Author: Chen Shanwen (Huashan Hospital, Fudan University)
There are many methods of foreskin surgery (circumcision, commonly known as circumcision), in recent years, with the invention and application of some auxiliary instruments, the foreskin surgery has been improved day by day, which not only greatly shortens the operation time, reduces the pain of patients, greatly reduces the occurrence of postoperative complications, and the aesthetic degree of postoperative surgery has also been improved.
Foreskin surgery is usually performed in an outpatient small operating room or operating room, and only 1 to 2 doctors are required to complete it, without the need for hospitalization. Commonly used modalities include traditional circumcision and instrumental assistance (e.g., lacess and sutures) circumcision.
Image source: Stand Cool Helo
1. Manual excision and suture is legal (traditional foreskin surgery)
Anesthesia mode
Local infiltrative anesthesia is often used, and a needle containing an anesthetic is used to prick the skin around the base of the penis, and it can take effect in a few minutes, and the doctor will use forceps to clip the foreskin and other patients who have no pain and then operate.
Duration of surgery
Surgery takes about 20 to 30 minutes, outpatient surgery, no hospitalization required. After the operation, if there is no special discomfort, such as wound cracking, bleeding, black and black hematoma under the skin, bandage shedding, etc., you can go home.
Note that if the bleeding is only stained with red part of the gauze, it can be stopped without special treatment, and the bleeding can often be stopped on its own; if the bleeding from the incision does not stop, resulting in a gradual increase in the redness of the gauze, or if there is a continuous drip of blood from the gauze, or the patient cannot determine the condition of the wound, please seek medical attention immediately.
Surgical modalities
Skilled doctors can accurately remove excessive foreskin, supplemented by reliable bipolar electric knife subcutaneous bleeding point electrocoagulation to stop bleeding, large blood vessels can be ligated with sutures, solid and reliable, plus unscreen absorbable thread sutures, elastic bandage gauze bandage.
Postoperative care
Within 3 days after surgery:
Not suitable for showering.
Oral anti-swelling, anti-erectile, antibiotics and other drugs.
It is advisable to be calm and calm, and to be pure of desire. It's all for your own good, because erections can be very painful, very painful, and easy to make the sutures break apart.
Within 3 days, due to tight gauze, edema, etc., the urine is bifurcated (please try to lean forward as much as possible when urinating, and the urethral orifice is straight down to avoid urine flowing onto the gauze, and the paper is dried after disassembly), the glans wound is yellow water (wound exudate, even such as sweat drops), and the tolerable swelling pain is normal.
Within 3 days, the gauze drop or special discomfort is diagnosed immediately, and on the 3rd day after the operation, the surgeon in the hospital is reviewed and removed to bandage the gauze (which has the effect of stopping bleeding and protecting), generally speaking, the doctor's affairs end here, and then rely on the patient's own care.
After removing the bandaged gauze:
Disinfect the wound with disinfectant lotion/spray (disinfect until the wound heals), shower with caution (shower after removing the bandage gauze 3 days after the operation, dry it in time after showering or blow dry with a hair dryer to avoid the occurrence of infection).
Say important things three times: the entire penis and scrotum contact area remain dry, dry, dry, dry, or incision will be ugly;
1 to 2 weeks postoperatively:
Penile edema will be very severe, even worse after erection, so remember not to sit for a long time, stand for a long time, suitable for lying flat, sitting for a while, standing for a while, lying for a while;
In terms of diet, avoid spicy and alcoholic.
Stitch removal: Absorbable threads are sutured without stitch removal, so when the exposed thread is gone, you recover, and it takes about 40 days.
Sexual life: the wound is completely healed and can be sexually lived, it takes about 4 to 6 weeks; sexual life (sexual intercourse or masturbation) within 1 month after surgery may still cause the wound to crack, once it occurs, please come to the hospital in time to deal with it.
Doctor evaluation
This method is VIP-level treatment, but also the most traditional, the most versatile surgical method, can cover all ages, postoperative hemorrhagic hematoma is almost zero, healing is also the fastest, the most critical is that the incision length will look good. Of course, the disadvantage is that the operation time is long, and the technical requirements of the surgeon are high. Unfortunately, the cost of this surgical method is too low (~400 yuan), the technical requirements are high, and many hospitals are reluctant to carry it out, but it can be achieved through communication with doctors.
Second, the shanghuan laxative method
Same as traditional foreskin surgery.
It is much shorter than traditional surgery, about 5 to 10 minutes, and postoperative observation is the same as traditional foreskin surgery.
Choose the matching stapler according to the diameter of the penis. The stapler is divided into an inner ring and an outer ring, and the inner ring is first inserted into the penis, the foreskin is turned over to the inner ring, the length of the inner and outer plates is adjusted, the outer ring and the inner ring are stuck, and the excess foreskin is removed. The foreskin of the stuck area will naturally necrosis and heal.
Shower on the day after surgery to keep the penis dry;
7 to 10 days after surgery, ring removal, ring removal;
Other precautions are the same as traditional foreskin surgery.
In this way, the operation time is short, and the surgical incision is standard round. You can shower on the day after surgery, there is no bleeding during surgery, the chance of postoperative bleeding is very small, and the postoperative effect is also guaranteed. 7 to 10 days after surgery to remove the ring, slightly painful when removing the ring, the incision after the ring removal takes about 3 weeks to heal, during which there may be necrosis of the incision tissue, increased yellow secretion, incision cracking, etc., but generally can heal and recover automatically, but the edema subsides slowly.
Third, the method of foreskin cutting suture
Adult surface anesthesia or local infiltrative anesthesia.
Significantly shorter than traditional surgery, which takes about 8 minutes.
Select the matching ring cutter according to the diameter of the penis, put it into the bell-shaped glans seat, adjust the length of the tie and inner plate and cut the excess foreskin at one time, while the titanium alloy suture nail is fixed, and the elastic bandage is bandaged with the incision.
Remove the bandage gauze 2 days after surgery, other precautions such as traditional foreskin surgery.
The foreskin cutting suture has the problem of titanium nail shedding, if there is obvious bleeding during surgery, it will be sutured 1 to 2 stitches, and the titanium nail can fall off on its own in about 2 to 4 weeks (it will passively fall off when bathing, etc.), if it does not fall off for more than 1 month, it needs to be manually removed by the hospital.
The operation time is short, the surgical incision is standard round, the incision margin is very neat, the appearance is very beautiful, the bleeding during the operation is small, and the postoperative edema is mild. The suture nails fall off automatically, and the postoperative healing time is comparable to that of traditional surgery, and it is also necessary to pay attention to the postoperative observation of bleeding problems, and its hemostasis effect is still a certain gap with manual sutures. Bruising may occur on the foreskin and glans penis after surgery, but both resolve spontaneously.
Finally, please note!
Regardless of the surgical method chosen, there is no need for additional infusions, lighting and other treatments during the procedure. If you have used infusion and illumination, do not be afraid, do not worry, you can immediately go to the regular hospital urology, andrology outpatient consultation, the doctor will provide reasonable advice. I once received a patient who was illuminated after foreskin surgery, and the penis was severely burned and caused ulceration infection, and finally half of the penis was amputated, a real blood and tear lesson!
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