Circumcision
What is circumcision?
Circumcision is a surgical procedure that involves removing the foreskin, which is the fold of skin covering the head of the penis. It may be performed for medical, functional or cultural reasons. The aim is to relieve symptoms, prevent recurrent problems and improve comfort and hygiene. For many individuals, circumcision provides a long-term solution to issues related to a tight or problematic foreskin.
Why is it needed?
Circumcision may be recommended when the foreskin cannot be comfortably retracted due to phimosis, or when it becomes trapped behind the head of the penis in a condition known as paraphimosis. It may also be advised for those who experience recurrent infections beneath the foreskin, such as balanitis or balanoposthitis.
Other conditions, such as scarring or inflammation caused by lichen sclerosus, may also require circumcision. Some individuals choose circumcision for cultural, religious or personal reasons. The procedure may also be considered when a tight foreskin causes pain or difficulty with urination or sexual activity.
What happens during the procedure?
Circumcision may be performed under general or local anaesthesia depending on age, preference and clinical factors. The foreskin is gently separated from the glans, and the excess skin is removed using surgical instruments or a cautery device.
The remaining edges are stitched with dissolvable sutures. A light dressing may be applied to protect the area. The procedure typically takes between thirty and forty-five minutes. Most individuals return home the same day.
What are the alternatives?
Alternatives to circumcision may be appropriate in selected cases. Topical steroid creams may help soften and loosen the foreskin when phimosis is mild. A preputioplasty, which involves making a small incision to widen the foreskin while preserving it, may be an option for individuals wishing to avoid full removal.
Observation may be suitable for those with mild or intermittent symptoms.
Potential risks and after effects
Circumcision is a safe and commonly performed procedure, but some temporary effects are expected. Mild pain or swelling may occur for several days. A small amount of bleeding may be present initially and usually settles with simple pressure.
Infection may develop in a small number of individuals and may require antibiotics. Healing may take several weeks. Some people may notice permanent changes in sensitivity or appearance, although these are rarely troublesome. Rarely, either too much or too little skin may be removed. Meatal stenosis, which is narrowing of the urine opening, is also rare.
After the procedure
Mild soreness and swelling are common in the days following surgery and gradually improve. The area should be kept clean and dry, and showering is usually acceptable after twenty-four hours. Loose-fitting underwear is recommended to reduce irritation.
Simple pain relief can be used as needed. Sexual activity and masturbation should be avoided for four to six weeks to allow proper healing. If a dressing has been applied, it may fall off naturally or be removed after one to two days. Dissolvable stitches usually disappear within two to three weeks.
Follow-up care
A follow-up appointment is usually arranged within four to six weeks to ensure the wound has healed well. Earlier review may be necessary if there is persistent pain, bleeding, swelling or signs of infection.
Long-term follow-up is rarely required unless complications arise.
Paediatric Procedures
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