Circumcision

What is it?

This is the complete removal of the foreskin to leave the head of the penis permanently exposed. It is usually performed when your foreskin is tight which may cause infections, pain or tearing especially during erections or sexual intercourse. . It may also become necessary if there are suspicious lumps or lesions involving the foreskin or if the foreskin becomes stuck behind the head of the penis (glans). The latter is an emergency called paraphimosis.


How will I be assessed?

You will be seen by a Urologist who will take a history and then examine the penis. The diagnosis is usually made by taking a history and examining you by a Urologist


Do I need treatment?

No. Treatment is only advised if your foreskin is causing you problems.


What are the treatment options?

  • Do nothing
  • Steroid creams
  • Surgery: dorsal slit or circumcision

What does surgery involve?

Both surgical procedures may be performed under a local or general anaesthesia. They will both involve dissolvable stitches.


Dorsal slit

This involves a cut in the foreskin on its upper aspect. The cut is then closed in a different direction. This will relieve the tightness but may not be as cosmetically pleasing as a circumcision.


Circumcision

This involves a complete removal of the foreskin with incision on its inner and outer aspect. This will expose the glans completely while ensuring there is sufficient skin to allow normal erections. The skin is then stitched back together.


How long will I be in hospital?

You will normally go home the same day.


What can I expect after discharge?

It is normal to experience swelling and pain within the penis. This usually settles but you may require simple pain killers. We would advise you to avoid all types of sexual activity for atleast 6 weeks. The stitches will be dissolvable so will usually fall out by themselves over 4-6 weeks. The penis may take up to 6 weeks to heal fully. Avoid swimming or baths for 2-3 weeks although you may shower from 48 hours after the operation. As the glans may be very sensitive in the first few days after your operation, it may be advisable to wear loose clothes during that period.


What are the possible complications?

  • Swelling, bruising and discomfort in the penis
  • Bleeding from the wound which occasionally needs further surgery
  • Infection needing antibiotics
  • Altered or reduced sensation in the glans
  • Dissatisfaction with the cosmesis
  • Excess skin or insufficient skin requiring further surgery (see leaflet on revision of circumcision)
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