Urology

circumcision

1. Phimosis children are obstructed by stenosis or repeated infection due to stenosis of the foreskin. 2. Adults suffering from phimosis or suffering from excessive foreskin infection. Childhood prepuce is too long, infants have phimosis or children have too long prepuce, if there is no complication, circumcision should not be performed. Because the phimosis of children under the age of 3 disappears with age, and the other part of the child only retracts the foreskin repeatedly and enlarges the foreskin capsule, which reveals the penis head and does not need surgical resection. Treatment of diseases: too long foreskin phimosis Indication 1. Phimosis children are obstructed by stenosis or repeated infection due to stenosis of the foreskin. 2. Adults suffering from phimosis or suffering from excessive foreskin infection. Childhood prepuce is too long, infants have phimosis or children have too long prepuce, if there is no complication, circumcision should not be performed. Because the phimosis of children under the age of 3 disappears with age, and the other part of the child only retracts the foreskin repeatedly and enlarges the foreskin capsule, which reveals the penis head and does not need surgical resection. Preoperative preparation 1. On the eve of surgery and on the day of surgery, the patient is cleaned. 2. Patients with congenital foreskin and penile head inflammation should be treated with drugs and local immersion treatment, and the operation should be performed after the inflammation subsides. Surgical procedure 1. Position: supine position. 2. Washing and disinfecting: Wash the parts with soapy water and salt water, and disinfect with 1:1000 Xinjieer; the phimosis uses a syringe to cut the needle and inject the Xinjieer solution into the foreskin. 3. Separation and adhesion: If there is stenosis of the foreskin and adhesion between the foreskin and the penis head, first use the hemostatic forceps to enlarge the foreskin mouth, and then use two hemostats to clamp the middle part of the back side edge (the distance between the two clamps is 0.2cm). The adhesion is separated by a slotted probe until the penis head is completely separated from the foreskin. Clean the foreskin and penis head with sterile saline. 4. Design the incision: Hold the foreskin strap with a hemostatic forceps to lift the foreskin. With the tip of the knife, all the marks are drawn at a distance of 0.5 cm from the distal end of the coronary sulcus on the outer surface of the foreskin, and it is prepared as a circular incision to prevent excessive resection. 5. Cut the back side: Cut the inner and outer plates of the foreskin along the probe slot with scissors, and cut the inner plate of the foreskin to about 0.5 cm from the edge of the coronal groove. 6. Excision of the foreskin: Align the inner and outer plates of the foreskin, and pull out the hemostatic forceps clamped on the back side of the foreskin and the ligament, and then check the foreskin of the foreskin as the circumcision. If appropriate, use a curved shear to cut the right flap along the incision about 0.5 cm from the coronal groove, and then cut the left side. The inner and outer panels at the foreskin strap can be left uncut or more. 7. Hemostasis: The penis skin is retracted upwards, and the blood is stopped to stop bleeding. Special attention should be paid to ligation of the superficial vein of the penis in the medial side of the penis. 8. Stitching: Sewing a needle with the silk thread on the back, abdomen, left and right sides of the circular incision, and the ligation should not be too tight, so as to prevent the skin from damaging the skin. The suture is not cut short and is reserved for fixed dressings. Then stitch 1 to 2 stitches between each two stitches, and the needle should be worn close to the cutting edge. 9. Wrap: Place a vaseline gauze (stitched inside) around the foreskin incision, fix it with long stitching, and then wrap it with several layers of gauze.

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