Circumcision

Adult circumcision is a surgical procedure in which the foreskin, the fold of skin that covers the tip of the penis, is removed. Many men may require circumcision for conditions such as:

• Tight foreskin that cannot retract in the erect or flaccid state (Phimosis)
• Recurrent infections of the penile tip (Balanitis)
• Inflammatory skin condition (balanitis xerotica obliterans/BXO aka Lichen sclerosus)
• Pain or tearing of the foreskin during sexual activity
• Cancerous or pre-cancerous lesions of the foreskin

What are the alternatives?

• Topical creams (including short-term steroid cream) – these may decrease inflammation and relieve some tightness for phimosis, but symptoms often return once the treatment stops. Creams are a helpful option in some select patients
• Stretching devices – These are new to the market and allow preservation of the foreskin. They don’t have the same robust scientific data to show that these devices work as well as surgery.

Outline of procedure

Circumcision is usually performed under a general anaesthetic, but local or spinal anaesthetic alone may be occasionally used. Regardless of the type of anaesthetic, regional anaesthetic nerve blocks provide good postoperative pain relief. The foreskin is removed with a circular incision at a level just below the head of the penis, leaving the glans (head of the penis) completely exposed. The procedure typically takes about 30 minutes. Dissolvable stitches attach the skin of your penis to below your glans and usually disappear within one to two weeks.

Post-operative course:

It’s common to experience mild swelling and pain for a few days after the procedure and may require over-the-counter or prescribed pain medication. You will have a light dressing on the incision site for 24 hours. Your skin will be waterproof for showering the next day. Gently clean the area with mild soap and water, and pat it dry. Wear loose-fitting clothing for a few days. It’s recommended to avoid strenuous physical activity for 1-2 weeks following the procedure to prevent strain on your body. You should abstain from sexual activity for six weeks to allow all the skin layers to heal.

Risks and complications:

• Infection or Bleeding (1-2%)
• Increased sensitivity – this may last for a few weeks
• Irritation or redness
• Abnormal scarring or cosmetic dissatisfaction (1%)

Dr Kapil Sethi can guide you through the finer points of circumcision and offers this to males aged 16 and over.