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Ideal Age Range for Circumcision

29 September 2022 by Op Dr Nureddin ÇELİK
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Ideal Age Range for Circumcision

What is the Ideal Age Range for Circumcision?

When the age range is examined in the circumcision process, there are many different perspectives. There are different evaluations in terms of religion, surgery and psychology. While there is no age restriction in terms of religion, it is done during the newborn period in Jewish societies and India-Pakistan Muslims, while it is usually done in early childhood in our country. We frequently encounter this because the child remembers it at the “circumcision celebration”. However, newborn circumcision is gaining popularity with the abandonment of the circumcision celebration tradition, the increase in the urban population, and the emergence of psychological and surgical concerns.

 

Psychologically, it is expressed by Freud and psychoanalysis followers that it may be inconvenient in the phallic period, roughly between the ages of 1-5. However, the fact that the procedure is performed by specialist physicians instead of “circumcisers”, the use of appropriate anesthesia techniques, the effective implementation of hygiene and wound care, and the decrease in infection rates reduce the psychological trauma associated with circumcision. It seems that the idea that this should not be done in the phallic period weakens.

 

From a surgical point of view, it is obvious that the earlier the circumcision is performed, the better are the results. Among the surgical advantages of circumcision performed in infancy and especially in the neonatal period;

 

Wound healing is very fast,

Breast milk’s protective characteristic

Compliance with local anesthesia is quite good,

No need for general anesthesia or sedation,

The baby’s mobility is limited and there is no risk of infecting the penis by touching it.

It is considered appropriate to perform the circumcision procedure early in terms of wound healing and psychological well-being. Circumcisions performed up to the age of 1 are healthier as they can be performed with local anesthesia. If the patient is over the age of one, the operation must be performed with mask, general anesthesia or sedation.

 

When Should Circumcision Be Done?

Answering this question is possible by carefully evaluating the details I mentioned and analyzing biological, psychological and social issues. If there is no obstacle to circumcision, jaundice, heart valve diseases, developmental disorders, sucking difficulties, we, most surgeons, believe that circumcision will be beneficial in the newborn period. At this stage, isn’t the pixie very small, especially what mothers ask? I would like to give an answer to the question: The baby’s penis is proportionally large due to the hormones it receives from the mother. Even in the first year, the size of the penis does not change to a large extent. Therefore, there is no situation that threatens the success of the operation. Contrary to the fact that the baby can stand still in the circumcision process or the ease of restricting his movements, it makes the procedure safer and increases the importance of newborn circumcision.

 

Should circumcision be done as soon as the baby is born?

Although circumcision at birth or circumcision on the first day makes sense in terms of its applicability, the baby delays contact with the mother or even the father, delay the diagnosis and treatment of possible respiratory, circulatory and digestive disorders

It can be considered risky because the suspicion of jaundice has not been resolved yet.

In this case, if jaundice does not occur, if there is no difficulty in sucking and digesting, if the umbilical cord has fallen and there is no disruption in its healing, it is appropriate to do it as of the 10th day. If our baby is experiencing one or more of these problems, it would be appropriate to delay the circumcision process. It should not be forgotten that circumcision does not come before health. As a result, similar success and problem-free circumcisions continue in the first three months.

 

Stating that information and behaviors that frighten the child before circumcision may cause traumas in the child, he said, “Knowledge and behaviors that will frighten the child should be avoided beforehand, without taking into account the age and developmental characteristics of the child.

 

Before and after the operation, it should be explained that he will be with his parents or loved ones, that he will not feel pain and that he will return to his old life in a short time.

 

It is normal for the child to worry and cry a little before circumcision. In this case, it should be calmly reassured, it should be said that it is perfectly normal for him to be worried, and he can cry if he wants to.

 

Situations where circumcision is medically necessary:

Adherence of the foreskin to the extent that it covers the urine outlet hole (“phimosis”): It should be noticed in the newborn period and should be corrected with circumcision!

After the age of three, the foreskin is still attached to the tip of the penis

Penile tip circulatory disorder (“paraphimosis”) due to retraction of the foreskin: It is very inconvenient to pull back the skin at the tip of the penis, claiming to clean it! If not noticed, the tip of the penis or almost all of it can be gangrene and lost!

Recurrent episodes of penile tip and foreskin inflammation (“balanoposthitis”)

Some of the scientific evidence for the medical benefits of circumcision

Ensuring the continuity of penile tip cleaning

Prevention of recurrent penile inflammation

Less urinary tract inflammation if done in the neonatal period

urine from the bladder to the kidneys

Less incidence of back-escape (“reflux”) disorder into the channels called “ureters” located between the bladder and the bladder

Decreased sexually transmitted diseases

Reduced risk of cervical cancer in women with whom circumcised men have sexual intercourse

Reduced risk of penile head cancer

Situations where circumcision is medically objectionable

Ongoing health problems

Any serious illness

Hypospadias

Bleeding-coagulation disorders

Active infections

Conditions where the urethra opens to different parts of the penis from its normal place

Congenital wide anomaly of the urinary canal

“Chordy” deformity where the penis is tilted forward

Fusion anomaly where the skin of the penis and the skin of the scrotum are adhered

I’ve started working as a doctor since I attended Uludağ University Faculty of Medicine. I stopped working in the hospitals in 2020 with the thought of opening my own medical clinic. At the beginning of 2022, I opened my office in Karşıyaka Mavişehir Park Yaşam Ofisleri. In our urology clinic, I deal with my patients along with my team.


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