Circumcision is carried out for various indications. It can be done for cosmetic reasons or for medical reasons. There are also many relative indications of circumcision, including penile and cervical cancer prevention, sexually transmitted infection prevention, especially HIV, and urinary tract infection prevention. Many surgeons would also perform a circumcision during surgery for hypospadias,.
Absolute Medical Indications for Circumcision
For Pediatric:
Most common cause for pediatric patients is religious.
The second common cause is congenital phimosis or too long prepusal skin which allows ballooning at the time of urination.
The third reason is parents specially the father wants his son exactly should be like him. So if the father is circumcised he will love to get his son circumcised too.
The fourth reason is trauma to prepuce in zip injury
For adults:
1. Phimosis is a condition that happens when it is not easy to pull the foreskin back over the penis head. During sexual intercourse or masturbation, men with this condition often experience pain.
There can be physiological phimosis or long precpusal skin or a skin band which does not allow the prepuce to retract back over the glans in the erect position
There are several causes for Pathological (acquired) Phimosis. Other causes may include scarring caused by forced foreskin retraction and balanitis.
- The glans and/or foreskin are inflamed in Balanitis. It can affect men of all ages including boys (most frequently around three or four years of age). Poor hygiene, tight foreskin, skin disorders, allergy to products like soap or washing powder, or latex or condom spermicides can all damage the skin and, if infected, balanitis may develop.
- Lichen sclerosus et atrophicus (presumed to be the same as balanitis xerotica obliterans)
- Balanitis xerotica obliterans (BXO) is considered to be a common (or even the principal) cause of pathological phimosis.
- Other causes may include scarring caused by forced foreskin retraction and balanitis.
- Diabetic senile patients
- Multiple recurrent warts on penile skin.
2. Paraphimosis occurs when after retraction the foreskin is not pulled back over the glans. There is a tight band that causes distal penis swelling and acute discomfort. Reduction under local or general anesthesia with several minimally invasive methods is almost always possible. But if you have experienced paraphimosis once then it is preferred to get circumcision.
3. Isolated Trauma. Tears, zipper injuries, or crush injuries usually heal leaving a scarred foreskin, but circumcision is not indicated unless this scarred foreskin subsequently becomes non-retractile. During penetrative intercourse, uncircumcised men also appear to have a relatively high incidence of microtrauma and frenular tearing.
4. Circumcision Revision: The most common complications that can occur can be grouped into three categories:
1. Too much skin removed.
2. Excessively small skin removed.
3. Remaining foreskin that is stuck to the head or glans of the penis (adhesions).
4. Old circumcision scar that becomes painful
5. 5) Old circumcision scar that looks ugly.