Circumcision is a surgical operation to remove the foreskin of the penis. Circumcision is more commonly accepted for religious/cultural/cosmetic reasons and less commonly for medical reasons. Physiological variants of the penile foreskin are clinical conditions that are frequently referred to for circumcision. Some of such conditions are absolute medical indications for circumcision. Medical circumcision is circumcision performed for penis problems and treatment in Chennai. However, absolute medical indications for circumcision surgery are often delayed, in search of alternative solutions.
Circumcision – Entry Point for Male Health Services
Many men have their first contact with health services while accessing circumcision surgery. Many aspects of men’s sexual and reproductive concerns can be addressed at this point of contact. Hence circumcision is considered as the entry point for male health services like:
* Health education and counseling with a focus on sexual and reproductive functions
* Screening and treatment for sexually transmitted infections
* Counselling and testing for HIV
* Education on family planning and contraception
* Evaluation and management of infertility
* Counseling on gender issues
* Awareness about cancers of the male reproductive organs such as the testes, penis, and prostate
* Counseling on addiction and substance abuse which is associated with many male health risks.
Circumcision – Best possible treatment to save the penis
There are certain conditions in men, where circumcision is sometimes considered to be the best possible treatment option. They form the medical reasons for men to have circumcision otherwise leading to dangerous consequences.
* Phimosis – is where the foreskin is too tight to be pulled back over the head of the penis because of a narrowed preputial opening. The condition is called physiological phimosis when the foreskin is non-retractile but in all other aspects, it appears and functions normally. Physiological phimosis often leads to a pathological one at any stage when the preputial orifice itself is abnormal and scarred. Symptoms include pain and discomfort when the penis is erect and in some men, passing urine becomes difficult. The incidence of pathological phimosis is estimated to be about 1.5% at the age of 17 years. Analysis of tight foreskins are more commonly associated with paraphimosis, urinary tract infections balanitis xerotica obliterans. Circumcision is the best permanent option such penis problems and treatment in Chennai. If phimosis is left untreated or circumcision is delayed, it can lead to increased swelling and in extreme cases lead to gangrene and eventually the loss of the penis. With phimosis, there are also more chances likely to get penile cancer.
* Paraphimosis occurs as a common urologic emergency in uncircumcised men. Paraphimosis is where the foreskin cannot be returned to its original position from being pulled back. When the foreskin becomes trapped behind the corona of the glans penis, it causes the head of the penis to become swollen and painful. This can lead to strangulation of the glans, painful compromise of the penile blood vessels, distal venous engorgement, oedema, and even necrosis. To avoid serious complications, such as restricted blood flow to the penis, immediate treatment is needed. Manual reduction methods are usually unsuccessful. Complications that can occur with paraphimosis include pain, infection, and inflammation of the glans penis. There are chances that the distal penis can become ischemic or necrotic if the constriction is not relieved in a sufficiently prompt timeframe. Circumcision is strongly recommended for all men who have had significant paraphimosis due to the very great risk of a recurrence.
* Balanitis and Balanoposthitis occur in about 1% of males where they develop inflammation of the glans (balanitis) or erythema and oedema of the prepuce and glans (balanoposthitis). These conditions occur in uncircumcised men when the foreskin is usually non-retractile. The inflammation often spreads along the shaft of the penis and is accompanied by purulent discharge. Symptoms include redness and irritation of the glans and the shaft of the penis. Untreated balanitis can cause chronic inflammation that is associated with dysuria. Lasting inflammation can cause urological as well as general health issues. It is common for balanitis to return after treatment. Timely circumcision can prevent recurrent infections and prevent complications.
* Balanitis xerotica obliterans also called Lichens sclerosis is a chronic skin condition of unknown cause that occurs when the skin on the glans hardens and turns white. This condition most often affects the glans and prepuce but sometimes extends into the urethra. The hard tissue can make it difficult or impossible for urine and semen to flow through the urethra. Scarring of the opening of the penis and inadequate blood supply to the penis are common complications. Consequences may include the development of pain, ulcerative lesions of the glans/foreskin, phimosis, paraphimosis, and meatal/urethral stricture. It has been reported from research that malignant transformation of premalignant lesions can occur if the hardened skin to be removed by circumcision is delayed.
* Urinary tract infection has an association with urinary tract abnormality and the uncircumcised state of the penis. Several observational and case-control studies have found 3 to 7 times increased risk of urinary tract infection in uncircumcised males. Complications from UTI include fistula formation, recurrent infection, bacteremia, hydronephrosis, pyonephrosis, and gram-negative sepsis. A meta-analysis of the effect of circumcision in boys revealed that circumcision would benefit those at high risk of urinary tract infection or recurrent infections or with abnormal urinary tracts such as high-grade vesicoureteral reflux.
* Trauma that is isolated to the foreskin is unusual but always raises the possibility of non-accidental injury. Tears, zipper injuries, or crush injuries usually heal leaving a scarred foreskin that can subsequently become non-retractile. Uncircumcised men also seem to have a relatively high incidence of microtrauma and frenulum tearing during penetrative intercourse. Circumcision at the right time can prevent complications.
Latest techniques in circumcision prevent complications by using the laser while shortening the operation time, decreasing the infection risk, and eliminating the need for postoperative suture removal at an affordable cost of circumcision surgery in Chennai. With male circumcision, it is possible to bring medical benefits such as easier genital hygiene, decreased risk of urinary tract infection, no risk of infections under the foreskin, lower risk of penile cancer, and decreased risk of getting sexually transmissible infections (STIs).
