Circumcision

About the Circumcision Procedure

Circumcision is the oldest surgical procedure performed for over 10,000 years.
Circumcision means the surgical removal of excess foreskin covering the glans. It is a procedure often performed in the Cosmedica Clinic, both for young children (1-4 years) and adults.

During circumcision, the foreskin is separated from the head of the penis, and the excess skin is removed by excision. Circumcision, the removal of the skin that covers the penile gland, can be partial or total. If it is made for newborns, the procedure takes about 20 minutes. Circumcision in adults lasts about 40 minutes. Healing after circumcision is generally between 5-7 days. The procedure may include excision of the brake – frenuloplasty (penis thread) or this can be performed as an individual procedure. The result will be a complete discovery of the penile gland.

Is circumcision necessary?

Circumcision for medical or health reasons is an ongoing issue. The American Academy of Pediatrics has found that the health benefits of circumcising male newborns are great.

The procedure is recommended for newborns, older boys or even adults to treat phimosis (inability to retract the foreskin) or to treat a penis infection.

What are some common reasons for circumcision?

• Religious motives, especially in Muslim or Mosaic populations;
• Occurrence of phimosis – in both children and adults;
• Infectious reasons – due to inflammation of the glans and foreskin
• Sexual reasons – are evidence-based studies that suggest that premature ejaculation disorder can be improved because after circumcision the glans will remain less sensitive. with the passage of the first months after & nbsp; operation.

If you need or think you need circumcision, here are some of the most important things that will help you

What are the benefits of circumcision?

There is evidence that circumcision has health benefits, such as:

• A low risk of urinary tract infections; severe urinary tract infections can lead to serious kidney problems over time;
• Low risk of contracting sexually transmitted diseases (including HIV);
• Protection against penis cancer and a reduced risk of cervical cancer in female partners;
• Prevents inflammation of the glans as well as inflammation of the foreskin;
• Prevents phimosis (inability to retract the foreskin) and paraphimosis (inability of the foreskin to return to its original position).

Circumcision (also known as “circumcision”) helps maintain proper penis hygiene.

A circumcised penis is as fertile as an uncircumcised penis, circumcision does not affect fertility, nor does it diminish sexual pleasure for the circumcised man or his partner.

Ideal candidates for circumcision

Circumcision can be done at any age. If you were not circumcised at an early age, you may later decide to have circumcision for medical reasons. Your doctor may suggest circumcision for the following reasons:

• You have repeated foreskin infections that do not respond to any treatment;
• You can’t move your foreskin away from the tip of your penis.

Before circumcision

You need a set of tests that can be done beforehand and if they are OK you will be able to come directly for the intervention according to the understanding and programming that you have done before with one of our doctors. After receiving the results of the tests, please send them to us and make sure that you have received confirmation of their interpretation.

It is very important that the urine and urine culture summary examination be taken seriously because a urinary tract infection can cause quite serious complications manifested by suture dehiscence and vicious scarring, which further leads to pain and abnormal positions of the erect penis.

Even if you spoke to one of our doctors by phone for some details about the operation and made an appointment, it is necessary to arrive at least 1 day in advance to perform consultation; this way you will find out everything that the operation entails, the recovery period and you will also receive the answers to any questions you may have.

Our doctors recommend that each patient perform a disinfection and cleansing of the penis, glans, coronary groove and tissues at least once a day before the operation. around the penis with an antibacterial solution (Chlorhexidine or Betadine solution); in this way the area where the operation will be performed and the surrounding area should be decontaminated as well as possible in order to further reduce the risk of infection.

Circumcision surgery is usually performed in the vast majority of patients with local anesthesia combined with deep sedation, but to avoid any discomfort, we recommend that on the day of surgery eat food and fluids at least 4 hours in advance.

Circumcision procedure steps

How is circumcision performed?

Anesthesia can be local combined with deep, epidural, or general sedation (depending on patient preference or indication of anesthesiologist in some situations)

Duration of circumcision

Duration of circumcision: about 45 minutes
The procedure involves removing excess skin from the foreskin covering the glans, by multiple, varied techniques. . Our technique consists in the complete removal of the foreskin, so that the glans remains uncovered almost completely, even in a relaxed position, keeping the shape of the skin that is to be molded on the glans at the level of the ventral face. There are situations in which the glans can be left partially uncovered, but then it is important for the patient to perform the daily decalotation movement several times until the suture heals because there is a risk of synechiae (adhesions between the circumcision suture and the glans). There are some patients who have phimosis & nbsp; however, they want to keep the foreskin as long as possible, so the foreskin will be removed immediately after the foreskin narrowing area, which did not allow decaling.

The suture used will gradually melt, & nbsp; he will fall alone in the first 14-21 days during local hygiene or in the shower. If it persists, it can be removed without pain for 14 or 21 days, because we give the patient local anesthesia by applying an anesthetic cream 45 minutes before removing the suture.

h2 id=”5″> After circumcision

The patient may leave the clinic on the same day – for children or on the 2nd day for adults;

Regular check-ups every 7 days for nearby patients or only if needed for outpatients.

