Circumcision

Learn more about circumcision at King Edward VII’s Hospital

Why would I need a circumcision?

There are several reasons why you may medically need a circumcision. The most common reason is due to phimosis, which is when the foreskin is tight and won’t pull back.

Other reasons include recurrent balanitis (inflammation and infection of the foreskin and head of the penis), paraphimosis (when the foreskin won’t return to its original position), balanitis xerotica obliterans (which causes phimosis), and penile cancers.

What symptoms does a circumcision address?

The procedure should treat any pain or discomfort that was caused by the foreskin.

This may be particularly noticeable when you have an erection or involved in sexual activities.

If there are any lesions/red areas on the foreskin, these will be examined by a histopathologist after the surgery to ensure no further treatment or follow up is needed.

When should you speak to your specialist about a circumcision?

If you are experiencing any discomfort in the head of your penis, or have tightness, swelling, infection or discomfort of the foreskin, speak to your GP or consultant about possible treatment options.

In most cases circumcision won’t be recommended until less invasive treatments such as topical steroids have been tried.

How is a circumcision performed?

Circumcision is usually carried out on a day patient basis.

The procedure will either be undertaken with a local anaesthetic (area is numbed) or a general anaesthetic (where you will be unconscious during the procedure).

The simple procedure involves the removal of the foreskin, with scalpel or surgical scissors, just behind the head of the penis.

Any bleeding during the procedure will be stopped using cauterisation (heat) and then the remaining skin is stitched together using dissolvable stitches.

What is the recovery like for a circumcision?

When you are discharged you will be given advice about your recovery. This may be slightly different depending on what type of anaesthetic you received. Any dressing left on the penis should be removed the following day.

We would advise avoiding showers for 24 hours and no baths/swimming for 1 week. You may still get erections in the first few days; this shouldn’t cause any trouble but avoid any sexual activity for 4-6 weeks post operatively.

It usually takes at least 10 days to heal after the procedure, and you may be advised to take some time off work to heal.

You will likely experience some discomfort around the head of the penis for a few days after the procedure. Simple painkillers such as paracetamol and ibuprofen should be enough to keep you comfortable. If pain continues, or you have unusual symptoms not discussed by your specialist, tell your GP or specialist immediately.

You should wear light and loose fitting clothes for a few days after the operation, however supportive underwear to minimise movement of the penis is advised. Applying Vaseline (petroleum jelly) around the tip of your penis will help to stop it sticking to your underwear.

Are there any risks/complications associated with a circumcision?

Complications after adult male circumcision are rare and most men don’t experience any significant problems.

The two most common problems associated with the procedure are bleeding and infection.

Other possible complications of circumcision can include:

• Initially increased sensitivity of the head of the penis for the first few weeks, however in the long term you may notice a reduction in the sensitivity of the head of the penis, particularly during sex
• Dissatisfaction with the cosmetic result
• Scarring and tenderness of the scar
• Stitch removal
• A further operation to remove more skin

How can I prepare for a circumcision?

Prior to surgery, your surgeon will discuss with you how best to prepare, as each patient will have differing needs.

Are there alternatives to a circumcision?

• A one month trial of topical steroids can be used initially, however if your symptoms return when the treatment stops, this may indicate a more invasive treatment is needed.
• Frenuloplasty – this is often a temporary solution as it will not treat the underlying disease of the foreskin.
• Dorsal slit of the foreskin – this involves a simple slit on the tip of the penis but it has a poor cosmetic result.