Paraphimosis

Phimosis (Tight Foreskin) Treatment | Asia’s Leading Sexual Health Clinics

Why do we need circumcision?

Circumcision has been a longstanding tradition in Thailand and Bangkok, practised on boys and men for many generations. Typically, this procedure is carried out during childhood due to religious or cultural beliefs. Circumcision is often regarded as a significant rite of passage in a boy's life, signifying the transition into manhood.

In line with this, circumcision is often associated with considerable pain, leading to special ceremonies and celebrations to honour boys who undergo the procedure. However, with the advent of the internet and social media, there is a growing awareness of the advantages of adult circumcision, prompting more men to consider it for themselves. Nevertheless, the primary reason deterring them is the fear of pain.

Medical reasons for circumcision are typically based on specific health conditions or concerns that may necessitate the surgical removal of the foreskin (prepuce) from the penis. It's important to note that while circumcision is sometimes recommended for medical reasons, the decision to undergo circumcision for adults should always be made in consultation with a healthcare provider.

Here are some common medical reasons for circumcision:

1. Phimosis (Tight Foreskin): In Thailand, phimosis is a condition in which the foreskin is too tight to be pulled back over the head of the penis (glans). This can lead to discomfort, difficulty urinating, and an increased risk of infection. Circumcision may be recommended in cases of severe or recurrent phimosis.

2. Paraphimosis: Paraphimosis occurs when the foreskin is pulled back behind the glans and stuck in that position. This can cause swelling, pain, and impaired blood flow to the glans, a medical emergency. Circumcision may be required to alleviate paraphimosis.

3. Recurrent Balanitis: Balanitis is the inflammation of the glans and foreskin. Some individuals may experience recurrent episodes of balanitis, which can be painful and lead to scarring. In such cases, circumcision may be recommended to prevent future inflammation.

4. Balanoposthitis: Balanoposthitis is the inflammation of the glans and the foreskin. Like recurrent balanitis, severe or recurrent cases may necessitate circumcision to prevent further inflammation.

5. Male Urinary Tract Infections (UTIs): Some studies suggest that circumcised males may have a lower risk of male urinary tract infections, especially during infancy. UTIs can be severe in young children and may be a consideration for circumcision in some instances.

6. Penile Cancer: While penile cancer is rare, it can occur. Some studies have suggested a lower incidence of penile cancer in circumcised males. However, the overall risk of penile cancer is low, and circumcision is not a primary preventive measure for this condition.

7. Sexually Transmitted Infections (STIs): Research has shown that circumcision may reduce the risk of acquiring certain STIs, including HIV, herpes, and human papillomavirus (HPV). However, circumcision is not a substitute for safe sex practices, such as condom use.

8. Personal Choice: Some individuals or parents may choose circumcision for personal or cultural reasons. While this is not a medical indication, it is a valid choice after informed consideration.

It's essential to emphasize that the decision to undergo circumcision should be made individually, considering the person's medical history, preferences, and cultural or religious beliefs. It is essential to consult with a healthcare provider who can provide guidance and information tailored to the specific circumstances and needs of the individual or family.

In our clinics, many men are reluctant to circumcision, citing fear of pain as the primary factor. Some are even unwilling to contemplate the foreskin removal procedure due to this concern.

Is circumcision painful?

Aside from traditional circumcision, methods and devices enable quick and painless circumcisions. The two new methods are the Shang Ring and the ZRS Stapler methods, designed to make the procedure swift, easy, and low-complicated.

1) Traditional Circumcision

Traditional circumcision can be painful, even though anaesthesia can make the process painless.

Conventional circumcision typically involves administering a local anaesthetic injection in the pubic area. The anesthesia process can be uncomfortable, leading some men to opt for general anaesthesia (GA). While GA ensures you won't feel any pain during the procedure, it comes with significant risks that may not justify the simplicity of a circumcision.

2) Shang Ring Circumcision

With the Shang Ring method, only numbing cream is applied for anesthesia, eliminating the need for injections. After applying the cream for about 30 minutes, the skin becomes numb, and the procedure can commence. This method involves using two components: an inner and an outer ring.

The process begins by inserting the inner ring into the inner foreskin. Once in place, the outer ring is clamped onto the inner ring from the outside of the foreskin. After secure clamping, the excess foreskin is removed. Shang Ring circumcision in Thailand can be completed in as little as 5 minutes, and the ring device will naturally fall off on its own after three weeks.

Regarding the cost of circumcision, our procedures are swift, take only 15 minutes, and do not require injections or stitches.

3) ZRS Stapler Circumcision

ZSR circumcision in Thailand is a specialized method that utilizes a surgical stapler to cut and seal the skin edges, eliminating the need for traditional sutures. In conventional circumcision, the surgeon typically begins by cutting the skin with a knife and then stitching it. However, in ZSR stapler circumcision, the stapler device performs both the cutting and stitching.

The circumcision stapler is designed for single use. This disposable circumcision stapler is a sterile, handheld, manual surgical tool preloaded with non-bioabsorbable skin staples specifically intended for circumcision procedures. Its purpose is to cut the foreskin and apply circular rows of staples near the incision site. 

The stapler component usually includes a dome designed for insertion under the foreskin over the glans penis and a circular cutting stapler mechanism with a manual lever to be positioned externally over the foreskin.

The typical steps involved in stapler circumcision include the following:

• Anaesthesia: ZSR Circumcision can be performed under local, regional, or general anaesthesia, depending on the age and medical condition of the male.
• ZSR Surgery Duration: The procedure typically takes about 10-15 minutes and is conducted on an outpatient basis, allowing the patient to return home on the same day.
• ZSR Surgery Stitches: Unlike traditional methods, stapler circumcision does not require stitches.