Circumcision

Normally, when entering adolescence, the foreskin should be able to be pulled back to reveal the entire glans of the penis and can be pulled back without pain or difficulty. If it cannot be pulled back completely, it will be impossible to clean the dirt that has accumulated under the skin, which consists of sweat, urine, and dirt, causing white stains that we call smegma. The reason we are able to pull the foreskin down is because of the body's growth mechanism, which is caused by the increase in the size of the core of the penis during adolescence. However, in some people, the skin in this area is very narrow, no matter how hard they try to pull it back, they cannot get it down. And if they do it too hard, it will hurt until they bleed, even when they are adults.

The problem of phimosis in some adults is so narrow that they cannot pull it back even when they are erect. This is a problem that brings some people to see a doctor because

• There is inconvenience in having sex because the glans, which is the area that uses the most nerves, is not able to receive full sensation.
• The odor and dirt build-up can also hinder women from having sex, especially those who engage in other sexual activities such as oral sex.
• Sometimes it can cause infertility (Infertile) because the hole is too narrow, making it difficult for semen to reach the tip of the woman's vagina each time you ejaculate. The narrow hole also causes difficulty in urinating.

If the foreskin is very tight, sometimes when used vigorously, such as masturbating or having rough sex, in some people, even if they try to pull it back down, they cannot pull it back. There may be a strangulation around the shaft of the penis, causing swelling and pain, requiring immediate medical attention for correction. This is called Paraphimosis.

Therefore, it can be seen that if we do not take good care of the foreskin, which is very narrow, it can cause a lot of problems. Not to mention being a source of various diseases such as urinary tract infections, penile cancer, and cervical cancer in women. Therefore, circumcision will solve these problems and help with hygiene, preventing odors or unpleasant odors.

Benefits of circumcision

• Reduce the incidence of urinary tract infections in young children
• Reduce the incidence of penile cancer Reduce the incidence of cancer by 1 per 100,000
• Reduce the incidence of some sexually transmitted diseases (Sexual Transmitted Disease) because it reduces the inner skin that can receive infection
• Prevent problems that occur with the foreskin, such as parapymosis
• Prevent the condition of phimosis
• Easier to clean the genitals
• Reduce the incidence of cervical cancer in women Circumcision reduces the incidence of HPV infection, which is the cause of cervical cancer in women.

Surgical techniques

Circumcision techniques can be divided according to the amount of skin left after cutting. If a lot is cut, it will be very tight. If a little is cut, a lot of skin will remain, which may not be very useful. However, some people are satisfied with a small amount of cutting because there will be no significant change in the physical appearance of the penis and the mechanics of intercourse. To determine how much to cut, we have to look at the general normal condition and the erection. In normal condition, the upper edge should be able to be closed, but the erection should not be very tight.

Cutting techniques can be roughly divided as follows:

• Minimal circumcision aims to preserve the physical characteristics and mechanics of sexual intercourse and only removes excess skin from the tip of the penis, making it difficult for men with very long foreskin or a narrow tip that makes it difficult to retract the penis. The surgery allows the glans to be opened for easier cleaning.
• Partial circumcision: Part of the glans is cut off, leaving some skin covering the glans when flaccid, but when erect, the tip of the urethra is not covered and can be fully opened.
• Loose circumcision: After surgery, the head of the penis is completely open. When flaccid, there will be wrinkled skin around the edge of the penis. Except when the penis is more flaccid than normal, such as in very cold weather, there may be skin covering the edge of the penis. When erect, the skin is not very tight and can be moved a little. The advantage is that when wearing swimming trunks or underwear, the skin covering the edge of the penis will help prevent the shape of the penis from being too obvious.
• แบบตึง (Tight) แบบนี้จะตัดหนังหุ้มปลายอวัยวะมากทำให้ไม่มีผิวหนังห้อยๆ บริเวณขอบของอวัยวะเพศในระยะอ่อนตัวเวลาใส่กางเกงในหรือกางเกงว่ายน้ำก็จะเห็นรูปร่างหัวอวัยวะเพศชัดเจน เวลาที่แข็งตัวจะไม่สามารถขยับผิวหนังขึ้นลงได้

Surgical Procedures

In some cases, it is not necessary to shave the pubic hair. It is recommended to shave the pubic hair before the surgery because after the surgery, the surgical wound must be taken care of, with gauze around it and a plaster. If there is pubic hair, it will be difficult to put on the plaster and when removing the plaster, it may stick to the hair, causing severe pain when opening the wound.

• The surgery is performed by injecting local anesthesia into the base of the penis.
• Excess skin is cut as needed.
• Stopping bleeding in the tissues inside the wound.
• The wound is closed with dissolvable stitches.