Circumcision is the removal of the prepuce (foreskin) that covers the glans penis (head of the penis).
In an adult, there are a few reasons that a circumcision might be performed.
- Phimosis. This means that the opening of the foreskin has scarred down and consequently, the patient cannot put it back properly, or in some cases, at all. This may result in poor hygiene, and in extreme cases, interfere with urination. In the long term phimosis may predispose a person to developing penile cancer.
- Balanitis or Prosthitis. This means that the head of the penis or foreskin becomes infected.
- Elective: In these case, an individual may tell the urologist that he wants a circumcision for cosmetic or religious reasons.
- Discomfort with Intercourse: In rare instances, a patient can have a prominent frenulum. This is the web-like tissue on the undersurface of the penis that goes from the shaft to the head of the penis. In some males, this can be tight and cause a pulling sensation during sexual intercourse.
Please refer to the detailed information provided by the rooms. This information is also available on the website. The procedure will not be performed if you are currently taking, or have recently taken any medication that may interfere with your ability to clot your blood (“blood thinners, aspirin, anti-inflammatory medicines, etc…”). The most common of these medications are aspirin and all related pain relievers or anti-inflammatory compounds (whether prescription or over the counter
The procedure usually takes less than one hour. Circumcisions are performed under general anaesthesia (complete sleep).
There are many different methods to perform circumcisions. Basically, the excision margins are carefully marked out and the foreskin is excised with care taken to ensure enough skin remains to allow erections to occur without any problems. If there is a tight or pulling frenulum (web of tissue on the undersurface of the penis), this may also be divided. Antibiotic ointment may be placed around the incision and a gauze dressing may be wrapped around the incision.
In the vast majority of cases the procedure requires a day-only admission. You may have discomfort over the incision. There may be small blood staining that soaks through the gauze. If the dressing becomes soaked, or you see active blood oozing, please contact the hospital. We will usually instruct you to remove the dressing the following day and take a shower. You should avoid a bath or swimming for the first few days unless otherwise instructed. We ask that you refrained from any strenuous activity until your follow up. Every patient has some degree of swelling and bruising, and it is not possible to predict in whom this might be minimal or significant. We encourage you to take the following day off of work and perhaps more if your occupation requires very strenuous activity or heavy lifting. In the first 24 hours, it is to your advantage to minimise activity. Some patients have almost no discomfort while others are a bit uncomfortable for a few days. We may provide you with a prescription for pain medication but you certainly may take an over the counter pain reliever medication to which you are not allergic. The sutures we use are self-dissolving, and therefore just fall out on their own within 2-3 weeks after surgery.
*You must abstain from any type of sexual activity until we tell you that you may resume. This period if typically for 3-4 weeks but may even be longer in diabetic patients who often heal more slowly.
Possible Complications of the Procedure
The vast majority of patients will not experience any problem after a circumcision. However, any procedure, regardless of complexity or time, can be associated with unforeseen problems. They may be immediate or even quite delayed in presentation. These may include, but are not limited to:
This is when a small blood vessel continues to ooze or bleed after the procedure is over. The result is greater swelling and bruising because the blood may be caught under the suture line. This almost always resolves over time.
Infection is possible in any procedure. Usually, local wound care and antibiotics are sufficient.
Injury to the Glans Penis
The foreskin can be stuck to the glans. Sometimes an abrasion or laceration can occur when separating the foreskin from the glans. This will heal in time. Antibiotic ointments may be applied.
Please contact the office within 3 days of discharge. You should make an appointment to see Dr Sved in 6 weeks. Do not hesitate to call at any time if you have any concerns.