Circumcision

What is circumcision?

Circumcision is the surgical removal of the skin covering the tip of the penis called the foreskin. Circumcision is common for newborn boys in certain parts of the world for religious and social reasons. Circumcision after the newborn period is sometimes performed for medical reasons, but it’s a more complex procedure.

What are the medical indications for a circumcision?

Circumcision is commonly performed for religious reasons. It can also be performed for social reasons such as keeping of family tradition, personal hygiene or preventive health care.

There are medical reasons when circumcision must be performed, including:

• Phimosis – very tight foreskin where is cannot be retracted over the head of the penis
• Recurrent tears or bleeding of the foreskin during sexual activity
• Reducing risk of sexually transmitted infections in certain parts of the world where the risk is very high

How is it performed?

Circumcision is usually performed with a Plastibell circumcision ring in newborns. The ring and sutures are applied to remove the foreskin.

The procedure is more complex in adults and older children. Redundant foreskin is carefully measured out to make sure the exact amount is removed. The foreskin is removed and 10-15 sutures are used to approximate the wound. A penile nerve block is performed to reduce post-operative pain.

What are the risks?

The most common complications associated with circumcision are bleeding and infection. Other rare complications include an unsatisfactory cosmetic appearance of the foreskin where it is cut too short or too long or tearing of the foreskin wound.

What does the post-operative care involve?

The procedure is usually performed as day surgery. There will be a dressing wrapped around the penis after the operation, there is an opening for the tip of the penis to allow urination.

There will be some pain when the local anaesthetic nerve block wears off, pain killers will be prescribed to treat pain.

• The wound takes 7-10 days to heal.
• The dressing should be removed are 48 hours.
• The penis and the wound should be washed daily in the shower with clean running water. Do not use soap until the wound has healed.
• Pat the penis dry with a clean towel and apply a new dressing daily for 7 days.
• Wear tight briefs to allow support of the penis.