Circumcision

The benefits of circumcision for religious or health reasons are as follows:

• Foreskin inflammatory diseases aren’t seen after circumcision.
• Shortness of foreskin isn’t seen after circumcision.
• Because the foreskin is long and narrow, choke the head of penis as fledging back to the skin isn’t seen after circumcision.
• Formation of stone under the foreskin isn’t seen after circumcision.
• Collection of urine under the foreskin and then transformation into inflammation and the situation damaging to the kidneys isn’t seen after circumcision.
• Scar in circumcision skin isn’t seen often after circumcision.
• Penis cancers can be seen in those with uncircumcised. This situation isn’t seen often after circumcision.
• It is also encountered to cancer of the cervix with partners of uncircumcised men more frequently than the other.
• Sexually infected diseases are more common in the uncircumcised.

WHEN THE CHILD SHOULD CIRCUMCISE? PSYCHOLOGY OF CIRCUMCISION

Traditional view is circumcise should be done at an early age. The Jews circumcise a male child the 8. day of his birth with a ritual. The benefits of doing the circumcision within the first 30 days are as follows:

• Because of baby’s pain sensation doesn’t fully develop within the first month, circumcision can be done without anaesthetized.
• Bleeding will not occur during circumcision because vascularity is not too much in penis.
• Wound healing is quicker in infants, for this reason circumcision wounds heal faster.
• By doing the circumcision in an early time, situation requiring emergency circumcision is prevented. The foreskin strictures may occur in an advanced age.
• The Personality doesn’t develope in newborn, for this reason, the negative effect of the circumcision is prevented by doing the circumcision in an early time.

Between 1-6 years, especially between 4-5 years, is the period of psycho-social development of children. Children are afraid to lose their wienie in this period. Also they are strongly dependent on the mother. A circumcision ??at an early age can cause psychological adverse effects. For this reason, circumcision isn’t recommended at this age. Children who are circumcised in this age are deprived of sociological perspective, customs and ceremonies. Because of this reason, in later years they may enter into a crushed.

After 7 years of age, this psycho-social circuit enters a recession and continues until the age of puberty. At this age the circumcision will develop the child in psycho-social aspects. He will distinguish he is is a member of the community, will understand the circumcision’s causes.

For these reasons, circumcision should be done in the first 30 days or after 7 years.

WHO SHOULD DONE THE CIRCUMCISION

A specialist (urologist – pediatric surgeons – general surgeon – plastic surgeon) needs to do healthy circumcision. Thus, a lot of circumcision faults can be prevented.

The benefits of circumcision which is made by a specialist are as follows:

• If the child has an illness such as non-stopping blood (hemophilia), side effects of this disease will be prevented by drugs.
• If it is done by an expert doctor, it reduces the possibility of faulty circumcision.
• Because the surgical instruments sterilized so good under the supervision of a doctor, it reduces the possibility of grabbing hepatitis B, hepatitis C.
• The foreskin of the penis is taken up as required, in advanced age, growth and development of the penis will be normal.
• Circumcision is done under pain-relieving medications, for this reason; the children’s pain does not.
• Wound healing will be quicker, because the circumcision wound is planted.

When the village circumciser will do the circumcision, it is more difficult seize the child; because he feels pain and he will be too very restless and irritable. For this reason, the psychology of the child deteriorates.

HOW THE CIRCUMCISION SHOULD BE DONE ?

Circumcision has been done in various ways over the years. At first, the foreskin is compressed with two ropes; the remaining portion of the skin was cut. Then, instead of the rope, various wood and metal clamps were used. Jews used a metal sheet whose middle is split, and during the Ottoman period each doctor chose to use clamps associated with his name.

Nowadays, there are “bell” s and “clips” in various shapes and sizes which can be used as a surgical. However, experienced surgeons perform aesthetic surgery circumcision using no special equipment.

REALIZATION OF THE METHOD OF CIRCUMCISION

The general hygienic conditions are prepared. According to the age of the child will be circumcised, in addition to general anesthesia (narcosis) or intravenous sedation (intravenous drug medicine), regional anesthesia (with a needle) is made. After that, a pliers or a clamp placed on the foreskin in 5-6 mm away from the top of penis. It must pay attention, portion of the penis head doesn’t enter into the forceps mouth or into the clamp. Then, it is cut just below the penis with a lancet (scalpel). The bleeding vessel nozzles are connected one by one. The two ends of the cut skin are sewn with stitches. The most recent, over the wound of cuts are wrapped with a cloth placed on ointment. Dressing is not required. The rope used in stitches melts itself. There is no need to get stitches. The stitches will break and fall spontaneously till one week. The child can walk immediately. After 2-3 hours, painkiller syrup or suppositories can be given to the child because the influence of needle passes.

Our preferred method for circumcision is intravenous sedation + local anesthesia technique. In this way, there is no fear and excitement in children and also side effects of general anesthesia and loaded conscientious to families are reduced. Child does not see the tools while using; doctor can operate in much more peaceful environment and circumcision will be completed as a more aesthetic. After a very careful control of bleeding, the remaining skin sews aesthetically in this way the need for dressing after circumcision disappears. Child can eat his meal and do all kinds of his social activity one hour after circumcision. In babies, a diaper can be placed immediately after circumcision. We request the parents the child doesn’t ride a bike for 1 week, avoid the activities will impact the penis and entering the sea. full healing of the wound takes about 1 week.

FAULTS OF CIRCUMCISION

• Circumcision faults occur when the people who don’t know how to do circumcision very well.
• Circumcisions which are not done ??with attention in hygienic environment have many side effects and faults:
• Less cutting of the foreskin: It is seen very common. Except for creating an aesthetic problem, it can lead to stick the skin to the head of penis. There is no a major mind. If necessary, the redundancy is cut on a 2. operation.
• Cutting the head of the penis (glans): It occurs after carelessness. It is very difficult to repair. There is no choice without prosthesis in full cuts.
• Bleeding: It is seen often. In treatment, the circumcision scar will be opened, the bleeding vessels are kept.
• Penis gangrene: Although uncommon, it is the result of tight binding of the penis.
• Circumcision should not be done in the situation (hypospadias = Born in half-circumcised) which the urine outer hole is at the bottom of penis. These children need operations. With this operation, urine outer hole is taken the tip of the penis. During the operation, these children are not circumcised because the foreskin will use. If the circumciser who does not know this accidentally circumcised the child, the success chance of the operation will fall.
• If the circumciser doesn’t pay attention cleanliness and hygiene, inflammation occurs. Pus is collected, and this also causes to raise the fire in child. Chills, nausea and vomiting occur. In addition, diseases such as hepatitis B, hepatitis C can be infected.
• Over Penis Head Sensitivity: Up to 3 months after the circumcision, hypersensitivity may occur in the beginning of the circumcision and it also loses during this time.
• Depending on tightly bandaged after circumcision, the child may not urine.
• Urine hole stricture may occur.