Circumcision

What is involved in the Circumcision procedure?

Foreskin removal, or circumcision, entails the complete elimination of the foreskin and is typically undertaken for various reasons. These include conditions like phimosis, characterized by a tight and non-retractable foreskin, recurrent infections such as balanitis, skin ailments on the foreskin and glans, large warty lesions of the foreskin, and cancerous or pre-cancerous lesions. Alternatives to circumcision include topical creams and washes, including short-term steroid cream use, which may alleviate inflammation and tightness in cases of phimosis. However, these alternatives may not be effective for all patients, and circumcision becomes necessary if topical agents prove unsuccessful.

Circumcision main points

Key Points:

Circumcision

• Typically conducted as a brief outpatient procedure using local or general anesthesia

• Involves complete removal of the foreskin, exposing the head of the penis

• Results in both a visual and tactile change in the appearance and feel of the penis

• Utilizes absorbable stitches that naturally dissolve within two to three weeks after the procedure

surgery

What occurs on the day of the procedure?

A/Prof Homi Zargar will discuss the surgery once again to ensure your understanding and obtain your consent.

Details of the procedure:

• The procedure typically performed under local anaesthesia, though general or spinal anaesthesia may be alternatives.

• Regardless of anaesthesia type, local anesthetic nerve blocks are employed for post-operative pain relief.

• Antibiotic injection may be administered before the procedure, following allergy checks (although infrequently).

• A circular incision is made in the foreskin just below the penis head, removing the entire foreskin and exposing the glans.

• Dissolvable stitches used to connect penile skin below the glans, usually disappearing within two to three weeks.

• A tight dressing is applied that requires to be removed the next day.

After-Effects and Risks of the Procedure:

• Swelling of the penis, typically lasting a few days: Common in almost all patients

• Increased sensitivity of the penis head, persisting for up to two weeks: Common in almost all patients

• Potential permanent alteration or reduction in sensation of the penis head (glans): Occurs in 1 in 50 to 1 in 100 patients (1 to 2%)

• Infection of the incision, necessitating antibiotics or surgical drainage: Occurs in 1 in 50 to 1 in 100 patients (1 to 2%)

• Wound bleeding, occasionally requiring additional procedures: Occurs in 1 in 50 to 1 in 100 patients (1 to 2%)

• Possible dissatisfaction with the cosmetic outcome: Occurs in 1 in 50 to 1 in 250 patients

• Oedema (excess skin swelling), potentially requiring further surgery and skin removal: Occurs in 1 in 50 to 1 in 250 patients

• Risks of anaesthetic or cardiovascular complications, including intensive care scenarios such as chest infection, pulmonary embolus, stroke, deep vein thrombosis, heart attack, and even death: Occurs in 1 in 50 to 1 in 250 patients