Surgery (OP)
Surgery for phimosis (narrowing of the foreskin) is indicated if complications occur after the end of the 2nd year of life due to the narrowing of the foreskin. Such complications can be recurrent infections, which are favored by the narrowing of the foreskin. One should then consider phimosis surgery.
The surgery that comes into question is the so-called radical circumcision. This involves the circular removal of both foreskin leaves. The operation is performed either under local or general anesthesia, depending on age.
For children, general anesthesia is used, while for adults a local anesthetic (mepivacaine 1%) is injected subcutaneously as a so-called penis block. This is injected at the root of the penis on both sides. This suspends the pain sensation of the penis and the operation can be performed.
In the course of the surgery, adhesions are first and if necessary, removed. Then the foreskin is incised on the back (dorsal) and the two foreskin sheets are cut around the penis in a circular fashion (circular). This is done at the level of the so-called sulcus coronarius, the furrow under the glans of the penis.
The next step is to cut off the arteria frenularis. This is a so-called ligature. This artery runs in the frenulum, the frenulum of the foreskin, and serves to supply the foreskin with blood.
The frenulum is also severed. As a last step, the inner and outer foreskin sheets are then connected with sutures. A further operation is the so-called plastic circumcision.
In this procedure, adhesions are also removed, but only the foreskin is slightly dilated afterwards. After the operation, the surgical wound is treated with an analgesic ointment dressing, which should be left in place for a few days to relieve the pain.There are rarely complications with this operation. However, such complications could be wound infection or wound margin necrosis, as well as recurrent phimosis (recurrent phimosis), especially if too much residual foreskin was left. If there is a meatal stenosis, i.e. a narrowing of the urethra (urethral stricture), further surgery may be necessary. In general, the hygiene of the penis and the penis glans is better after such an operation and it is generally considered more hygienic if the glans is exposed.
