Source: Department of Science Popularization, Chinese Medical Association
"The child's foreskin is too long, do you need surgery?" Parents with boys in their families are inevitably troubled by such problems.
Parents are worried about whether the development of their child's penis after foreskin surgery will be affected? After all, this is related to the "sexual" happiness of the child's life.
First, the role of the foreskin
To know the answer to the question, you should first understand the role of the foreskin. The foreskin is the foreskin of the penis, the inner layer of skin is thin and smooth, migrating to the head of the penis through the coronal sulcus and migrating to the urethral mucosa at the external urethral meatus. The foreskin is tan, thin and soft, the thinnest skin in the whole body, about 1 mm thick, due to the lack of subcutaneous fat, rich in elasticity.
Every part of the human body has a function, and every normal male has a foreskin, which is a kind of self-protection of the human body, just like bananas and banana peels.
The foreskin is a necessary part of the composition of the male organ and acts to protect the head of the penis.
1. The foreskin is the first line of immune defense of the male reproductive organs. Due to specialized epithelial cells, immune system components are abundant on the outer surface of the foreskin, and immunoglobulins are hidden in the foreskin, which have the effect of fighting infection.
2. The foreskin is sensitive like fingertips, it contains concentrated diversity and special nerve endings that can distinguish movement and sense changes in temperature.
3. The foreskin is very cleverly structured, it can slide on its own, and it can secrete lubricants inside, which is not found in any other organ.
Second, the cause and impact of excessive foreskin
The cause of excessive foreskin is that the male penis has a long foreskin, which covers all the head of the penis and the external urethra, and the foreskin can be turned upwards to expose the head of the penis and the coronal sulcus.
In fact, excessive foreskin is a normal phenomenon in boys' formative years, not a pathological symptom. Boys at the age of 11~15 years, 2/3 of the foreskin can be completely turned up.
The effects of excessive foreskin on boys are as follows.
1. It will accumulate smegma, leading to chronic inflammation (such as penile capitis), foreskin phallitis, which can cause penile itching, which can cause pain and even cancer.
2. If the foreskin opening is particularly small, it will cause the foreskin to not retract, hindering the development of the head of the penis and the entire penis.
3. It is easy to cause posthitis and cause itching and redness at the head of the foreskin, that is, the head of the penis.
4. Pay attention to whether there is a stenosis in the boy's outer foreskin. Some people have suffered from inflammation of the external foreskin, which is not noticed at the time, and then scarring, the external foreskin mouth becomes narrow, even the size of the eye of a needle, which will seriously affect urination, causing the child to bulge when urinating.
Third, the foreskin is too long, the best time for surgery
Normal foreskin length means that when the penis is naturally weak, it is located at the neck of the penis, that is, the coronal sulcus, while excessive foreskin means that the foreskin completely wraps the head of the penis, and after the penis is erect, the foreskin can be turned up to expose the head of the penis.
In infancy, most boys have a congenital foreskin that does not require treatment and surgery, and if there is no urethral opening stricture, difficulty urinating, and repeated infections, the child's foreskin is not turned up.
In early childhood, if the foreskin is longer, the foreskin will wrap around the head of the penis and the mouth of the foreskin will be small, but as the boy grows, the foreskin will slowly recede and the head of the penis will be exposed. Many of the pseudoforeskins in childhood are too long, and as they get older and the penis develops, they can relieve themselves and surgery is not recommended.
After boys are over 10 years old, the chance of the foreskin turning naturally is very small. If phimosis is still present at this time, it is necessary to seek medical attention in time to determine whether surgery is required.
After puberty, the true foreskin is usually too long, so it is necessary to turn the foreskin frequently for cleaning, otherwise it is easy to cause foreskin penile headitis. If the boy's penis is often inflamed, he should seek medical attention and follow the doctor's instructions for surgery.
Doctors generally advise parents to observe the growth and development of their child's foreskin. After the boy is 10 years old, observe whether there is phimosis and excessive foreskin, should seek medical attention in time, choose the best time for surgery, should not exceed puberty at the latest, so as not to miss the best age for boy development.
Overweight children should lose weight first, insist on turning the foreskin up, and after losing weight, see whether there is still a situation of excessive foreskin, and then decide whether to operate.
4. What to pay attention to before and after foreskin surgery
Circumcision is mainly the removal of excess foreskin from the penis so that the head of the penis is sufficiently exposed. Surgery is performed to completely remove smegma and expose the head of the penis.
1. Preoperative precautions
(1) Assist the doctor to complete preoperative related examinations, including electrocardiogram, blood test, urine routine, etc. 4~6 hours fasting, drinking, change clean, loose pants. Follow your doctor's instructions for preoperative infusions and medications.
(2) Conduct psychological communication with the child, explain in detail the relevant knowledge of excessive foreskin, explain the necessity of surgery, gain the child's trust and give encouragement.
(3) Have good hygiene habits. Insist on washing the penis with warm water, gently turn the foreskin back during washing, wash the exposed penis head and remove smegma, and reset the foreskin in time after washing.
(4) Observe the child's urination, and if there is repeated difficulty urinating, go to the hospital as soon as possible to find a professional doctor for treatment.
2. Precautions for postoperative care
(1) Bed rest for at least 1 week and reduce activity to reduce penile edema and bleeding.
(2) Do not eat spicy food, choose the eating time according to the anesthesia situation after surgery, if it is local anesthesia, there is no need to fast, if it is general anesthesia, it is often fasting, fasting for 6 hours, drinking 10~20 ml of warm boiled water after 4~6 hours, and observing for 20 minutes if there is no vomiting can enter a liquid diet. Resume the recipe 1 day after surgery, eat small and frequent meals, and eat high-protein, high-calorie, easy-to-digest crude fiber foods. Keep stool smooth and promote wound healing.
Although circumcision is a relatively simple procedure, it is also dangerous compared to other surgical procedures.
Therefore, in order to diagnose and treat safely and quickly, it is recommended that parents go to a regular hospital to find a clinically experienced doctor for diagnosis and surgery.
Author: Qi Jinchun, Chief Physician, Second Hospital of Hebei Medical University
Review: Liu Guihua, Chief Physician, Sixth Affiliated Hospital of Sun Yat-sen University