Circumcision is a surgical treatment that solves problems of phimosis (impossibility of preputial retraction), repeated balanitis or discomfort with sex due to a narrow foreskin and/or short frenulum.
It is not a sexual mutilation, but the excision of the foreskin that covers the glans penis without affecting in any way the sensitivity or erectile capacity of the glans or the penis.
When is it necessary?
It is necessary when it is impossible to retract the foreskin daily (see the glans penis completely) in spite of the topical treatments we use at any age. It is necessary in case of repeated balanitis, typical of diabetics or dermatological diseases affecting the skin of the penis, such as lichen. Although there are traditions around the world of circumcision at birth in a systematic way for non-medical beliefs, it has been demonstrated that there are no advantages for sexual relations, but there are no disadvantages either.
As a curious fact, in Africa it has been demonstrated that circumcision helps to prevent the spread of AIDS. In our environment we perform the surgery when it is medically necessary and only exceptionally by request of the interested party without medical cause.
What differences are there between circumcision in children, adults or older people? Is there a greater risk or complications at an older age?
There are few differences. It is more frequent to perform circumcision in children due to unresolved physiological phimosis, it is true that in our environment due to the preference to preserve foreskin in children a preputoplasty can be attempted to solve the problem, but it is not rare to need a future circumcision if it is not properly managed.
In adults it is usually done because of discomfort during intercourse and in adults because of dermatological problems. In children we cannot perform it with local anesthesia, therefore, general anesthesia is required. On the other hand, nowadays sedation with local anesthesia is the norm in adults and the elderly. Dermatological diseases, such as lichen, can cause complications such as discomfort or abnormal scarring.
How is the procedure performed?
The Urology specialist performs it on an outpatient basis (without admission) with local and/or general anesthesia or sedation. By the traditional way with scalpel or fine surgical scissors and resorbable stitches with a temporary compressive bandage that requires local cures for a week.
For some time now, it has been possible to use automatic suturing and cutting systems that offer clear advantages.
What are the advantages of automatic suturing systems?
On the one hand, the cut is quite precise and symmetrical over the entire penile circumference thanks to pre-measurement. In addition, the placement of small staples with a circumferential tape facilitates healing and improves the aesthetic result. All this makes the recovery less painful, faster and with a more satisfactory result for the patient, both aesthetically and functionally.
How is the recovery and what guidelines should be followed?
Recovery is rapid, the next day you can lead a normal life with daily self-applied dressings for 7 days and sometimes pills to reduce discomfort for the first 48 hours.
The need for reoperation for abnormal scarring or poor aesthetic result is exceptional and almost non-existent in the case of automatic suturing.