Scientific Perspectives on Circumcision Choices, Emergency Treatment of Penile Trauma, and Penile Lengthening Surgery

The medical community advocates for caution when performing circumcision. True phimosis is rare; more often, it's due to a tight foreskin. If it's caused by severe psychological distress, surgery is unnecessary. Surgical indications are true phimosis (the foreskin cannot be retracted at all, causing bulging during urination) and recurrent infections of the glans or foreskin. True phimosis requires surgical intervention. Penile trauma presents with complex symptoms, but common symptoms include pain, swelling, hematuria, and urinary difficulties.

Penile contusion: Caused by blunt force during erection, resulting in ecchymosis or hematoma. In the acute phase, apply cold compresses to stop bleeding; after bleeding stops, apply heat to promote absorption. Penile dislocation: Caused by twisting or violent impact, resulting in the penis detaching from the skin; surgical suturing and fixation are required. Penile strangulation: Often caused by foreign objects such as metal rings lodged on the penis, restricting blood flow; the strangulation must be removed as soon as possible. Penile fracture: Caused by external force during erection, resulting in rupture of the tunica albuginea of ​​the corpora cavernosa. Once ruptured, blood spurts into the subcutaneous tissue, accompanied by severe pain.

Immediate surgical suturing of the tunica albuginea is necessary; otherwise, curvature or erectile dysfunction may result. Penile amputation injuries: caused by war wounds or sharp object injuries; if recent, reimplantation should be performed promptly. The key to penile lengthening surgery lies in severing the superficial and deep suspensory ligaments of the penis, separating the portion of the corpus cavernosum buried in the perineum, effectively increasing the length by 3-5 centimeters. However, this surgery comes at a cost, primarily reduced stability and potential changes in the erection angle. The surgery must not damage sensory nerves and blood vessels, otherwise, erectile dysfunction may result.

The treatment principle for penile trauma is to preserve the original shape as much as possible, considering the recovery of sexual function and urinary function. In the face of sudden injury, timely medical intervention is the only chance to salvage function. For selective cosmetic surgeries, such as lengthening surgery, patients need to find a balance between their expectations and the surgical risks. Only medical decisions made with a full understanding of the surgical principles and potential complications demonstrate responsibility towards one's own body.