Phimosis and circumcision    

“What is circumcision like? Is it beneficial?” These are questions urologic surgeons get asked frequently. Regarding the anatomy of the male reproductive organ, newborn boys normally have constricted foreskin opening (phimosis) since birth. However, they can still urinate through a tiny opening. The foreskin loosens and can be retracted over time as boys grow up. Parents can help their boys with retraction and regular cleansing of the underneath of the foreskin. Over time, the foreskin will finally loosen fully. In some male children, however, their foreskin is very tight, causing difficulty urinating and pain during urination. This can result in ballooning of the foreskin, leading to infection. For this reason, circumcision should be performed at young ages.

Additional reasons to have circumcision at young ages:

• Thick white discharge (smegma) under the foreskin
• Penile and urinary tract infections
• A history of paraphimosis (inability to pull the skin back)
• Inability to retract the foreskin after four years old
• Religions

Male adults can develop recurrent posthitis, leading to the inability to retract the foreskin. Chronic wounds can happen on the foreskin area, due to diabetes, and on the glans, causing pain and bleeding during sexual intercourse. In addition, poor hygiene due to redundant prepuce can be a reason for circumcision.

Benefits of circumcision

• A simpler hygiene and reduced foul smell.
• Reduced risk of developing infections in the urinary tract and penis.
• Decreased risk of developing infections from sexual intercourse. Despite that fact, safe sexual practices, such as using condoms, are vital for the prevention of STDs.
• Minimized risk of penile cancer, notwithstanding its rare prevalence.
• Reduced risk of transmitting the virus causing cervical cancer to female sexual partners.

Circumcision can lead to more numbness at the glans due to constant friction. However, it can control premature ejaculation for some men.
Contraindications
Circumcision is not recommended for males with blood clotting disorders and boys with penile anomalies, such as hypospadias.

Steps

• Circumcision for newborns usually occurs within ten days after birth. Pain relieving in newborns is simpler than in older kids and adults.
• Preoperative preparation for boys and men is not different. The procedure is performed under local anesthesia unless in older kids who do not cooperate. In that case, general anesthesia may be required. 
• The procedure takes around half an hour to one hour.

Postoperative care for circumcision

• It takes about seven to ten days for the penis to heal.
• Older boys and male adults may need to take a leave of absence for a few days due to post-surgical pain.
• Men can have sexual intercourse from week three or four after the procedure.
• The glans may be reddish, bruised, and swollen at first. Yellow fluid can be spotted at the tip of the penis because the stitches dissolve.
• Patients can clean the surgical wound by themselves throughout the recovery period, no suture removal is required.

Risks or complications of circumcision

The most common complications of circumcision are bleeding and infection in the surgical site. In addition, the foreskin can be seldom cut too short or too long. However, the latter can be fixed.