has the following indications:
- Phimosis and paraphimosis. The prerequisites for the disease are visible in half of the born boys. By the age of 3, in 40% of children they disappear, after puberty, pathology remains in only 1% of young men. Doctors are in no hurry to prescribe circumcision for children up to adolescence. The exception is cicatricial phimosis, which itself does not pass, and the removal of the foreskin will save the child from inflammation of the glans penis.
- Chronic balanitis and balanoposthitis. Dead skin cells accumulate in the skin pocket and sebaceous gland secretions, the moist environment of the genitals accelerates the process of reproduction of bacteria. The operation eliminates a similar problem.
- Shortened frenum of the penis. In this case, circumcision is optional. The doctor’s decision depends on the individual structural features of the baby’s genitals.
- Excessive overgrowth of the foreskin is a situation when it is better to circumcise a child so that he can urinate normally and carry out hygiene.
- Papillomas and growths on the skin fold.
- Mismatch of the openings of the urethra and the foreskin when urine lingers on the penis.
In all other cases, the operation is not mandatory and depends only on the decision of the parents of the baby or the desire of the teenager.
In which countries and why do circumcisions in a child
The need to change the penis of a boy is dictated by the religious canons of different faiths:
- Muslims believe that child circumcision will make a child a real man. They perform the ritual at the 7th week from birth, at 7 or 13 years.
- Jewish communities preach that circumcised men are given the opportunity to become closer to God. Jews make circumcision at the age of 8 days or 8 years to their sons.
- In the African settlements, the foreskin is removed to increase strength and health. From a medical point of view, the ritual often yields a negative result due to the impossibility of proper care: heat, lack of sufficient water, and unsanitary conditions.
Regardless of the country of residence and religion, young men go for surgery for aesthetic reasons, believing that in this way they will increase intimate attractiveness in the eyes of the opposite sex.
Preparing for circumcision in children
Circumcision is not a complex surgical operation and does not require special preliminary measures. The child is prescribed tests and a test for susceptibility to the components of anesthetics.
If circumcision is planned under general anesthesia, the baby does not need to be fed and watered 8 hours before surgery to prevent bouts of nausea. Typically, circumcision in children is performed in the morning, so you need to come on an empty stomach. With local anesthesia, it is enough to refrain from eating for an hour.
How to circumcise boys: operation
To ensure sterility and safety, the procedure should be performed on an outpatient basis. According to rituals, circumcision of boys from Jewish families is carried out in the synagogue or at home. Muslims, in most cases, do not go to the clinic, arrange a specialist visit and prepare a magnificent celebration on this occasion.
Depending on the age of the child and the indications, different methods of removing the foreskin are used:
- For babies, a plastic ring or clip is put on the head and the protruding flesh is cut off. The area is treated with an antiseptic, the patients are not sutured. After 4-5 days, the wound is healed, the latch itself disappears.
- Older children are put into a state of sleep, the foreskin is pushed aside, and excision is made around the circumference at the site of fusion with the penis. Suture with self-absorbable sutures and a sterile dressing.
- The operation is performed in the same manner for adolescents using local anesthetics.
The flesh is removed in whole or in part, using the classical or laser method. In the second case, the operation is faster, without blood, but costs more and is not practiced in all clinics. On the procedure for circumcising boys from photos and videos, you can see that not all children are ready for it and tolerate it equally.
How to care for a child after circumcision
The main condition for quick recovery is to ensure sterility. If a bandage is applied to the penis, it must be periodically changed with the use of antiseptics and antibacterial ointments. Any drugs can be used only as directed by a doctor.
You can bathe the child on the 3rd day after circumcision. When the dressing is removed, the genitals should be washed with warm water with the addition of baby soap, then rinsed with a decoction of chamomile or a weak solution of potassium permanganate.
In the first days after the operation, you should not give the child diuretic drinks, but it is better to feed him with liquid light food.
Whatever the nature of the complication, eliminating it is easier with timely detection and treatment. Therefore, you need to come to the reception even when visually everything is normal. An urgent visit to the doctor is mandatory at the first symptoms:
- increase in temperature of the penis or general
- blackening or cyanosis of the head of the penis,
- purulent discharge
- weakness and drowsiness in a child,
- tissue edema longer than 3 days,
Before circumcising the boy, you need to make sure that he has no contraindications and the operation will not harm the child. It is better to consult with several specialists.
Why do boys circumcise?
Circumcision in boys, or scientifically - circumcision, is carried out not only by Jews and Arabs, but also by other peoples of the world - some according to the canons of religion, and some according to medical indications or of their own will. The most common reasons for cutting off the foreskin are:
- Religious In the modern world, Jews make it, as a confirmation of the covenant between God and the Jewish people. In Jewish families, it is customary to circumcise on the eighth day of the boy’s life or when converted to Judaism, regardless of age. Cutting off the foreskin is a must for Jews. It is customary for Muslims to circumcise a child, but it is not a mandatory procedure and is performed at an older age. Muslims believe that the cutting off of the foreskin must be carried out in order to embark on the path of the prophet Ibrahim.
- Medical. There are diseases for which circumcision is used. This is complicated phimosis and paraphimosis (pathology of the foreskin, preventing the opening of the apex of the penis), balanitis (inflamed scalp), postitis (inflammation of the foreskin), synechia (closure of the urethral canal), complicated condylomatosis (various growths on the foreskin), urethritis, cystitis and others (we recommend reading: what do synechia look like in girls, their photos and how should it be normal?).
