Post Date April, 15 2023
Every summer vacation, many parents have to grapple with a question: Do you want to circumcise your child? Especially parents whose children have phimosis.
Phimosis refers to the fact that the foreskin cannot turn up and expose the glans. If you pay attention to your child, you may find that almost every boy is born with phimosis, so phimosis is mostly a physiological state rather than a disease, and it is a physiological state that will gradually disappear as the child grows up.
According to foreign data, 80% of children's foreskin can be turned up at the age of 3, while domestic children seem to be slower. A Chinese study published in the American Journal of Pediatrics in 2014 counted more than 2000 kindergarten children, 55.5% of them had phimosis at the age of 3-4 and 44.1% at the age of 5-6.
Since it is a physiological phenomenon that can be solved by itself, it is generally not recommended to treat those without symptoms. It is neither necessary to turn it over with special force, nor need to go to the hospital for prepuce expansion to avoid unnecessary pain, bleeding and injury of the child. In serious cases, it may also lead to scarring phimosis, let alone conventional prepuce cutting due to phimosis.
Neonatal circumcision is mainly due to religious and cultural reasons. From the perspective of health, neonatal circumcision also has some benefits. In 2012, the policy statement issued by the American Academy of Pediatrics believed that the health benefits of circumcision for newborns were greater than the risks, including the prevention of urinary tract infection, penis cancer and the spread of sexually transmitted diseases (including HIV), so it was believed that parents could support what they wanted, but not recommend that all newborns should be circumcised.
The views of Europe are somewhat different. The 2017 edition of the European Association of Urology Guidelines believes that it is unnecessary to circumcise newborns routinely to prevent penis cancer. There is no cultural tradition of circumcision for newborns in China, so it is generally not performed in the neonatal period.
In general, circumcision for children has some benefits, but not many benefits. The risks are small but not completely absent. The benefit-risk ratio is very low. It depends on the wishes of parents. Doctors with strong will generally agree.
There is no strict age limit for circumcision. European guidelines believe that it can be done after the age of 2. Domestic doctors have different habits, and most prefer to do it after the age of 5. However, if there is no discomfort, the phimosis child can completely wait to be separated. Those who want to treat can also apply hormone ointment under the guidance of the doctor (domestic doctors seem not accustomed to using it), and surgery can be the last choice.
If the child has symptoms, such as repeated prepuceitis, urinary tract infection, or secondary phimosis caused by scar stenosis, early excision is recommended. If the child is old or doesn't he separate naturally? Nielsen Pediatrics suggests that if there are blisters when urinating or hormone treatment is not effective after the age of 10, it is recommended to cut.
