A B C D E F G H I J K L M N O P R S T U V W

CIRCUMCISION

Why being performed ?

A circumcision is only necessary when the opening of the foreskin is too narrow to slide back (or retract) over the penis. This is called a phimosis and is rare, both in children and in adults. The foreskin does not usually retract until the age of 2 years. Therefore, inability to retract the foreskin before this age is not a reason for circumcision. If the opening of the foreskin is too narrow, it may also balloon out when urine is flowing. An inflammation (called balanitis) may then develop under the foreskin. Under these circumstances, circumcision may then become necessary. In adults, a narrow foreskin causes different problems, particularly during erection and sexual intercourse. The foreskin should normally retract easily when the penis is erect. If the foreskin is too tight, discomfort and inflammation may occur during sexual intercourse. Sometimes the foreskin will retract with difficulty, but will not then return to the normal position. This is called a paraphimosis and is a reason for circumcision. Inflammation of the end of the penis can occur for many different reasons and a circumcision will sometimes be helpful in preventing the problem from recurring.

Preparations needed

There are no special preparations. The operation is usually performed as a day case. This means that you will be asked to arrive at the hospital or day surgery unit on the same day as the operation. If the operation is to be performed in the morning, you will be asked to eat and drink nothing from midnight on the previous evening. If the operation is to be performed in the afternoon, a light early breakfast may be all right but you must check this with the doctor at the hospital. You must notify the doctor of any allergies and any previous medical conditions.

What Happens

A general anaesthetic is always required for children and is advisable for adults. The operation is usually performed as a day case. The foreskin is cut off during the operation and this leaves a circle of small stitches around the end of the penis. These stitches will eventually dissolve. Depending upon the type of stitch used, the dissolving process will take anything from 1 to 4 weeks.

Possible Complications

A little bleeding is common during the first week, but if there is persistent oozing of blood which lasts for more than half an hour, tell the doctor immediately.

Afterwards

If the foreskin has never been retracted, one must expect considerable post-operative swelling and inflammation. In children this looks much worse to the parents than is the discomfort which the child experiences. The stitches will dissolve and this may take 3 4 weeks. Do not apply creams or antiseptics. Regular bathing in salt water is the best and safest post-operative care. A little bleeding during the first week may occur. In adults, erections may be painful during the first week after circumcision. There is no particular treatment to prevent erection. Children will need to be away from school for at least 1 week: adults should remain at home and away from work for a similar period. Sexual intercourse can be resumed a month after the operation, or when all the stitches have dissolved.

If not performed

In children, infection may continue to be a problem. In adults, problems would continue, causing discomfort during and after intercourse. Occasionally in adults when the foreskin will not move back over the penis, cracking of the skin and a little bleeding may occur.