- Hygienic and preventive. It is carried out with the aim of removing the prepuce bag and, as a result, simplifying the care of the genital organ, reducing the accumulation of sperm and urine with an unpleasant smell under the skin, and preventing inflammatory processes due to the development of pathogenic microorganisms under the foreskin.In Africa, circumcision is done to prevent HIV and AIDS.
- Social. To normalize sexual activity, with an aesthetic goal, for visual augmentation.
With phimosis, circumcision is not always shown, often it goes away in a child with age or after exercise to stretch it. A surgical procedure is performed when it is accompanied by painful urination, persistent inflammatory processes and fungal infections.
Optimum age for surgery
At what age is circumcision better? According to religious rules, in Judaism the 8th day of a baby’s life is considered the best age. There is a certain logic in this, since the necessary elements of blood coagulation - vitamin K and prothrombin - are formed in sufficient quantities by the end of the seventh day of a newborn’s life, so the 8th day is the first life of a baby in which it is least dangerous to have a Brit-mil operation.
Muslims are circumcised at any age. For example, in Turkey it is customary to spend 8-14 years, and in Iran and Iraq - 3-4 years.
Doctors do not agree with such an early circumcision as the Jews, and believe that this surgical intervention is not advisable until 3 years. The reasons that allow penile surgery from birth can only be serious pathologies that require immediate treatment.
Types of surgery on the foreskin
Depending on the disease or the desired result, circumcision is divided into the following types:
- Optimal. Often performed for medical reasons. Indications: excess amount of the foreskin, the presence of a scar ring. It consists in removing a small area of the skin, as a result of which the foreskin remains a standard size and completely covers the tip of the penis.
- Partial After the procedure, only the opening of the urethra is ajar.
- Free. Bottom line - the head of the penis always remains open, but in cold water it can slightly cover it, the skin is not stretched.
- Average. The most common circumcision in which the head is always open, even in cold weather. The result is shown in the photo.
- Tight. It is performed only at the request of the patient or medical indications. After this operation, the skin fold on the penis is absent, and it seems smaller.
Where and what do circumcisions do for children?
Circumcision can be performed both in the hospital and on an outpatient basis. It is advisable for children not to spend at home, but in a clinic to quickly prevent possible negative consequences.
The operation is carried out with a scalpel or using a laser. Laser conducting has the following advantages:
- shorter operation time
- lack of bleeding due to relief of blood vessels,
- neat cut and less noticeable seam,
- not so much pain compared to the classical method,
- minimal risk of infection,
- reduction in the likelihood of complications,
- there is practically no tissue edema after the procedure,
- short recovery period.
The circumcision procedure does not last very long. When using a laser - about 30 minutes, with a scalpel - up to an hour.
In children, circumcision by the traditional method is done under general anesthesia, which is more dangerous for the body. Bleeding, infection and other complications are possible. Today, this method is outdated and more and more preference is given to modern methods.
When circumcised before the age of 2 months, anesthesia is not performed, since it is believed that pain is dulled in newborns. Up to 12 years of age during surgery, general anesthesia is indicated. It is carried out using Propofol or inhaled anesthetics Halotan, Isoflurane, etc. Its advantage is that, in addition to anesthesia, the child is still, the degree of accuracy of the operation is increased, the risk of additional damage from involuntary movements of the boy is reduced.
Starting from the age of 12, surgery is performed under local anesthesia. For these purposes, anesthetic is injected into the base of the penis. The most commonly used are lidocaine, markain, novocaine and others. Anesthetic gels may also be used.
Features of the procedure
The procedure takes place in several stages. First, local or general anesthesia is anesthetized, then a cut line is noted. According to this trait, the skin is cut with a laser or a scalpel. The operation ends with suturing with absorbable sutures (catgut, vicryl). If the threads were used not self-absorbable, then after a few days it is necessary to remove the seams.
Before the intervention, the following contraindications should be considered:
- acute balanoposthitis with pus,
- congenital pathologies of the penis, various deformations and abnormalities,
- wounds and ulcers on the genital mucosa,
- venereal diseases,
- hemophilia and other bleeding disorders,
- oncological neoplasms.
It is more preferable to perform circumcision in childhood because the healing process is faster. The smaller the child’s age, the easier it is to care for the genitals in the postoperative period.
After the operation, it is not advisable for newborns to bandage the penis or use cotton-gauze materials. In older boys, a sterile dressing is applied to the damaged area. In the first 24 hours it is forbidden to remove it. Starting from the next day, its replacement is carried out 6 times a day for as many days as it takes to tighten the wound (on average, from three to four). When the wound is healed, the dressing can not be done, as the access of air promotes healing.
If the penis is bandaged, then the adhered bandage should be moistened with hydrogen peroxide. This allows you to remove it without additional damage. When dressing a child, the penis is treated with Chlorhexidine, Miramistin, a solution of potassium permanganate or Furacilin. Peroxide is not suitable for treating the wound itself, as it increases the healing time. If the incision was not sutured with catgut or other absorbable sutures, after several days it is necessary to remove the stitches.
To alleviate the condition in the postoperative period, the doctor may prescribe a painkiller. For antiseptic purposes, ointments are used to facilitate care: Levomekol, Erythromycin and Tetracycline. If the incision does not heal well, Solcoseryl gel helps well. They also contribute to the healing of ointments and creams of Bepanten Plus, Panthenol, Dexpanthenol in children.
Water procedures can be taken only after two to three days. Bathing is carried out in water with a small addition of salt, decoctions of chamomile and sage. This promotes wound healing.