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Surgery of external genitals
Surgery of the External Male Genitals is a specialized field of medicine that deals with the diagnosis and treatment of diseases of the male reproductive system. Among the most common surgical procedures in this area are circumcision for phimosis, ligation of the spermatic veins for varicocele, eversion of the tunica vaginalis for hydrocele, and frenulotomy or frenuloplasty for short frenulum.
Phimosis: Circumcision
Circumcision is a surgical procedure in which the foreskin is surgically removed from the penis. It is performed in outpatient surgery with an operative time of about 30 minutes. Before the procedure, the patient must shave the pubic hair, and fasting is not required. Upon discharge, home therapy includes applying ice for 24 hours and dressing once a day as per instructions. Rest is recommended for 24 hours, and return to work after 24 hours. Weekly check-ups are necessary until the stitches fall out, which generally occurs within 2-3 weeks. Resumption of sexual activity is possible after 4 weeks. Today, this technique can be performed with mechanical suturing devices; in our center, we use CIRCUMSAFE or CYRCUMCISION. In this case, the procedure takes 5 minutes and is performed under local anesthesia. It requires a compressive bandage. The stitches fall out between 15 and 30 days; the aesthetic result is certainly better compared to all other techniques. Our center currently has the largest Italian case series referring to this technique.
Varicocele
Varicocele is a varicose dilation of the veins in the scrotum. The most common surgical procedure for the treatment of varicocele is ligation of the spermatic veins using micro-surgical technique, performed in Day Hospital with an average operative time of about 20 minutes. Before the procedure, the patient must shave the pubic hair and fast from midnight the day before. Upon discharge, home therapy includes antibiotics and painkillers. Rest is recommended for 3-4 days to avoid complications like hydrocele. Return to work is possible after 4-7 days and to sports activities after 4 weeks. Removal of sutures generally occurs after 7 days.
Hydrocele: eversion of the tunica vaginalis
Hydrocele is a collection of transudate within the two layers of the tunica vaginalis. The most common surgical procedure for the treatment of hydrocele is eversion of the tunica vaginalis, performed in Day Hospital with an average operative time of about 30 minutes. Before the procedure, the patient must shave the pubic hair and fast from midnight the day before. Upon discharge, home therapy includes antibiotics and painkillers. During the procedure, a drain is left in place and removed after 24 hours. Rest is recommended for 3-4 days. Return to work is possible after 4-7 days and to sports activities after 4 weeks.
Short frenulum: frenulotomy and frenuloplasty
Frenulotomy or frenuloplasty is a surgical procedure performed in an outpatient setting for the treatment of a short frenulum. The operative time is generally short, about 15 minutes. During the surgical procedure, the short frenulum is incised or divided to allow greater mobility of the glans during erection. This procedure can be performed under local anesthesia, and the patient can go home the same day of the surgery. After frenulotomy or frenuloplasty, the patient may experience slight discomfort or pain in the treated area for a few days. It is important to follow the doctor’s instructions regarding dressings and activities to avoid during the healing period. The patient should avoid sexual activity for at least 2-3 weeks after the procedure to allow proper healing.
In general, surgery of the male external genitals is a specialized field of andrology that deals with various conditions that can affect the penis, scrotum, and testicles. These surgical procedures are generally considered safe and effective and are performed on an outpatient or day hospital basis, with short operative times and a relatively quick recovery of normal daily activities. It is important to consult a specialized physician for the diagnosis and treatment of male external genital pathologies.
