When is circumcision required?

Circumcision is usually recommended when the foreskin is accompanied by recurrent infections, phimosis, or affects normal urinary function.

1. Repeated infection

When the foreskin is too long and it is difficult to clean, it is easy for secretions to accumulate between the foreskin and the glans to form smegma, which may cause balanitis. If infection symptoms such as redness, swelling, pain, and abnormal discharge occur more than three times within a year, surgery may need to be considered after conservative treatment fails. During the infection, topical drugs such as erythromycin ointment and clotrimazole cream can be used as directed by the doctor to control inflammation, but surgery is the fundamental solution.

2. Phimosis

The complete inability of the foreskin to turn up to expose the glans is called phimosis, which may affect children's development or adult sexual life, and increase the risk of penile cancer. Surgical intervention is required when manual dilation fails or is associated with cicatricial phimosis. Acquired phimosis is mostly related to the stenosis of the foreskin opening caused by chronic inflammation, which manifests as symptoms such as difficulty in urinating and thinning of the urine line.

3. Urinary dysfunction

Severe foreskin stenosis can lead to urinary system problems such as urinary retention and increased residual urine volume in the bladder, and may damage kidney function in the long term. When infants and young children experience crying during urination, dribbling of urine, or urinary tract infection, they need to be evaluated for pathological phimosis. In adult patients with benign prostatic hyperplasia, foreskin stenosis can aggravate lower urinary tract obstruction symptoms.

4. Impacted phimosis

Failure to reset the foreskin in time after forcibly turning up the foreskin may lead to incarceration, manifested as swelling and purple glans with severe pain, which is a urological emergency. Immediate surgical release is required after emergency manual reduction failure, otherwise it may cause ischemic necrosis of the glans penis. Even if the reduction is successful for those with a history of incarceration, elective circumcision is recommended to prevent recurrence.

5. Special medical needs

When a spouse has recurrent fungal vaginitis or HPV infection, circumcision can reduce the risk of sexually transmitted diseases. People at high risk of HIV infection can reduce the chance of viral invasion through surgery. When diabetic patients with foreskin lesions have difficulty healing, surgical treatment can help control local infection foci.

After surgery, you need to keep the perineum dry and clean, and wear loose cotton underwear to reduce friction. Avoid strenuous exercise during the recovery period for 2-4 weeks, use sterile gauze to cover the wound and disinfect it regularly. The diet should be light, and appropriate supplementation of high-quality protein and vitamin C can promote healing. If abnormalities such as persistent bleeding, suppuration, or fever occur, follow-up visits should be made promptly. Parents of child patients after surgery should supervise them to avoid scratching the wound and rinse gently with warm water when bathing.