Circumcision is a common practice among the Muslims and Jewish. Have you ever thought about that? Recent development of Medical science shows the Indications of Circumcision. Circumcision did not originate among the Jewish people: they took the practice either from the Babylonians or from African tribes, probably the latter. It had been practised in West Africa for over 5000 years. It is the most commonly done surgical operation.
What is Circumcision?
A circumcision is a surgical procedure that removes the foreskin (the loose tissue) covering the glans of the penis. In infants and young boys, circumcision is most usually performed at the request of the parents for social or religious reasons.
History of Circumcision
‘….and Abraham took Ish’mael his son, and all that were born in his house, and all that were bought with his money, every male among the men of Abraham’s house; and circumcised the flesh of their foreskin in the selfsame day, as God had said unto him……”_______(Genesis 17:23)
Initial records concerning circumcision date back to ancient Biblical times when Abraham circumcised himself at the age 99 in response to Devine request.
Again circumcision is one of the oldest of surgical procedures, and most frequently performed surgical procedure in the world. Evidence of circumcision also found in the study of Ancient Egypt, as identification of circumcised mummies.
Anatomy of Penis
- Is a sleeve of skin that covers the end of penis in its flaccid state.
- consisting of 3 million cells, 50 nerve endings, 12 feet of nerves, 100 sweat glands and 3 feet of blood vessels.
- It’s main function is to protect the sensitive tip of the flaccid penis.
- Initially, the inner surface of the prepuce and epithelium of the glance are fused
- completely retractable, 4% in newborn, 20% at 6 m, 50% in 1 year, 70% in 2 year and 90% at 3years.
Advantage of circumcision?
- The prevention of urinary tract infection in infants
- The prevention of STD’s
- The prevention of penile cancer.
Why Need circumcision?
- Preputial adhesions- Preputial Synache and Tight prepuce
- Phimosis (stenosis or inability to retract the prepuce.)
- Balanoposthitis( Inf. Of glans & prepuce.)
- Smegmal cyst
- Trauma to foreskin
- Prior to radiotherapy in Ca penis
When Can Not Be Done?
- Genital anomalies
- Buried penis
- Medical condition (Unstable, sick infant or family H/O bleeding disorders)
When Circumcision Is Done?
What is the suitable time for circumcision? The most commonly questions asked by Parents.
- Abraham circumcised himself at the age 99 in response to Devine request
- Jewish boys are circumcised on the 8th day of life
- Muslim boys after birth before leave the hospital ( Saudi Arabia)
- Optimum age is the preschool age ( after 3yr)
Operative Procedure, How To Done?
Techniques of Circumcision-
1) Guillotine method / Freehand technique: In past it was the only method but rarely practised now.
2) Dissection method / Sleeve procedure
3) Dorsal slit method
4) Gomco Clamp or Plastic disposable devices
Images for Sleeve Method of circumcision
The sleeve resection method requires good surgical skill and is better suited to a hospital rather than a clinic setting. The technique requires an assistant. If bipolar diathermy is available the procedure can be virtually bloodless. Although the cosmetic results are better than with the other two techniques, there is more room for surgical error, either by cutting too deep when making the two circular incisions or cutting too deep when dissecting the skin flap free.
Photos of Dorsal slit method of circumcision
Common method for both procedure to Stop any bleeding and suture
Photos of Gomco Clamp
Where to Done Circumcision?
It must be done in well organised hospital under a paediatric or general surgeon. It is actually a nightmare for the child to be circumcised, so General anesthesia may be done.
Complications of Circumcision
- Injury to the glans, urethra->meatal stenosis.
- Entire penis may be ‘scalped’
- Removal of to much or to less skin.
- Infection-Necrotizing fascitis.
- Minor cosmetic imperfections
- Inclusion cyst
- Urethro-cuteneous fistula
INFORMATION FOR PARENTS CONSIDERING CIRCUMCISION FOR THEIR CHILD
Parents should be given information about circumcision so that they can give informed consent to the procedure. The information should be given verbally in the local language using non-technical terms. In addition, the clinic should have printed information sheets that the parents can take home. Information given needs to be specific to the clinic, and should include the following topics.
The benefits of circumcision: The main benefits of circumcision are improved penile hygiene, reduced risk of sexually transmitted infections, including HIV, and reduced risk of cancer of the penis.
The risks of circumcision: It should be explained that complications from male circumcision are extremely rare but can include poor cosmetic outcome, bleeding, infection, or injury to surrounding structures.
What to do before circumcision: No special precautions are needed before the operation. If the child becomes ill before the planned operation date, the parents should contact the clinic to postpone the procedure until after the child recovers.
What to do after circumcision: The instructions will depend on the procedure that has been used (see descriptions of
techniques in Chapter 6).
What to do if there are any complications or problems after circumcision: In particular bleeding, infection or other concerns. This will usually be for the family to bring the baby back to the clinic, but if distance makes a return visit difficult then an
alternative health facility should be identified.
Ok, Thats a Huge post, Save it for future. To download PDF Click on the PDF link below.
Incoming Search Terms:
- sleeve resection circumcision (19)
- dorsal slit (11)
- gomco clamp (10)
- circumcision (8)
- dorsal slits (7)
- sleeve circumcision (6)
- circumcision method (6)
- freehand circumcision (6)
- gomco clamps (5)
- mcburney incision (5)