What the surgeon examines in teenagers

Circumcision of the foreskin helps to avoid a number of diseases associated with infections in the genital area: hygiene is easier and transmission of infections is more difficult. In addition, this is often the only way to treat phimosis (narrowing of the foreskin and incomplete opening of the tip of the penis) and to ensure normal development of the organ.

What the surgeon checks in teenagers

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Pediatric Surgeon (Pediatric Surgeon)

A doctor who treats children surgically from birth to age 14 is called a pediatric surgeon. His responsibilities include advising, diagnosing, prescribing and performing surgical procedures, as well as overseeing the rehabilitation of the operated child.

First of all, he is the best specialist in his field, because in a child, surgical intervention must be performed very carefully, taking into account the immaturity of the body, its possible growth and constant changes. The pediatric surgeon not only surgically treats childhood diseases, but also deals with developmental disabilities, congenital defects, and congenital anomalies.

Main areas of pediatric surgery at the SM Clinic

The doctor decides on the need for surgical intervention in each individual case, based on a number of factors: the nature and characteristics of the disease, the current condition of the child, etc. In preparation for the operation, the child must undergo a number of instrumental and laboratory tests .

Children are routinely operated on, and a peculiarity of pediatric surgery is that some operations are not recommended until a certain age or stage of disease development. This gives parents enough time to consult their doctor and make an informed decision.

The pediatric surgeons of our clinic give qualified answers to all questions about the need for surgical treatment, surgical techniques and procedures, etc.

inpatient surgery

How do I prepare for an operation appointment?

Before your first visit to the surgeon, you should shower or bathe and wear comfortable clothing that you can easily remove. It is best to go to the specialist in the morning and on an empty stomach, so that you can immediately carry out the examinations recommended by the surgeon. You should prepare a list of questions you would like to ask the specialist, describe your condition in detail and thoroughly, and remember any medications and their dosages that have been used to treat the symptoms you are concerned about. If you have already done tests, you should bring the results with you.

The first appointment with the surgeon begins with the patient describing their symptoms. You should indicate the exact location of the pain or discomfort, tell the specialist how long ago it occurred and describe the characteristic features. The doctor determines whether the patient has comorbidities and chronic diseases, what illnesses he has undergone and what surgical procedures he has undergone, and inquires about hereditary predispositions to any diseases.

The surgeon then performs a physical exam. For example, he listens to the chest with a stethoscope and then measures temperature, blood pressure, pulse, sensitivity and reflexes. During the examination, the specialist looks at:

• the color of your skin; the presence of inflammation, pus or tumors on your skin;
• abnormalities on the feet;
• the condition of the abdominal organs (palpation of the abdomen)
• the position of the spine (sitting, bending)
• Limb mobility (how easily and efficiently they perform their functions);
• Presence of varicose veins, blockage of blood vessels.

What tests and examinations the surgeon may recommend at the first visit

At the end of the physical examination, the surgeon informs the patient of the need for individual laboratory tests, since the test results are insufficient to make a definitive diagnosis. Depending on the patient's condition, the specialist may recommend biochemical blood tests, tests for hepatitis and sexually transmitted infections. The surgeon often prescribes diagnostic tests such as MRI, ultrasound, X-ray, CT, EKG and endoscopy. The specialist doctor can carry out some diagnostic tests himself (e.g. lymph node puncture, thyroid gland). If necessary, the surgeon may refer you to a specialist (for example, a mammologist if a breast lump is found).

Usually, children are referred to the surgeon by their pediatrician, but sometimes parents arrange a visit to rule out developmental problems and possible age-related abnormalities. For example, adolescents often experience problems stemming from poor posture (from sitting incorrectly at a desk), abnormalities in the digestive system (from an inappropriate diet and eating large amounts of unhealthy food), and various injuries.

The reasons for seeing a surgeon can be different, especially in the first year of a child's development:

• stiffness of movements;
• Increased muscle tension;
• asymmetry in the bend of the legs and back;
• The child begins to slouch when lying down;
• The child turns more often and tilts the head to the left or right side;
• Injuries of any kind, wounds, burns, cuts, presence of purulent formations.

Peculiarities of the first visit to the pediatric surgeon

During the first visit, the doctor gets to know the patient, listens to the complaints and collects the anamnesis. The doctor then carefully examines the child, paying particular attention to the anatomy and function of the limbs. The mucous membranes, the skin and the lymph nodes are not neglected either.

If necessary, the doctor can feel the chest, soft tissues, peritoneum, joints and bones during the initial examination. In addition, the doctor can perform special outpatient manipulations.

If there are indications for a follow-up examination, the doctor issues a referral for the necessary examinations, MRI, X-rays and ultrasound computer diagnostics.

At the end of the examination, the surgeon makes a preliminary diagnosis, gives the necessary recommendations for the prevention of the disease or selects effective therapy (if necessary), prescribes referrals for examinations by other specialists, initiates a program of spa rehabilitation and physiotherapy.

What does the initial examination of a newborn by a surgeon look like?

