“Have the Circumcision Specialized”
Circumcision is an important ritual in our country, as it is seen as the first step towards masculinity. For this reason, it is an important surgical procedure that has many benefits, especially reducing urinary tract infections, although it is often performed without a medical necessity in our country. Circumcision, which has obvious benefits in terms of general hygiene, should be performed in the hands of experienced surgeons under appropriate conditions and with the right methods. However, this very important once-in-a-lifetime surgical procedure, which should make the child feel as special as a prince, can turn into a nightmare that can affect the child’s whole life in the hands of unauthorized and unqualified persons.
What is circumcision?
Circumcision is the process of removing the skin fold (foreskin) covering the tip of the penis in boys by cutting. Since the history of humanity, it has been applied as a requirement of traditions in different cultures or as a religious ritual in some religions. However, circumcision practices performed for health reasons are becoming more and more common all over the world.
How is circumcision done?
Which circumcision method is the best?
After the numbness of the penis and the cleanliness of the area, the adhesions of the foreskin to be removed are first opened and the line to be cut is marked. Then, the skin fold that covers the tip of the penis is cut with a scalpel, scissors or cautery, small bleeding areas are controlled, and then the incision line is sutured with thin dissolving threads. In circumcision performed with disposable instruments called circumcision clamp (Ali’s clamp, Plastibel, etc.), which is easier and more practical, the instrument is inserted after the foreskin is marked, and then, depending on preference, the excess foreskin is cut and removed.
In this method, it is not necessary to suture or control bleeding. The most accurate method is the one in which the circumcision performer is the most experienced and the most suitable for his penis. Who should I do the circumcision? Circumcision is a serious surgical intervention. For this reason, the point that families should pay attention to is that this process, which they consider and care about as the first step of their children to manhood, can turn into a nightmare in the hands of incompetent people. It should be known that circumcision of non-physician persons is prohibited by the relevant law. The authorized doctor must have experience in approaching children; Pediatric Surgeons and Pediatric Urologists are competent and experienced at this point.
Which children should be given anesthesia, why and how?
Circumcision can be performed under local (by numbing only the penile area) or general anesthesia (sedation). Here, the choice is made considering the age of the child and, more importantly, the psychological trauma that circumcision will cause fear and stress on the child. Circumcision can be performed more easily under local anesthesia, since awareness does not occur in children younger than 6 months, and children over 6 years old are mature enough to understand and comprehend the situation. In children aged 6 months to 6 years, it is possible to perform circumcision under local anesthesia by attracting the attention of the child or gaining his trust. Otherwise, it is more appropriate not to stress the child more and to prefer general anesthesia in terms of the success and quality of the circumcision procedure.
What is the best time for circumcision?
The preference of summer months for circumcision in our country for a long time causes a false perception that circumcision is performed only in summer. Circumcision is a procedure that can be done at any age and in any season. Seasons do not affect the healing of the circumcision wound. However, circumcision of school-age children during the holidays may be logical to prevent them from falling behind in school.
What is the right age for circumcision?
The most important point is that the child is spiritually ready for circumcision and is at the age and maturity to correctly understand the form and results of the procedure. For this reason, it is thought that 3-6 years of age are not suitable for circumcision with local anesthesia in the psychological development of the child. However, this idea has not been scientifically proven. As a result, circumcision can be easily performed with local anesthesia (only by numbing the penis) in experienced hands, without turning it into a nightmare for the child and without allowing him to experience fear.
Is there an advantage to circumcision in the newborn period?
Cell renewal and development capacity is very high in our body during the newborn period. For this reason, circumcision performed in healthy newborn babies shows faster recovery. In addition, since babies do not have any concerns about the procedure before circumcision, the possibility of psychological complications due to surgery will be much less.
What are the benefits of circumcision?
The foreskin protects the head of the penis from external factors. However, as time passes under this skin, a secretion called scum and smegma is formed. It is also thought that the foreskin has a carrier and facilitating effect for sexually transmitted diseases. Moreover, in some children, the narrow foreskin can prevent urine outflow and cause penile inflammation and abscesses, also called balanoposthitis or postitis, with the effect of accumulated secretions. Urinary tract infection is less common in circumcised children. Together with these, the foreskin can be compressed, impairing the blood flow in the penis and causing problems that we call paraphimosis, which require urgent intervention and may even cause the loss of the penile tip. It is also reported to prevent future penile cancer. As a result, removing the foreskin will be a precaution against the problems mentioned.
Where should circumcision be done?
It is essential to create sterile areas free from germs while performing surgical procedures. In addition, a team and equipment should be available for immediate and effective intervention to complications that may develop due to surgery and anesthesia during circumcision. The most ideal circumcision is to be performed in hospital and operating room conditions. However, after the desired conditions are created, it is possible to perform it with local anesthesia outside the operating room.
Is pre-circumcision analysis necessary?
Before circumcision, some bleeding tests and some blood tests should be done in patients who will undergo general anesthesia.
What are the developments and innovations regarding the circumcision process?
The prevalence of circumcisions made with circumcision clamps is increasing due to the fact that it can be applied quickly, easily, without stitches, without bleeding, with local anesthesia and because it is aesthetic. In addition, there are methods that use tissue adhesive instead of stitches in surgical circumcisions.
Is there a laser circumcision?
With the introduction of laser technology into many areas of our lives, the concept of laser circumcision has also been mentioned. A system for circumcision with laser technology has not yet been developed in the world. However, electric or battery powered cautery or soldering iron is used for circumcision. In this method, which is popularly called “laser circumcision” but has nothing to do with laser, the foreskin is cut by means of an electrically heated wire. With the burning effect of heat, the veins burn and bleeding is not observed. However, the use of heat in this method and the fact that it can affect the surrounding tissues may cause numbness in the penis.
How is the healing process of the circumcision?
In circumcisions performed with a circumcision clamp, a dressing is not required after the procedure and the clamp is usually removed within 2-4 days. In surgical circumcisions, a dressing impregnated with antibiotic ointment can be placed. After 48 hours, the dressing can be taken and a bath can be taken. If the bandage has come off by itself, it will be sufficient to apply only antibiotic ointment instead of re-wrapping.It may be necessary to use painkillers for the first two days after circumcision.However, sometimes this period may be extended for 1-2 days in clamped circumcisions.Slight swelling and redness at the tip of the penis after circumcision is an expected situation especially after clamped circumcisions .But drink 1-2 weeks The penis will regain its normal appearance.
What causes wrong circumcision?
Is there a possibility to fix it later?
Some of the aesthetic errors that occur in circumcisions performed by non-qualified persons and incomplete circumcision can be corrected later. However, many consecutive surgeries may be required to correct injuries related to the urinary canal (urethra), penile body and head. In fact, sometimes it is not possible to correct this situation and it may result in loss of penis.
Who is not circumcised?
Circumcision should definitely not be performed in children who are congenitally circumcised or with hypospadias (urinary hole being further back), which is also called prophetic circumcision. Because the foreskin can be used in the corrective surgeries of these patients. In addition, in patients with bleeding problems (hemophilia, etc.), circumcision should be performed after the necessary precautions are taken meticulously. Otherwise, serious bleeding problems will occur that can even lead to death. Apart from this, in infections of the foreskin and/or penile called postitis and balanoposthitis, circumcision should be postponed at least until the infection is treated.
