Indications of circumcision
Nerve Sparing Esthetic Circumcision
– Phymosis: Phimosis is defined as the inability to retract foreskin covering the head (glans) of the penis. This condition is physiologic in infants and usually resolves around 5-7 years of age.
With false beliefs, parents sometimes try to retract prepucium forcefully that may cause tearing and bleeding and inflammation. It results in a scar tissue at the tip of prepucium called “phymosis ring”. If there is ballooning of the foreskin during urination, difficulty with urination, or infection, then treatment may be warranted.
– Paraphymosis: In case of retracting forcefully, phymosis ring of prepucium may squeze the glans of penis. Because of circulation of prepucium fails, edema, pain and urine retention occurs. It needs urgent intervention.
– Balanitis : Balanitis is inflammation of prepucium with yellow discharge caused by infections. After treatment of antibiotic, circumcision may be planned.
– Trauma: Injuries of prepucium (crushing, abrasion, trapping into a zip, etc…) may necessitate circumcision urgently.
– Recurrent urinary tract infections.
The microbes placed under prepucium may play a role in urinary tract infections. To prevent urinary tract infections, circumcision is advised for patients with congenital urologic anomalies (such as vesicoureteral reflux) and children who have normal anatomy but suffer frequent urinary tract infections. The percentage of urinary tract infection in circumcised children and uncircumcised ones is 0.1-0.2% and 1.1-4.2% respectively.
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- Morten Frisch MD PhD, et al. Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision. Pediatrics doi: 10.1542/peds.2012-2896 March 18, 2013
Hakan ERDOGAN, M.D
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