Circumcision!

Circumcision is one of the most performed surgeries in the world. It is performed both for protective purposes because the foreskin (preputium) poses a risk for recurrent urinary tract infections and penile cancer in children, and for religious beliefs, as in our country. It must be done in competent hands to create a cosmetically acceptable penis and to avoid sexual problems in adulthood. Because, although it seems to be a relatively easy operation, when the circumcision series in the literature is examined and when the children who apply after circumcision in our urology practice, especially from rural areas, are reviewed, we see that the possibility of encountering very important complications is not at all low.

It should be noted that the age of circumcision to be chosen is also very important in terms of the psychological development of the child. The recommended ages today are the period up to the first 2 years and after the age of 6 years. Circumcision can be performed locally or with general anesthesia (sedation). Although there are many surgical techniques, the most commonly used circumcision technique is dorsal slit surgery. After absorbable sutures are removed, circumcision dressing is performed and the child is discharged with the necessary recommendations. In general, recovery is faster in younger children and takes an average of 4-5 days. Complications related to circumcision include early complications such as bleeding, wound infection, penile adhesions, excessive or underremoval of the foreskin, secondary phimosis, damage to the glans, urethra or penile shaft, and late complications such as meatal stenosis.

While the most common complications are bleeding and infection, which are usually easily treated, serious complications, which are extremely rare, are life-threatening. It has been shown that the complication rates related to circumcision in Turkey are considerably higher in children performed by unlicensed circumcisers outside the hospital compared to circumcisions performed in hospital urology clinics, and circumcisions performed in non-sterile environments outside the hospital and by unlicensed persons can have life-threatening early and long-term effects. reported to cause complications. The most annoying of the complications related to penile skin is having more penile skin removed than necessary. In cases such as having a hidden or buried penis, Factor VII-VIII deficiency that causes prolonged bleeding, and a penis with a skin curtain, primary precautions should be taken and circumcision should be done carefully. Another important condition is that in the case of hypospadias (half circumcisedness) with the urinary hole on the lower surface, circumcision should never be performed because the foreskin is used for repair.

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