Policlinic: The parents apply to the polyclinic for the complaints of the five-year-old child. The child, avoiding his parents, approaches the doctor’s desk, with his beautiful eyes and shy state, he puts both his chubby hands on the edge of the doctor’s desk and smiles at the doctor.
The doctor smiles.
—Here, sit down, welcome, what is your complaint? All three smile, the child turns his head to the left and looks at his mother, waiting for his mother’s speech.
—Doctor, the boy’s penis is small, he was circumcised 2 months ago, and the circumcised person said take the boy to a doctor.
—Where did you get the circumcision done, wasn’t it the doctor who did it?
—We did it in a private polyclinic.
—Well, was he a doctor? Didn’t you ask?
—We asked, but we don’t know.
—So you don’t know the name, surname and presumption of the person who performed the surgical procedure on your only child? The parents remain silent, the doctor explains that this situation is important, “If it is the physician who performed this procedure, my approach to the child will be different, if it is sent by a physician, the severity and importance of the event will be different. It is possible. Physicians do not see with your eyes, or as the people say, with the eyes of a circumciser. They can evaluate the situation in a healthy way and give us a healthy direction.”
The doctor made eye contact with the child and said:
—How old are you my dear?
—I am five and a half years old, uncle doctor.
—Do you have a complaint?
—My penis is very small.
—Do you have any burning while peeing? Do you have pain?
— Does urine spill to the right and left while peeing?
— No, uncle doctor.
— Can you hold your pee while you pee?
—I can hold it.
The doctor takes the child’s health card and tells the mother while taking a look at the drugs she has used before and past illnesses:
—Does your child have any other disease?
The doctor takes the child to the examination table.
During the examination, the doctor realizes that the child’s penis is “BUILT PENIS”.
The mother meanwhile:
—They said that if circumcision is done, it will improve, but it has not.
—Have you noticed that after the circumcision is done, it shrinks even more than before? “Yes, doctor,” says the mother, and she is sad and has a feeling of guilt.
—Your child’s penis is not small or small, both eggs (testes) are of normal size and healthy. But he has a condition called “buried penis”, “hidden penis”. Your child’s weight hides his penis, it looks small. In addition, the ties that push the penis outward have shortened, and there have been problems of fusion (connection) between the structures we call fascia, so the outside part of the penis, which should be, is inside, not outside. The erroneous circumcision also exacerbated this situation, and there were things to be done before circumcision. But it is useless to think about them now. The degree of embedding does not require operation “for now”, but there is work to be done. For now, it is enough for me to refer you to pediatric endocrinology in terms of eating habits, obesity and possible hormonal diseases. If necessary, they will direct you to a diet and nutrition specialist. In addition, my advice that I would like to ask you to follow is that you should give your child the habit of eating vegetables and fruits that contain balanced and low-calorie foods instead of high-calorie fatty foods. You should get into the habit of freshly squeezed fruit juices, water and soda instead of sugary drinks and cola. In addition, your child needs to do sports and regular exercise. After these, it is sufficient to apply to our clinic for a control 3 months later.
—Thank you doctor, will there be any problems in my child’s future sexual life, because of this hidden penis and circumcision?
—No, we do not expect a possible problem in your sexual life in the future due to this inconvenience, of course, if you do not disrupt your controls and follow my instructions.
—Thanks, doctor, son. Will you give me some medicine or something?
—No, you don’t need any medicine.
—Thank you, doctor.
The cases of buried penis have increased considerably in the last ten years.
Babies and children with a buried penis and a lower limit of normal penis size should be distinguished, of course, this task is the physician’s. When the penis is pressed around the root, if the penis emerges from the skin and its body appears, this situation is called “BUILT PENIS” or “hidden=hidden penis” in English. The cases of buried penis have increased considerably in the last ten years. Experts attribute this situation to the increase in socioeconomic status, increase in information opportunities, the decrease in the threshold to consult a doctor, and the increasing incidence of child obesity. Children’s families usually apply because they think that their child’s penis is small, as in the above case. They also apply less frequently due to skin adhesions, burning during urination, and inflammation of the glans penis. It can also be due to obesity-related conditions or as a result of insufficient initiation of the fascia of the penis, which has been emphasized in recent years. It may also develop due to the shortening of the foreskin during circumcision immediately after birth. Treatment is planned according to the severity of the impaction and the age of the child. Here, doctors do not ignore possible gender identity confusion and the child’s loss of self-confidence and recommend surgical treatment to the family if necessary. In the above case, the child’s weight concealed his penis, and the accompanying pipi was slightly shortened, and there were problems with fusion (attachment) between the structures we call fascia. Surgical treatment is not recommended. In recent years, doctors are in favor of not waiting too long to recommend surgical treatment due to psychological disorders that are difficult to reverse.