What is circumcision?
Circumcision is the process of cutting the foreskin to a suitable length all around, exposing the glans (penis head), and suturing the skin with the remaining mucosa.
Why is circumcision done?
It is mostly applied for sociocultural, religious and rarely medical reasons. Frequent urinary tract infections, phimosis (too narrow foreskin tip), recurrent attacks of balanitis (inflammation of the foreskin), regionally for protection from AIDS can be counted among the medical causes. Circumcision is a surgical procedure regardless of who performs it, and physical examination and tests must be done beforehand.
When should circumcision be done?
It is one of the most frequently asked questions to us. There is no absolute truth about this. However, we have an answer to the question of when we should not have more done. We do not recommend this time period, especially since the age range of 2-5 years, which we call the phallic period, is the age range where the fear of castration is experienced. In my newborn period (first 1 month) or after the age of 5, if the patient is prepared enough, it can be done with local anesthesia if he/she wants it. We recommend that all circumcisions be performed under superficial anesthesia.
What tests should be done before circumcision?
Since circumcision is a surgical procedure, the doctor who will perform the circumcision must evaluate the patient. Knowing and detecting additional diseases by thorough examination before circumcision is important in terms of minimizing possible complications. In addition, additional diseases such as hypospadias, undescended testis, inguinal hernia, hydrocele should not be overlooked.
Children who will be circumcised should also be asked for a hemogram (blood count), PT and PTT (bleeding-clotting time determination) and confirm that these tests are normal.
Who should be circumcised and by what method?
It is the oldest and the most performed surgical procedure in the world. We call it a surgical procedure because if it's not done in the right hands and the right way, it can cause problems. Pediatric surgeons, pediatric urologists, urologists or general surgeons trained for this procedure perform this procedure.
There are two types of surgical techniques as performed technique. One of them is the method of blowing, pinching the excess skin just above the tip of the pipi with the help of a clamp and cutting it with a scalpel or cautery. However, our most preferred technique is the open (dorsal slit) technique. It is the cutting of the prepisium by first opening it vertically with scissors, seeing the mucous part you will leave, and adjusting it to the desired width. It is the best technique in terms of both less complications and aesthetics.
What are the complications of circumcision?
Although the complication rate of circumcision is low (1-7%), some complications can cause lifelong distress in the child. There are 21 complications described so far. Some of the most common complications are;
- Bleeding
- Narrowing of the urethra
- Having your penis buried and pretending to be uncircumcised
- Injury of the urinary tract
- Such as cutting part or all of the head of the penis during the procedure.
In which situations is circumcision objectionable?
The child to be circumcised must be in full health. If the infant or child has fever, upper respiratory tract symptoms (fever, cough, runny nose, etc.), circumcision should be postponed and performed after the complaints have subsided.
The most important condition in which circumcision should not be performed is the presence of hypospadias. Especially in severe groups, this foreskin is needed in hypospadias surgeries. You can find detailed information about this disease from the hypospadias disease section of our website or from the address www.hipospdias.com.tr.
How should the care after circumcision be?
We do not hospitalize you after the circumcision procedure. In our application; A few hours after the procedure, the baby/child goes home after urinating and feeding. We do not want him to survive that day in terms of payment. We generally do not apply dressings, we only want the antibiotic cream to be applied 2-3 times a day on the penis for two days. Even under general anesthesia, they do not feel pain for about 6-8 hours since we use local pain relievers during the procedure. Afterwards, we recommend continuing with pain relief syrups for a day or two at home. Especially in adherent pipi, there is an increase in yellow secretion on and around the pips after circumcision, and families may perceive this as inflammation. In particular, we tell families that this is not a problem, that this is a normal thing. We recommend warm sitz baths three days after circumcision, in order to increase the healing of the penis and to dissolve the stitches we have thrown during the procedure. Warm sitz baths should be in the form of sitting in warm water 3-4 times a day and for 10-15 minutes. We recommend doing about 5-7 days.