Author: Chen Shanwen (Huashan Hospital Affiliated to Fudan University)
There are many methods of circumcision (circumcision, commonly known as circumcision). In recent years, with the invention and application of some auxiliary instruments, the circumcision has been perfected day by day, which has not only greatly shortened the operation time Time, reduce the pain of patients, greatly reduce the occurrence of postoperative complications, and the degree of aesthetics after surgery has also been improved.
Circumcision is usually performed in an outpatient minor operating room or operating room, and can be done by 1-2 doctors without the need for a hospital stay. Commonly used surgical procedures include traditional circumcision and device-assisted (eg, ligature and stapler) circumcision.
Image source: Zhanku Hailuo
1. Pure manual excision and suture (traditional foreskin surgery)
Types of anesthesia
Local infiltration anesthesia is often used. A needle filled with anesthesia is inserted into the skin around the base of the penis.
Operation time
The procedure takes about 20-30 minutes and is an outpatient procedure without hospitalization. Observe for half an hour after the operation. If there is no special discomfort, such as wound dehiscence, bleeding, large black subcutaneous hematoma, bandage falling off, etc., you can go home.
Note that if the bleeding is only partially dyed with red gauze, no special treatment is required, and the bleeding can often be stopped on its own; if the incision bleeding does not stop, the gauze will gradually increase in red staining, or the blood will continue to appear. In case of dripping from gauze, or if the patient is unsure of the condition of the wound, seek medical attention immediately.
Surgical methods
Skilled doctors can accurately remove excessive foreskin, supplemented by reliable bipolar electrocautery coagulation at subcutaneous bleeding points to stop bleeding, large blood vessels can be ligated with sutures, which are solid and reliable. Suture with absorbable suture without stitches, elastic bandage gauze dressing.
Postoperative Care
Within 3 days after surgery:
Shower should not be used.
Oral anti-swelling, anti-erect, antibiotics and other drugs.
It should be calm and quiet. It’s all for your own good, because erections can be painful, painful, and tend to pop open sutures.
Divided urination within 3 days due to tight gauze, edema, etc. (please lean forward as much as possible when urinating, and keep the urethra straight down to prevent urine from flowing onto the gauze, and after removing the paper Drying), yellow water from the wound on the glans (wound exudate, even like sweat drips), and tolerable pain are normal.
If the gauze falls off within 3 days or has special discomfort, see a doctor immediately. On the 3rd day after the operation, go to the hospital surgeon for review and remove the bandage gauze (for hemostasis and protection). Generally speaking, the doctor’s This is the end of the matter, and then it’s up to the patient’s own care.
After removing the gauze:
Use disinfectant lotion/spray to disinfect wounds (disinfect until wound heals), shower carefully (take a shower after removing the gauze 3 days after surgery, and dry in time after showering or blow dry with a hair dryer, avoid infection).
Important things said three times: Keep the entire penis and scrotum contact area dry, dry, dry or the incision will be ugly;
1-2 weeks after surgery:
The edema of the penis will be very severe, especially after an erection, so remember not to sit or stand for a long time, it is suitable for lying flat, sitting for a while, standing for a while, lying for a while;
Avoid spicy food and alcohol.
Stitch removal: Absorbable sutures do not need to be removed, so when the exposed thread is gone, you will recover, which will take about 40 days.
Sex: It takes about 4-6 weeks for the wound to fully heal and have sex; sex (intercourse or masturbation) within 1 month after surgery may still cause the wound to open , in case of occurrence, please come to the hospital for treatment in time.
Doctor Reviews
This method is VIP-level treatment, and it is also the most traditional and versatile surgical method, which can cover all age groups, with almost zero postoperative bleeding and hematoma, and the fastest healing. The most important thing is that the incision 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 fee for this surgical method is too low (~400 yuan) and the technical requirements are high. Many hospitals are reluctant to carry it out, but it can be achieved through communication with doctors.
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Second, Shang ring bandage method
Types of anesthesia
Same as traditional circumcision.
Operation time
Compared with traditional surgery, it is greatly shortened, about 5~10 minutes, and the postoperative observation is the same as that of traditional foreskin surgery.
Surgical methods
Select a matching stapler based on the diameter of the penis. The stapler is divided into an inner ring and an outer ring. The inner ring is first put on the penis, the foreskin is turned over 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 at the stuck site will necrosis and heal naturally.
Postoperative Care
Shower the day after surgery to keep the penis dry;
Remove the ring 7~10 days after surgery, remove the ring;
Other precautions are the same as for traditional circumcision.
Doctor Reviews
This method has a shorter operation time and a standard round incision. You can shower on the day after the operation, there is no bleeding during the operation, the probability of postoperative bleeding is very small, and the postoperative effect is also guaranteed. The ring is removed 7-10 days after the operation. It is slightly painful when the ring is removed. The incision takes about 3 weeks to heal after the ring is removed. During this period, incision tissue necrosis, increased yellow secretions, and incision cracking may occur, but generally they can heal automatically and recover. , but the edema subsided slowly.
Three, foreskin cutting and suture method
Types of anesthesia
Topic or local infiltration anesthesia in adults.
Operation time
Much shorter than traditional surgery, the surgery takes about 8 minutes.
Surgical methods
Select the matching circumcision device according to the diameter of the penis, put it into the bell-shaped glans seat, adjust the length of the frenulum and inner plate, and then cut the excess foreskin at one time, and fix it with titanium alloy sutures and elastic bandages. Bandage the incision.
Postoperative Care
Remove gauze 2 days after surgery, other considerations such as traditional circumcision.
The foreskin stapler has the problem of the titanium nails falling off. If there is obvious bleeding during the operation, 1~2 stitches will be sutured, and the titanium nails will fall off by themselves in about 2~4 weeks (bathing). It will passively fall off when it waits), if it does not fall off for more than 1 month, it needs to be removed manually by the hospital.
Doctor Reviews
The operation time is short, the incision is standard round, the incision margin is very neat, the appearance is very beautiful, the intraoperative blood loss is less, and the postoperative edema is light. The staples fall off automatically, and the postoperative healing time is comparable to that of traditional surgery. At the same time, it is necessary to pay attention to the problem of bleeding after observation. There is still a certain gap between its hemostatic effect and manual suture. There may be bruises on the foreskin and glans after surgery, but they will subside naturally.
Image source: Zhanku Hailuo
Finally, take note!
No matter which surgical method is chosen, no additional treatment such as fluid infusion, light, etc. is required during surgery. If you have used infusion and lighting, don’t be afraid. If you are worried, you can immediately go to the regular hospital for urology and male outpatient consultation, and the doctor will provide reasonable advice. I once treated a patient who was exposed to light after circumcision. The penis was severely burned and caused ulceration and infection, and half of the penis was eventually amputated. The real lesson of blood and tears!
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