Circumcision in Overweight Children Requires Careful Assessment

Many parents are also faced with the problem that boys do not know how to remove the foreskin to clean the dirt themselves. In order to avoid repeated inflammation, they often choose to circumcise their boys to eliminate worries. However, pediatric surgeons point out that not all boys are suitable for circumcision, especially some fat men who have partially hidden penises due to excessive accumulation of fat in the pubic bone.

Circumcision surgery involves removing the foreskin that is too long or too narrow covering the glans of the penis so that the glans can be exposed. Pediatric surgeon Zhang Chengde said that before circumcision, the length of the penis must be measured accurately and a suitable amount of foreskin should be reserved to avoid cutting too much or too little: if too much is cut, there will not be enough foreskin left, and the nearby skin will be pulled up when the penis is congested, causing pain; if too little is cut, the foreskin wound will be narrowed after the operation, and the glans cannot be exposed. If the above two conditions occur after surgery, another surgery may be required.

But some boys may suffer from a little hidden penis. From the appearance, the penis looks shorter and shaped like a small triangle, but in fact it just shrinks into the pubic bone. This condition is more common in young obese boys because they have too much fat accumulation, especially on the pubic bone. Therefore, it is not suitable to circumcise the circumcision too early to avoid misjudgment of penis length.

Zhang said that doctors may suggest that after the obese boy grows taller and loses weight, he can see if the penis is still partially hidden before deciding whether to circumcise. However, if a boy grows older and gets fatter, the problem of hiding the penis may become more serious. Boys with hidden penis are not suitable for early standard circumcision. Some patients with severe cases may need to undergo more complex foreskin reconstruction surgery.

In addition to the need for boys with hidden penises to retain their foreskin for penis reconstruction surgery, those with hypospadias also need to retain their foreskin to reconstruct the urethral opening, and the foreskin cannot be circumcised.

In addition to circumcision, medical studies have also shown that applying steroid ointment to the foreskin can loosen the foreskin. When combined with daily care, opening the foreskin and cleaning it may help prevent the foreskin from narrowing. However, Zhang Chengde pointed out that steroid ointment can only be applied for two months at most. There is a chance that the boy will return to his original shape after stopping the medication. When a boy is seven or eight years old and does not need the help of his parents to bathe, it is also critical whether he can clean and turn the foreskin himself. If he fails to take good care of it, the foreskin may shrink again.

Circumcision is a minor daytime surgery, but the waiting time for circumcision in public hospitals is very long. If the patient does not turn to a private doctor and continues to wait in the public hospital, he must be cleaned and cared for during the period to avoid inflammation.

Notes on cleaning foreskin:

Dander will form between the foreskin and the penis to form smegma. It must be kept clean to prevent bacteria from breeding and causing odor or inflammation. The foreskin should be opened and cleaned every day, but remember to restore the foreskin after cleaning. If the exposed glans is tightly trapped by the narrow part of the foreskin, blood circulation will be affected and the glans will swell. If the situation persists, it may even lead to necrosis of the glans and penile tissue. If this happens (the foreskin cannot return to its original position), you should go to the hospital for emergency treatment as soon as possible.