A 5-7 day treatment with antibiotics and anti-inflammatory drugs is recommended, and locally a cream with antibiotics and hygiene by washing with antiseptic solutions during after showering and urinating.

It is recommended that the dressing be discarded after a few days, but it is important that the underwear be clean and decontaminated by steam.

Sexual activity can be resumed after at least 4 weeks, sometimes requiring the use of a lubricating gel.

Usually the vast majority of adult and pediatric patients go to our clinic for circumcision for the treatment of phimosis, congenital synechiae or those after unsuccessful circumcision surgery. >

Phimosis is a congenital condition that involves a narrow foreskin that may have a fibrous ring that with forced decaling can cause paraphimosis (the inability to recalibrate the foreskin over the glans) – which It is a surgical emergency because that ring will cause compression in the coronal groove of the glans, which can even lead to necrosis due to vascular disorders. If in the case of children where the foreskin is quite loose and maybe after simple dilation the glans is discovered by decaling, in the case of men it is quite thick and only simple dilation does not solve the problem. Moreover, if the fibrous ring, represented by the hypertrophy of the intrapreputal elastic fibers, also appears, the chance that only the dilation will have a notable effect is very low. In addition, the attempt to dilate the foreskin in adults will cause a rupture of the elastic fibers, which then leads to bleeding and healing will be done with scars that will implicitly cause the foreskin to narrow. It thus enters a vicious circle for which the only solution is to remove the foreskin.

Our recommendation

In the case of men who have a long and tight foreskin over the glans, a condition called phimosis, with the risk of paraphimosis after decaling, the only real solution is circumcision.

Patients at Cosmedica Clinic often associate circumcision with penis enlargement procedures to create a normal-looking penis without excess skin. In order to ensure the optimization of the shape, appearance and survival of fat over time – circumcision is the procedure that can be considered in & nbsp; be performed in the first stage, at least 3 months before the fat injection.

h2 id=”6″> Circumcision risks

Like any other surgery, there are risks associated with circumcision. However, they are low:

• Durere;
• Risk of bleeding and rarely infection at the site of cutting;
• Irritation of the glans;
• Risk of inflammation of the penis opening;
• Risk of circumcised penis injury.

Principala complicatie care trebuie luata in calcul este hematomul. 

Asta inseamna o acumulare de sange in exces sub pielea penisului care apare datorita unui vas de sange aberant care a fost sectionat si neglijat, care pe parcursul operatiei nu a sangerat si nu a ridicat suspiciuni. Dupa operatie, datorita cresterii tensiunii arteriale acel vas de sange poate sangera in exces si astfel se poate aduna o cantitate uneori impresionanta de sange sub pielea penisului, care necesita reinterventie chirurgicala prin desfacerea suturii, eliminarea cheagurilor de sange si oprirea sursei sangerarii. Totusi, se intampla foarte rar, dar de cele mai multe ori in cazul adultilor deoarece aici vasele de sange sunt destul de mari. 

O alta complicatie poate fi legata de infectie, care trebuie luata in calcul ca si la orice operatie, dar care totusi se intampla foarte rar.

O alta complicatie, care este mult mai serioasa, este parafimoza ( penisul se poate decalota dar nu se mai poate recalota o data ce s-a instalat erectia ) – in situatia in care nu s-a inlaturat suficienta piele si inelul ingust care producea o ingustare la nivelul circumferintei preputului a ramas pe loc. Se intampla doar in situatia in care chirurgul nu are experienta.

O alta complicatie care trebuie prevenita intotdeauna, consideram cea mai importanta, este daca se inlatura o portiunea prea mare din piele, astfel incat in cazul erectiei corpii cavernosi nu se pot expanda suficient si apar dureri si incovoierea penisului in portiunea ventrala. Aceasta conditie se trateaza destul de greu, prin operatii reconstructive care presupun lambouri de la nivelul tesuturilor de vecinatate si de obicei necesita timpi operatori multipli.

Recovery after circumcision

Healing takes 7 to 10 days. The tip of the penis is likely to be inflamed at first and the penis may look red and slightly inflamed. You may notice a slightly yellow crust at the tip of the penis.

If the newborn is agitated as the anesthesia disappears, keep him close to you, with care and gentleness, taking care not to put pressure on the newborn. penis.

It is okay to wash the circumcised penis during healing. For newborns, change the bandage at each diaper change, dab the tip of the penis with a little cosmetic grease on the tip of the penis to prevent the penis from sticking to the diaper. The diaper should be changed several times, but it should not be caught relaxed, not very fixed. After the penis is completely healed, daily hygiene will consist of washing with soap and water during normal bathing.

Price of circumcision operation

The standard cost of circumcision surgery is from 1000 euros all inclusive with 1 day of accommodation and all checks until healing.

If you are interested in doing a circumcision , you can schedule a checkup with surgeon Mihai Chertif of the private clinic Cosmedica. Send an email to office@faloplastie.ro .