The doctor examines the baby to look for congenital abnormalities such as congenital injuries, dislocations, tumors, hernias, and musculoskeletal defects. The specialist is also tasked with analyzing the anatomical structure of the skeleton and urogenital system (in boys). If he finds abnormalities, the doctor sends the child to other specialists for further examination and follow-up.

Patients with the following conditions may benefit from an initial consultation with a pediatric surgeon:

At what age can a boy carry out his genital hygiene independently?

At the age of one and a half years, a child can brush his teeth or wash his hands, so at this age he can gradually be taught to take care of his own genital hygiene. Over time, this will become a habit for your child.

Contact your doctor. Painful urination can be a symptom of foreskin inflammation and other more serious urogenital disorders. If the pain comes on suddenly, you should see a specialist as soon as possible.

Your child needs to go to the toilet frequently. Is that normal?

There are no specific rules. The most important indicator is that the situation deviates from the norm. If your child used to go to the toilet much less often, then it is worth paying attention to this symptom. It's also important to know how much liquid he's drinking and what times he's going to the bathroom more often. If in doubt, you should consult a pediatric urologist or andrologist.

Boys have an erection from birth. This is because the bladder is full and is pressing on the prostate. This is not a cause for concern, it is not an abnormality.

What diseases does the pediatric surgeon deal with?

• umbilical hernias. When a baby cries, a bulge develops in the navel area. An umbilical hernia does not hurt and does not bother the baby
• Acute abdominal pain
• injuries
• Abnormal or restricted movement of the limbs
• Ingrown toenail
• Swelling and redness of soft tissues
• Empty scrotum in boys, or one half larger than the other
• soft tissue formation
• hernia. This hernia is compressed, which impairs blood circulation.
• Hydrocephalus of the testicles in boys
• balanopostitis
• phimosis
• cryptorchidism
• twist
• perianal hydrocele
• orchitis

Which organs are treated by the pediatric surgeon? A pediatric surgeon treats all the internal organs of the child's body.

When should you see a pediatric surgeon?

• A child has a bulge in the navel or groin when at rest or when crying;
• A child has an ingrown toenail;
• In boys, one half of the scrotum is enlarged or the scrotum is empty.

Many diseases, including those that are inoperable, begin with abdominal pain. At the same time, they are the main symptom of 'serious' surgical diseases such as appendicitis or intestinal obstruction. Therefore, when a child experiences abdominal pain, especially if it is not accompanied by other symptoms, the first thing they should do is see the surgeon. It is important for parents to know the nature of the pain (painful, stabbing, cramping, paroxysmal), its intensity (severe, moderate, mild), its duration (constant or intermittent and, if intermittent, how long it will last and for how long 'quiet' intervals between pain attacks) and then, if possible, describe them to the doctor. It is very important for the doctor to know how the child behaves during the pain: whether it is trying to lie still, 'not finding its place' or adopting a certain posture. All this information about abdominal pain can be very helpful in diagnosing the disease. If, despite the abdominal pain, the child does not feel any different and the condition does not worsen, you can visit a surgeon in the outpatient clinic.

Many children have irregular bowel movements. Sometimes this happens once every 23 days, but that still cannot be called constipation. It is desirable that the bowels should be emptied not only regularly once a day, but also at about the same time (morning or evening). If this is not the case, special measures should be taken, e.g. B. Trying to give the child more fruits and vegetables, which encourages regular bowel movements. Constipation is when irregular bowel movements are associated with painful bowel movements and the stool is very hard. If your child has these symptoms, you should consult a surgeon in addition to the pediatrician and gastroenterologist, as constipation is the main symptom of some 'surgical' bowel diseases and, in rare cases, serious conditions such as Hirschsprung's disease.

What tests you should have when you visit your pediatrician

If you come to a consultation with your child, no examinations need to be carried out beforehand. The doctor will order tests if necessary.

When your child is being prepared for surgery, there is a standard list of tests that the pediatric surgeon may add to depending on the reason for the surgery. The standard list of examinations includes:

• General blood and urine tests;
• blood test for HIV infection;
• blood for the Wasserman test;
• blood test for hepatitis B and C;
• electrocardiography;
• Consultation with a cardiologist and pediatrician.

Consult your doctor for a full list of required tests.

What diseases are treated by the pediatric surgeon?

The pediatric surgeon can treat diseases and traumatic complications that threaten the health and life of a child through interventions. Emergency surgical interventions are performed in these situations:

• when opening abscesses;
• in case of hernia strangulation;
• Resolving complications due to trauma;
• Acute appendicitis, intestinal adhesions and peritonitis
• removal of a foreign body;
• In case of heavy bleeding;
• in case of purulent inflammation etc.

In addition to emergencies, the pediatric surgeon also carries out routine treatment of diseases.

The pediatric surgeon advises parents to observe their child in order to timely identify changes in the child's behavior related to discomfort, pain and organ dysfunction.

