Circumcision (circumcision in medical language) is the removal of the part of the penis skin covering the area where the urinary hole opens at the tip of the penis (glans in medical language).
Circumcision has many benefits.
It has been shown that circumcision (Newborn Circumcision) performed within the first month after the baby is born reduces the risk of urinary tract infections by approximately 10-12 times in the first year of life. Circumcision should be medically recommended in the neonatal period for babies whose kidneys are enlarged or enlarged in the womb.
Circumcision almost completely prevents penile cancers.
Circumcision can reduce the transmission between partners of some types of viruses that cause warts on the genitals in men and women.
The most sensational finding is that the risk of transmission of the HIV virus, which causes AIDS, from women to circumcised men is reduced by approximately 60%.
The American Academy of Pediatrics (AAP) has informed the public about circumcision five times so far, and professional opinions on circumcision have been shared with the public. In 1999, it was stated that newborn circumcision has many benefits, but circumcision is not possible. It is recommended that the disadvantages and side effects such as bleeding associated with circumcision should be discussed with the parents in advance and the decision should be left to the parents. In the United States, newborn circumcision is currently performed in approximately 80% of births, and even more in some regions.
Circumcision is a surgical procedure that has cosmetic importance and may require parental care as it disrupts the post-operative comfort of the child's penis. Studies in our country and abroad have shown that undesirable consequences (complications) after circumcision are several times more common than normal in the hands of physicians or similar health personnel who are not interested in pediatric urology. It is recommended that circumcision in infants and children be left to Pediatric Urology specialists who are competent in this field.
The ideal circumcision is to remove the child's foreskin in a way that ensures maximum comfort of the child and parents after the circumcision, without endangering the physical and mental health. It is finished with the best cosmetic result. This excess skin can be cut off with a knife, which is the classical method, or it can be separated with the help of some plastic or metal clamps or with the help of high-heat tools (diathermy or laser). Among all these methods, the highest comfort with the lowest complication rate and the highest cosmetic response is provided by the classical method. In circumcisions performed with stitches, the stitches should be self-absorbable and, if possible, should not be noticeable when viewed from the outside. Special sewing techniques are used for this. The child should not have a rough dressing on his penis after circumcision. The dressing should be as gentle as possible, or only a medicated ointment should be applied and no dressing at all. The first 24 hours after circumcision are the most painful period. In order to spend this period comfortably, it is ideal to inject a long-acting painkiller into the coccyx or a painkiller injection around the penis. Afterwards, a very comfortable process is achieved when simple oral painkillers are used regularly. Since heavy and painful dressings after circumcision will disturb the child, the ideal dressing should be to apply only one ointment to the circumcision line once or twice. As a rule, it should be recommended that a circumcised child be able to take a bath after 48-72 hours. The best cleaning is washing with clean warm water. It should be known that drugs such as tendurdiode can cause serious chemical burns and allergies in the penis. Diaper diapers can be worn immediately after circumcision in babies with diapers, and large size underwear or circumcision panties can be worn in older children.
If circumcision is performed within the first month of infancy, it is called newborn circumcision and the baby is laid on a special table and placed only on the penis. It can be performed with or without stitches under anesthesia. In seamless circumcision, the foreskin is clamped between a special metal clamp and cut, and there is no need for stitches after the procedure. This method is the most commonly used newborn circumcision method in the United States. However, if the baby is older or has reached childhood age, performing the classical surgical method under light general anesthesia will give the best results. General anesthesia in a good center It is ideal to be administered by an anesthesiologist experienced in children. It is not scientifically correct that anesthesia will affect the child's intelligence development. In addition, giving a special medicine that will ensure that the child does not remember going into the operating room and being taken from the operating room to the bed will reduce the psychological trauma that the child will experience. Currently, in children's hospitals in the USA, it is preferred to give amnesia-inducing medication before anesthesia, followed by general anesthesia, even for all very simple interventions that may cause the child anxiety, and is especially recommended by child psychologists.
Circumcision is a surgical procedure. The aim is to minimize this circumcision concern.
The biggest source of anxiety between the ages of 1-2 is separation from the mother. Preventing this will provide the greatest comfort to the child. Therefore, it is ideal to put the child to sleep while in the mother's arms and then take him to the operating room for anesthesia and then wake up the child in the mother's arms.
The trauma will be minimized if all children over the age of 2 are put to sleep by explaining the situation to them in words they can understand, in the presence of their parents, and when they are taken to the operating room where they will receive anesthesia. In this age group, ensuring comfort after circumcision is the most important step. The child should not feel any pain and should see a cosmetically beautiful penis, either undressed or with a very gentle dressing. Regular painful dressings after circumcision also increase psychological trauma. Ideally, an ointment that the child can do on his own is applied twice a day.
As a result, circumcision can be performed at any age in accordance with the psychology of that age. However, if local anesthesia is desired, it is appropriate to avoid ages between 2 and 5 as much as possible.
Since circumcision is a surgical procedure, there is always a risk of complications no matter where, by whom and how it is performed. However, it is clear that the risk of complications will be lowest in the hands of an experienced pediatric urologist who also repairs circumcision errors. Sunnet errors are shown to be between 1% and 5%. The most common complication is bleeding after circumcision. In some cases this blood However, the child may even need to be taken to the operating room again. During circumcision, too much skin may be cut or the tissues of the penis that provide erection may be cut or ruptured. Sometimes, after the foreskin is removed, the penis may slip under the skin and the penis may not be visible when viewed from the outside. All circumcision errors can be repaired by pediatric urology specialists. However, unfortunately, a second operation will be needed under general anesthesia, which will take longer than circumcision.
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