phimosis correction

Foreskin surgery is to cut off the long foreskin, that is, cut a mouth directly on the back of the penis, and then cut a circle of excess foreskin in the lateral direction. Excessive foreskin can cause premature ejaculation, too long foreskin treatment will often affect the sexual life between husband and wife, because the long foreskin will cover the male glans - the most sensitive part of the male, so that it can not get stronger during sexual intercourse The stimulation, resulting in uncoordinated sexual life. After circumcision, good nursing methods can avoid postoperative infection and help the wound recover faster. Best time: better postoperative recovery after puberty or before marriage: better effect treatment of disease: prepuce is too long Indication 1. Males whose penis does not normally reveal the glans when it is erect. 2. Males with poor local hygiene and cleanliness. 3, a local recurrent infection, male between the foreskin and the glans. 4. Males with small phimosis openings and small urine flow. 5, push the foreskin to the roots, children with pain. Contraindications Heart disease, high blood pressure patients. Preoperative preparation Prepare one: check Go to the regular hospital urology clinic to see if surgery is needed. In general, phimosis (the foreskin can not be turned up), the foreskin mouth is too tight, repeated edema, affecting sexual life requires surgery. For children, surgery is better at around 10 years old. Preparation 2: Surgical method The most commonly used circumcision is circumcision, including laser or traditional surgery. Preparation 3: Appointment and testing General hospital circumcision surgery needs to be reserved 2 weeks to 4 weeks in advance, should be decided according to their own time schedule. Most hospitals require screening for infectious diseases and blood routines and urine routines before surgery. Preparation four: preparation of skin (After coming to the hospital, the hospital is responsible for preparing the skin.) One day before the operation, the pubic hair of the penis and scrotum is scraped off and bathed. Preparation five: psychological preparation The circumcision is usually an outpatient operation. Complications are rare and can be resumed in a week or so. Preparation six: traffic It is best to take a car or taxi to avoid cycling or driving. Preparation seven: return visit After the operation, take the medicine on time and return to the doctor in time to observe the wound healing. Surgical procedure One cycle cut: (1) Separation of the foreskin and penis head adhesion: Before the circumcision, first check whether the foreskin and the penis head are stuck. If the adhesion should be separated first. (2) Traction fixed foreskin: Place the foreskin in a natural position, and clamp the two vascular clamps in the medial and ventral medial sides of the foreskin, respectively. The distance between the two clamps is about 0.5 cm. (3) Longitudinal cutting of the ventral side foreskin: The assistant uses the left hand to pinch the root of the penis to temporarily stop bleeding. Then lift the two vascular clamps in the middle of the dorsal side. The surgeon cuts the foreskin longitudinally between the two clamps with scissors until it is 0.5-0.8 cm from the coronary groove. Then lift the two vascular clamps in the middle of the ventral side, and cut the ventral foreskin in the same way. The length of the foreskin at the ligament is slightly longer than the back side by 0.2-0.3 cm. Be careful not to damage the ligament when cutting. (4) Circumcision foreskin: After the longitudinal cut of the dorsal and ventral foreskins, the penis head and the coronary sulcus can be revealed. Pull the right two vascular clamps firmly, use scissors to cut the long foreskin from the longitudinal incision of the foreskin, 0.5 to 0.8 cm from the coronary sulcus, until the ventral longitudinal incision. Then pull the two vascular clamps on the left side and cut the foreskin of the left half in the same way. (5) Ligation and hemostasis: After the circumcision, the assistant relaxes the left hand and quickly pushes the foreskin toward the base of the penis to expose the wound. The bleeding point is ligated with a 3-0 silk thread. (6) suture incision: suture the inner and outer layers of the foreskin. Use a thin wire to suture one stitch before the lacing, and then stitch one stitch at the center of the back side and the center of the left and right sides. Knock the 4-needle stitch and keep the tail of the stitch, then in each of the two threads. Add 1 to 2 stitches between them, and cut the stitches after knotting. (7) dressing incision: Vaseline gauze is folded into a strip shape and wrapped around the foreskin incision, and fixed with a tail stitched with 4 needles up, down, left and right. Then wrap it around the oil gauze with gauze, the tape is fixed, and the penis head is exposed. The inner and outer plates are respectively circumscribed: (1) Draw the outer plate incision line: In the case of no tension of the foreskin, at the foreskin of about 0.5 cm distal to the coronal groove, draw an outer plate incision line parallel to the coronal groove. (2) Draw the inner plate incision line: turn the foreskin over the coronal groove, reveal the coronal groove, and flatten the inner layer of the foreskin, about 0.5 cm proximal to the coronal groove, and draw an inner plate incision parallel to the coronal groove. line. (3) Excision of the foreskin: along the incision line drawn on the outer and inner plates of the foreskin, the skin is cut with a sharp knife, and a longitudinal incision is made at the midline of the dorsal side of the foreskin to connect the transverse incision of the inner and outer plates. The vascular pliers are respectively used to lift the two corners of the pimp, and the shallow layers of the blood vessels are separated, so that the excised foreskin gradually falls off. (4) suture incision: After the wound is completely hemostasis, the incision edge of the inner and outer plates is used for intermittent suture. The suture should be sutured together with the connective tissue of the incision margin to prevent the skin of the incision. Root skin circumcision: (1) Incision line: After the foreskin is pushed up to completely reveal the glans, and it is confirmed that there is no possibility of incarceration, the area of the ring-cut skin is drawn at the root of the penis with gentian violet. (2) Circumcision skin: a penile skin is removed along the surgical line. (3) ligation and hemostasis: suture the wound surface with a thin thread to completely stop bleeding. (4) Stitching the incision: the skin on both sides of the incision was pulled together with a small forceps, and the suture was interrupted by a thin thread. (5) Wrap the wound: Apply a layer of sterile Vaseline oil gauze to the wound and apply it with sterile gauze. complication 1, bleeding: Mostly, the hemostasis in the operation is not complete, or the ligature is loose. The bleeding site most often occurs in the superficial veins of the penis and the foreskin ligament. The penile superficial venous hemorrhage is easy to form a hematoma, and the hemorrhage at the foreskin ligament often causes blood to flow out from the wound, and a hematoma can also form under the skin. Seek medical attention in case of this symptom. 2, infection: Preoperatively, the foreskin and penile head inflammation could not be effectively controlled. The incarcerated phimosis was mistaken for circumcision, and the aseptic operation or rough operation was not observed. Postoperative urine contaminated wounds could cause wound infection. After the infection occurs, part of the suture should be removed to make the drainage smooth, bed rest, and medication. 3, foreskin edema: The skin of the foreskin is too much, the dressing is too tight, and it is caused by standing or walking for too long on the day after surgery. In the case of edema of the circumcision, the bandage should be loosened, and the penis head should be moved to the abdomen side, and the "T" band should be used to hold the infection, and the drug should be used to prevent infection and physical therapy. 4, improper foreskin removal: Excessive circumcision, postoperative penile erection, severe cases can be corrected for skin grafting. The circumcision was too small, and the postoperative foreskin still wrapped the penis head. If there is no difficulty in flipping the foreskin, you can often turn it over and wash it; if you still can't be satisfied with the flip or still repeatedly infected, you can perform circumcision again.

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