When is the best time to do circumcision surgery on children?

The healthy growth of children is the common wish of many parents. However, when children are young, there will always be some problems due to incomplete physical development. The most common one is that the foreskin is too long. If you don't pay attention, it is easy to get infected. Now, this also makes many parents particularly worried. Many parents think that timely surgical treatment when the child is still young can make it easier to recover. Let's find out when is the best time to do circumcision surgery for children.

When is the best time to do circumcision surgery on children?

Phimosis refers to the condition in which the foreskin cannot be completely turned up to expose the glans penis. Phimosis is divided into the narrow external opening type (divided into the needle-like opening type and the narrow ring type. The former is incapable of turning up the foreskin, while the latter can only be partially turned up due to the obvious narrowness of the external opening of the foreskin) and the foreskin adhesion type. In recent years, domestic medical experts have used epidemiological survey methods to examine 1,400 children aged 3 to 18 in Urumqi, classified them according to international phimosis diagnostic standards, and conducted statistical analysis. The results showed that the incidence of phimosis in children aged 3 to 9 years was 82% to 93%, the incidence of phimosis in the 10 to 15 years old group dropped from 74% to 6%, and the incidence of phimosis in the 16 to 18 years old group dropped from 4% to 1%. Data show that phimosis in children and adolescents tends to heal on its own. As a part of the male reproductive organ, the foreskin has its normal development process and rules. It is a natural law that some foreskins reach a state close to that of adults only during puberty (or even until the end of puberty). It is inappropriate to measure whether the pre-pubertal state is normal based on the adult state.

Medical textbooks describe phimosis as a common disease of the male urogenital system. There are still many textbooks (even some related monographs) that mention that 90% of children can recover by themselves by the age of 3. However, most importantly, the previous belief that 90% of phimosis can heal itself by the age of 3 has been disproven by large-sample medical surveys and medical research institutes, which believe that the data is incorrect. Therefore, this misconception and the traditional idea that circumcision can prevent penile cancer actually lead to clinical overdiagnosis and corresponding overtreatment (premature circumcision).

This phenomenon has been controversial abroad due to unclear understanding of it, which has led to overdiagnosis and overtreatment. This has become a lesson in the West and has also been repeated in Asia. However, doctors in most of our hospitals are still making this kind of mistake, over-diagnosing children with foreskin problems as "phimosis" and performing circumcision surgery prematurely.

The spontaneous healing of phimosis is manifested in the loosening of the narrow outer ring of the foreskin and the separation of the complete keratinized epithelium between the inner plate of the foreskin and the glans penis, which is a process related to puberty development. Phimosis should be considered a disease for normal adults, and a normal physiological phenomenon for prepubertal and early adolescent children, and should not be prematurely diagnosed and over-treated (circumcision) as a disease.

For children under 6-8 years old, even if they have been confirmed to have phimosis with external stenosis, there is no need to be too aggressive in surgery unless there are abnormal conditions such as affecting urination or repeated foreskin infections; for phimosis with adhesion of the foreskin, manual peeling can be performed.

For adolescents who do have phimosis (narrow external opening), surgery can be performed at around 13-15 years old, depending on the specific situation and the development of the foreskin.

There is no need to perform circumcision on prepubertal patients with excessive foreskin. It is only necessary to give them necessary and detailed education on foreskin hygiene care so that they can develop a good habit of regularly pulling up the foreskin and cleaning the foreskin glans.

Surgery for phimosis should be performed on patients aged 17 to 20 years old.

The above is an introduction to when is the best time to perform circumcision surgery on children. After understanding it, we know that it is a normal phenomenon for children to have too long foreskin when they are relatively young. Generally, this phenomenon will gradually disappear as the baby grows day by day. Therefore, once the baby has a problem with the foreskin, don’t be too anxious to perform surgery. Try to wait until the baby is 6-7 weeks old before treatment.