Don't be afraid to take your child to the surgeon for a consultation. A visit to a surgeon does not mean your child will need surgery. The pediatric surgeon is able to treat a large number of surgical diseases as conservatively as possible.

Health as an indication for surgery

Plastic surgery is divided into two areas: reconstructive and aesthetic surgery. When it comes to repairing injuries and disorders of the musculoskeletal system, reconstructive surgery can be accompanied by plastic surgery. In this case, it is about the functional restoration of the body and the elimination of the consequences of surgical intervention.

Skin grafts after burns also fall into the plastic surgery category. The elimination of defects of any kind that interfere with the normal life of a person does not require special indications for the involvement of a plastic surgeon.

Does beauty come first?

If a child's desire to change their appearance is not medically justified, parental consent is required. Sometimes adults bring their children to the plastic surgery clinic themselves. A common example is the correction of hanging ears. This peculiarity of appearance does not pose a health risk and does not affect the functionality of the body, but many parents prefer to use the services of a plastic surgeon and correct this aesthetic defect in early childhood, treating it like an unevenness of the treat teeth. This wish is justified, because some aspects of appearance can serve to ridicule the child permanently and to shape negative character traits.

What is the difference between a parent's desire to improve their child's appearance and a teenager's desire to be beautiful?

First, children of this age are very sensitive to the opinions of others, and the teenagers around them can be very cruel. The belief that changing one's appearance can have a major impact on one's social status and position in society is often based on a lack of experience. Psychologists say that in 97% of cases, teenagers end up in plastic surgery clinics, and not because of a blemish, but to solve psychological problems and deal with complexes.

Secondly, most plastic surgeries are contraindicated for people before physiological maturity. For example, nose surgery (rhinoplasty) is only performed from the age of 18 (in some countries from 22 years of age) because bone and cartilage tissue continue to grow in adulthood.

Third, the cause is pubertal dysmorphophobia, in which teenagers suffer from an imagined lack of appearance. Especially at this age, dysmorphophobia can create a lot of suffering 'out of nowhere'. In most cases, this mental condition goes away after high school, but sometimes it worsens, takes on bizarre forms, and forces sufferers to keep seeing a plastic surgeon. Although another specialist, the psychiatrist, is involved in the treatment of such diseases.

Ways to eliminate physiological phimosis

Now we will try to correct this condition, take therapeutic and preventive measures to help the child get rid of phimosis without surgical treatment.

Ekaterina Valova, psychologist

Some parents are embarrassed about the subject of genitals, afraid of the child's reaction or ashamed when the need for manipulation arises. Adults try to avoid touching or generally draw attention to the issue, which can lead to developmental complications, illness, and the need for surgical intervention.

It is much easier to avoid this by using simple methods and rules of hygiene at a young age, when the child is small, the tissues are malleable, and the possibility of unduly affecting the child's sex education is small.

If the mother does not feel very safe, the father can take over the special care of the boy after the doctor has informed him. Because of their experience, men know better how they can and should handle the penis, feel more secure and can show and explain the rules of hygiene to their sons without feeling uncomfortable. And the older the boys get, the easier it is for them to ask their fathers about these issues, the experts say.

In any case, teaching genital hygiene at an early stage is just as important as teaching them how to brush their teeth or wash their hands. So trying to delay hygiene education is like trying not to brush or treat a child's teeth. Complications can seriously affect a boy's health and life.

Moms and dads, when bathing your child, pay a little more attention to the boy's genitals (don't forget about girls' hygiene, too). Stretch the foreskin by gently pulling it over the tip of the penis without exerting too much effort (otherwise a complication - paraphimosis - may occur) until the child feels pain. This exercise is done every day in the bath or warm shower, when the skin becomes more elastic and supple, for 5-10 minutes at a time.

Complications from careless handling of the penis

Why is it so important to be patient, not overzealous, and not trusting the child to do everything immediately and without supervision? Improper handling can lead to the development of paraphimosis. Paraphimosis is one of the complications of phimosis. It can be recognized by the following symptoms: The glans is completely exposed, the narrow part of the foreskin is behind the cornea and is difficult to push back. This complication can occur when a parent or child exposes the glans too much, causing herniation, swelling, and poor circulation.

Paraphimosis is an acute condition that requires urgent intervention. What to do if parents are confronted with this phenomenon?

The first thing to try is to push back the glans and 'cover' it with the foreskin; sometimes that's enough. If this does not work, you should stop trying and go to the doctor. If some time has passed and changes in the form of swelling are visible, then in most cases reduction on your own is no longer possible and surgical treatment is required. In this case, a specialist (urologist/surgeon) is required.

Ekaterina Valova, psychologist

Some parents are ashamed of the subject of genitals, afraid of the child's reaction, or embarrassed when the need for manipulation arises. Adults try to avoid touch or generally focus attention on this issue, which can lead to developmental complications, disease, and the need for surgical intervention.

It is much easier to avoid this by using simple methods and rules of hygiene at an early age, when the child is young, the tissues are malleable, and the possibility of unduly affecting the child's sex education is small.

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