Circumcision

WHAT IS A CIRCUMCISION?

Circumcision is the surgical removal of the penile foreskin.

WHAT ARE THE INDICATIONS FOR A CIRCUMCISION?

Reasons for a circumcision include:

• Tightening or narrowing of the foreskin such that retraction of the foreskin becomes difficult or impossible either in the erect or flaccid state. This is also termed phimosis of the foreskin.
• Repeated infections of either the foreskin or the head of the penis.

WHAT DOES THE SURGERY INVOLVE?

Circumcision is done as a day procedure under a general anesthetic in a hospital. You will be asked to fast for 6 hours before the surgery. Once you come to the hospital you will be admitted by the nursing staff. Once admitted you will be taken to the operating room when it your turn to be operated on.

The anesthetist will give you the medications to make you to go to sleep completely. Once you are asleep the surgery will commence.

Incisions are made on the outer as well as the inner aspect of the foreskin. The foreskin will then be completely removed.  The blood vessels that are exposed will sealed off with a diathermy machine. Once this is done the skin that covers the shaft of the penis will be reattached with dissolving stiches to just under the head of the penis. The operation on average takes half an hour.

Once the operation is completed, you will be woken up by the anesthetist and sent to the recovery unit, for observation.

Once you have fully recovered and woken up, you will be discharged from hospital on the same day.

As the surgery is done under a general anaesthetic you will not be able to drive home yourself and hence a friend or family member will need to take you back home.

WHAT ARE POSSIBLE COMPLICATIONS FROM A CIRCUMCISION?

While the majority of circumcision procedure are routine and do not have any complications a small percentage of patients may experience some complications.

Possible complications include:

• Bleeding – while rare if this does happen the penile area will appear swollen and possibly bruised. The majority of bleeding will resolve by itself. It will take 4 to 6 weeks for the swelling to subside.
• Infection – If this does occur the wound will appear red and swollen. Antibiotics may be needed for a couple of weeks to treat this.
• Stitching coming apart- this is uncommon but can happen if strong nocturnal penile erections tear some stiches apart. This is not a major concern, as the wound will heal itself, but will take 6 to 8 weeks for complete healing to occur.

RECOVERY FROM SURGERY

While recovery from a circumcision is quick and you will be able to get back to work within 48 hours after completion of the surgery,  there are some aspects that you need to be aware of.

• Sensitivity of the exposed head of penis. The sensitivity will resolve by itself and will take 2 to 3 weeks for his to happen.
• Some discomfort in the area of stiches for 1 to 2 weeks. Simple pain killers such as paracetamol can be taken to ease the discomfort.
• The stiches are very slow to dissolve and will take about 8 weeks to completely disappear. You do not need to see your GP to remove the stiches.
• It is advisable to abstain from sexual activity for 6 to 8 weeks, giving time for complete healing to take place.

FOLLOW-UP WITH DR VASUDEVAN

Dr Vasudevan will review you in his office 8 weeks after the surgery has been completed to assess the wound and also to discuss the pathology report of the foreskin that would have been sent to the lab for analysis at the time of the operation.

Please ring Dr Vasudevan’s office to make the follow-up appointment.