Phimosis or excessive foreskin is a problem that many men will encounter. The treatment method is often circumcision to remove excess foreskin, so as to prevent infection and reduce sexually transmitted diseases.
With the continuous popularization of concepts such as minimally invasive and aesthetics, some gimmicks have emerged as the times require. Korean, European, Japanese, Thai and other surgical methods dazzle male patients. In fact, for the most part, the basic principles of surgery are the same.

Male circumcision surgery can be divided into two categories
The surgical procedures of male circumcision can be roughly divided into two categories: "traditional open surgery" and "instrument circumcision" according to whether special instruments are used. The former mainly refers to traditional circumcision (classical operation) and some improved operations based on it; the latter is to perform surgery through special instruments, so as to improve the efficiency of surgery, shorten the operation time, and improve the appearance and other effects. .
What kinds of surgeries are widely used in clinical practice
1. Traditional male circumcision
Lift the male foreskin tube, cut the foreskin longitudinally along the dorsal side of the penis, to a distance of 0.5~0.8cm from the coronal sulcus Then cut the foreskin to the left and right sides circularly, and the incision will meet the frenulum position. At this point, the redundant foreskin tube can be cut off. After the bleeding is stopped, the inner and outer plates of the foreskin (the edge of the incision) are sutured intermittently. head of the penis.
This method is suitable for most male patients with excessive prepuce and phimosis. The technology is relatively mature, the operation is simple, it saves time compared with other surgical methods that do not use instruments, and the incision heals faster after surgery.
However, this method has more intraoperative blood loss, requires a longer operation time than the use of instruments, and is not easy to control the uniformity of the incision edge, the reserve of the inner plate and the length of the frenulum, and sometimes the edema lasts for a long time. Subcutaneous knots, etc. may remain.
2. Male circumcision
Commonly known as "Sleeve" is a relatively new male circumcision technique. Its principle is to use the squeezing effect of the inner and outer rings to block the blood supply at the distal end of the overly long foreskin, causing it to necrotic and fall off. Before the operation, measure the circumference of the penis body, choose the appropriate model, first place the inner ring on the inside or outside of the foreskin tube adjacent to the coronal sulcus, then press the outer ring on the inner ring through the foreskin, and cut off the excess foreskin. postoperative 7~10 days to ring.
The operation is simple and convenient, the operation time is short, there is no bleeding, and the operation time is 24 hours after the operation. The pain is mild, the incidence of postoperative bleeding and infection is low, the appearance is good, the incision margin is neat, the postoperative care is convenient, and there is no need to change dressings and remove sutures.
The disadvantage is that the skin on both sides of the outer ring is sometimes cracked, and the wound will take a long time to heal completely; the operation cost is high.
3. Male circumcision stapler method
It is relatively new at present, and it can be imagined as a stapler that can complete a row of dozens of staples with one press, and the staples are arranged in a ring. The first choice is to select the appropriate type of cutting suture according to the diameter of the penis, and then cover the bell-shaped penis head seat with the inner foreskin plate on the glans, and the edge of the bell cover is about 100% from the coronal groove. 0.5cm, about tie 0.8cm, tighten and fix it with a jacket. After determining the cutting position, cut out tiny "stapling needles" at the same time, which is equivalent to suturing the skin edges on both sides, then take out the cutting suture and the excised foreskin, and check the cutting and suture Whether it is complete and proper hemostasis, and finally use a self-adhesive elastic bandage for pressure dressing. After the operation, the "stapling pins" will fall off on their own after the wound has healed.
This operation is minimally invasive, has a short operation time, has a small amount of bleeding, has a short incision healing time, and has a neat cutting edge, which is more beautiful. Postoperative edema was mild.
The disadvantage is that the cost is high, and sometimes the metal "stapling pins" cannot fall off for a long time, or even get wrapped in the tissue, so it is necessary to go to the hospital to get the staples.
4. Male laser circumcision
Apply CO2 Laser circumcision is performed. The surgical operation is similar to the traditional method, that is, the scope of the foreskin is designed and marked before the operation, a suitable protective cover is placed between the glans of the penis and the foreskin, and the foreskin is covered on the surface of the protective cover, along the marked line. The foreskin was excised with a laser to stop the bleeding, sutured with absorbable sutures, and bandaged with gauze.
Due to the hemostatic effect of laser, this method reduces intraoperative bleeding, saves some time for ligating blood vessels, does not produce subcutaneous nodules, heals beautifully, has neat incision margins, simple operation and short operation time.
The disadvantage is that the high temperature cauterization of the laser prolongs the tissue healing time and the edema disappears for a long time.

How to choose the surgery method that suits you?
1. How to choose the surgical method for adult men and children?
For adult males, the above-mentioned surgical methods are all applicable, and you can choose according to the conditions of yourself and the medical institution you are visiting. The long-term effects of these surgical methods are not much different.
If it is a child, it needs to be selected according to the development of the penis. From the perspective of ease of operation, there are many ways to choose a collar.
2. Is the foreskin scarring?
For male patients with phimosis and repeated infection of the foreskin, or male patients with scarring phimosis, the selection should be made according to the degree of scarring, which requires specialized evaluation by a surgeon. If the local scar is relatively small and the scope is limited, instrumental circumcision can be used; if the local scar is relatively heavy, adhered to the glans penis, or combined with other problems, more traditional circumcision should be considered.
3. Is there a local infection in the foreskin?
If a male patient has foreskin, treatment is required, and surgery should be performed after the inflammation has completely subsided to avoid local infection, poor or even non-healing of the incision.
4. Under what circumstances is circumcision not feasible?

• Male anatomical abnormalities of the penis, such as epispadias and hypospadias, concealed penis, chronic incarcerated prepuce
  
• male genital ulcer disease
  
• local acute infection
  
• Penile cancer and other genital diseases that are not suitable for simultaneous surgery
  
• Chronic diseases of the penis and foreskin, such as filariasis
  
• Disorders of the coagulation mechanism.
  

In addition to the above 4 points, whether to operate, what method to use, and what anesthesia method to choose, it is also necessary to consider the overall cost, conditions of medical institutions, etc.
With the development of science and technology society, men have higher and higher requirements for appearance after circumcision. Male patients bring better diagnosis and treatment experience.