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Circumcision: all you need to know about baby circumcision
If circumcision, that is to say the removal of the foreskin, most often has religious or cultural reasons, it may also have a medical necessity. It then bears the name of posthectomy. Explanations.
Circumcision, what is it?
Circumcision, or posthectomy, is a surgical procedure that involves removing the foreskin, the small skin that covers the glans at the end of the penis.
When circumcision is medically indicated
Phimosis
We speak of phimosis when the foreskin is so tight that it prevents any cracking. In babies, this little physiological peculiarity rarely leads to complications. This is why it is no longer advisable to systematically seek to retract little boys, as has been the case in the past. Phimosis usually disappears on its own: the growth of the glans and the small erections contribute over the months to gradually relax and expand the skin hood.
The only possible concern: phimosis sometimes promotes the appearance of urinary tract infections or infections in the glans. These balano-posthitis cause redness, purulent discharge, discomfort, itching in the glans. To treat them, it suffices to clean the end of the penis well with compresses impregnated with antiseptic. No need to worry if it is an isolated episode.
Only frequent infections in the youngest or a phimosis that persists after the age of 4-5 years can lead the doctor to intervene. If the phimosis is moderate, the application of corticosteroid ointment may be sufficient. Otherwise a small operation will be considered to free the glans from the foreskin. The surgeon then has two options. He may be content to make a small incision to widen the foreskin opening (plasty). Or perform a circumcision (posthectomy), that is to say remove the skin covering the glans. Many parents dread such an operation, but it gives better results: a simple incision is not always enough, and phimosis can re-appear. Circumcision also requires less care.
paraphimosis
Rare in children, paraphimosis occurs when the foreskin, still too tight, remains in the lowered position. The end of the foreskin (the foreskin ring) then strangles the glans, which swells, becomes purplish, painful and can, if left unchecked, die off. Paraphimosis is therefore a medical emergency requiring immediate consultation. In case of failure of recalotting by a medical team, the surgeon may have to circumcise the foreskin to free the glans.
Other health benefits of circumcision
Since 2007, in Sub-Saharan Africa, there have been voluntary circumcision campaigns initiated by the World Health Organization with the aim of preventing the transmission of the AIDS virus. It seems that circumcision can reduce the risk of HIV transmission. But it is obvious that it does not replace the effectiveness of wearing a condom.
When can you choose to have your child circumcised?
In addition to medical reasons, circumcision is most often performed for religious reasons. The Jewish religion practices circumcision on the eighth day of birth, except for medical advice. The ceremony is named after Brit milah. Although not mentioned in the Qur’an, circumcision also persists among Muslims. But it is also found in certain Christian communities, especially in the East. Finally, circumcision is very widespread in Anglo-Saxon countries, this time for essentially hygienic reasons.
The course of the operation
As before any surgical intervention, a preoperative anesthesia consultation is scheduled before the posthectomy, which can take place under general, locoregional or local anesthesia.
The child is hospitalized the morning of the operation and most often comes out at the end of the day. The operative gesture itself lasts about twenty minutes. The surgeon proceeds to the total or partial removal of the foreskin. Most often, he cuts and sutures the frenulum by making stitches between the skin of the penis sheath and the glans.
Pain in the operated area is usually moderate, temporary and easily relieved with analgesics. Healing lasts 2 to 4 weeks and the sutures fall spontaneously usually within 2 to 3 weeks. The surgeon will specify for how long to avoid the baths.
In addition to the possible complications related to anesthesia, there are rare but possible complications directly related to the posthectomy: bleeding or the formation of a hematoma that may in some cases require local care or even reoperation, delayed healing or an infection of the scar… At puberty and adulthood, circumcision has no impact on the mechanical aspect of sexuality (erection, ejaculation…). Regarding pleasure, feelings and sensations remain very variable and subjective from one man to another.
The origins of circumcision
The term circumcision comes from the Latin circum (around) and hacked (to cut). Its precise origins remain poorly known but they could go back to the 3rd millennium BC, in Egypt. It would seem that circumcision was then practiced for hygienic reasons. It then spread throughout the world for religious or cultural reasons. In 2009, the WHO estimated that around 30% of men over the age of 15 were circumcised worldwide.