SURGICAL CIRCUMCISION APPLICATION
The process of removing excess skin tissue at the tip of the penis and making the head of the penis visible is called surgical circumcision.
BENEFITS OF SURGICAL CIRCUMCISION
Surgical circumcision should be performed on children who have urination problems due to narrowness of the foreskin at the tip of the penis (phimosis) or who have frequent urinary tract infections. Circumcision will protect the person from sexually transmitted diseases in the long term and will also reduce the possibility of developing penile cancer.
SURGERY WHEN SHOULD CIRCUMCISION BE DONE?
The most appropriate time for circumcision, which can be planned depending on the wishes of family members, is either in the first 6 months or after the age of 6. If the child has conditions such as difficulty urinating or infection, circumcision can be performed regardless of age restriction.
SUITABLE CONDITIONS FOR CIRCUMCISION
Families should know The most important point is that circumcision is not an ordinary simple operation. Circumcision must be performed by a urologist and in environments that meet operating room conditions (sterilization, surgical set cleaning, ensuring environmental hygiene). It is usually performed under local anesthesia in children younger than six months, and under general anesthesia, called light sedation, in older children. Applying local antibiotic creams after the procedure will be beneficial in protecting the wound area.
PLACEMENT OF PENile PROSTHESIS (happiness stick) IN CASE OF ERECTION PROBLEM
After psychological factors have been excluded, if a disease that may impair erection is detected in the patient, treatment alternatives for this should be prioritized. Improvements in erection level can be achieved, especially with lifestyle changes, quitting smoking, and treatment of diabetes and high cholesterol.
Penile Prosthesis (happiness stick): Penile prosthesis. It consists of two synthetic cylinders placed inside the penis. Fitting a prosthesis; It does not affect sexual functions such as urination, ejaculation and orgasm. Three types of prostheses are used. malleable e), semi-rigid prosthesis and inflatable prosthesis. Inflatable prostheses contain a pump and a reservoir in addition to the cylinders in the penis. Fluid is pumped from the reservoirs into the cylinders, thus making the penis erect. By pressing a button at the base of the pump, the fluid collected in the cylinders returns to the reservoir and the penis becomes soft.
Penile prostheses are mainly applied to the group of patients who cannot benefit from other treatment methods. This group consists of patients with uncontrolled diabetes, patients who have undergone surgery or radiotherapy with the diagnosis of prostate cancer or bladder cancer. Penile prosthesis placement in this group of patients has resulted in patient satisfaction rates of up to 90%. When all treatment alternatives are considered, it is the treatment method that provides the highest satisfaction for both the patient and the partner in terms of achieving permanent results.
OTHER TREATMENT FOR ERECTION PROBLEM ALTERNATIVES
ESWT (Shock wave therapy) : With shock wave therapy, new vascular formation can be achieved in the tissue with impaired blood supply in the penis. In this way, it is aimed to bring more blood into the tube structures that enable erection. Studies show that stem cells hidden in the penis can also be activated to create new vessels with shock wave therapy.
This form of treatment does not require any anesthesia and can be accessed by the patient on an outpatient basis. It is applied between 6-8 sessions. It seems to be the most ideal form of treatment for patients who do not want to use medication constantly due to erectile dysfunction or who do not consider having a prosthesis.
Drugs used orally: The first-line treatment of erectile dysfunction consists of medications taken orally. . Men with erectile dysfunction can use these medications before sexual activity or daily in low doses. Medicines increase the amount of certain substances that dilate the vessels in the penis during sexual intercourse. In this way, a better quality and longer-lasting hardening is achieved. Oral medications have mild and usually temporary side effects. The most common side effects are headache, feeling of fullness in the nose, They can be listed as hot flashes and muscle pain.
Intrapenile Injection: Vasodilator drugs can be injected into the tube structures that provide erection in the penis. These drugs work by expanding the penis tissue and the vessels within it. Thus, the amount of blood coming to the tubes increases and erection occurs. Intrapenile injection can be applied to the patient group where oral medications have previously been tried and failed. This technique can be easily learned by the patient for use at home. The patient injects himself 10 minutes before sexual intercourse, and as a result of appropriate dosage adjustment, an erection that will last for about half an hour is achieved. Patients who use intrapenile injections may experience pain during erection and scar tissue may develop on the penis during long-term use. Its use is now very limited due to the difficulty of use and the fact that the desired effect is not obtained in every patient.
Placing medication into the urinary tract: This practice is not used much today. Following the application of the drug to the urinary tract, erection may occur as a result of the absorption of the active substance in the drug and its reaching the tube structures that provide erection. Its use is now very limited due to difficulty in use and not getting the desired effect in every patient.
Vacuum Device: Vacuum devices consist of a plastic cylinder, vacuum pump and elastic compression band. A lubricant is applied to the penis. The penis is inserted into the cylinder and air is pumped out of the cylinder. Thus, a vacuum effect is created and hardening occurs. Although it seems technically beneficial, the rate of discontinuation of the treatment by patients is very high due to the difficulty of use after a certain period of time.
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