Circumcision; It is the process of exposing the glans penis (penis head), which is also called the foreskin, by removing the part of the skin covering it.
Circumcision is performed in some societies as a requirement of religion, in others traditionally and sometimes for medical reasons.
In the history of Herodotus, there is evidence that circumcision was practiced in Egypt about 6000 years ago. Since the beginning of the 19th century, circumcision has become widespread in some countries, as well as in the United States, on the grounds that it prevents cancer of the penis in men and cervical cancer in their wives.
In Muslim and Jewish societies, circumcision is performed for religious reasons. While the eighth day following birth is preferred for circumcision in Jewish society, it can be done during the period until puberty in Islam, but it can also be done during the newborn period.
Medical Reasons for Circumcision:
1) Phimosis: The most important medical reason for circumcision is that the foreskin (prepitium) opening is narrower than normal. In this case, in addition to the difficulty in urinating, the foreskin may swell like a balloon.
2) Urinary tract infections: The inner part of the foreskin creates a good environment for the reproduction of microbes and may cause urinary tract infections. UTIs are ten times more common in uncircumcised children than in circumcised children.
3) Foreskin inflammation problems such as balanitis and paraphimosis are seen in completely uncircumcised children and the treatment is circumcision following the regression of the inflammation.
4) Penile cancer: Penile cancer is a disease usually observed in uncircumcised men. In non-circumcised societies, the risk of penile cancer is higher than in circumcised societies.
5) Cervical cancer and sexually transmitted diseases: The risk of cervical cancer is higher in women whose spouses are uncircumcised. AIDS and sexually transmitted diseases are more common in societies where circumcision is not practiced.
Circumcision should not be performed:
Extrophia vesica (incomplete closure of the urinary bladder), urinary tract opening on the back of the penis (Epispadias) or the lower part of the penis (hypospadias) instead of the glans, micropenis (small penis of the penis) circumcision should not be performed. Because the foreskin may be necessary during the surgical correction of these anomalies. Circumcision should not be performed in children with bleeding diathesis, whose bleeding does not stop in a short time, and who have a family history of hemophilia without laboratory tests and taking necessary precautions. In such cases, the child may be lost due to bleeding.
Complications That May Develop Due to Circumcision:
In addition to complications such as bleeding and infection related to circumcision, insufficient or excessive cutting of the foreskin may cause cosmetic problems. Complications that may cause serious problems such as complete or partial cutting of the glans penis, unconscious use of cautery for bleeding control, necrosis of the glans penis, and opening of the urinary tract passing through the penis may occur in circumcisions that are not performed by competent hands.
Circumcision is a surgical operation that should be taken seriously. From time to time, irreparable complications arise in mass circumcisions performed at homes or entertainment venues. In our country, where most of the circumcision is not performed by competent hands, the high number of complications draws attention.
Time of Circumcision:
There are many different opinions on the age at which the circumcision will be performed. Circumcision can be performed in the neonatal period (within the first month) under local anesthesia with the help of instruments such as Bell, Gomco clamp, as well as without suture. It can also be done with a surgical method. Apart from the neonatal period, the most appropriate age we recommend is to be performed under general anesthesia between the ages of 4-7.
The indispensable thing in circumcision is that it should be done under operating room conditions and by competent hands (pediatric surgeons or urologists).
