CIRCUMCISION: Questions & Answers

What is meaning of circumcision?

A circumcision is the surgical procedure in which removal of the penile foreskin (the loose fold of skin on the head of the penis) done.

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What the indications of circumcision procedure?

routine ritual circumcision.
genital hygiene purpose.
Balanitis: a painful swelling and irritation at the glans (head of the penis).
Phimosis: the foreskin is too tight to retract over the head of the penis.
If the foreskin is too tight, it may be painful while having an erection or sex and may contribute with recurrent glans infections.

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What are the alternatives to circumcision procedure?

Creams and anti-inflammatory tablets may be helpful in some cases to relieve inflammation and avoid circumcision procedure.

What pre-circumcision preparations should be made?

In general, no special preparations for this procedure, but usually you should undergo pre-assessment to check your general fitness, and to collect blood sample for screening.

At the preassessment visit:

all information about the procedure (surgical steps, pros and cons) will be explained to the patient by his surgeon.
All information about anesthesia method will be given also by anesthetist.
stop eating and drinking instructions before surgery will be given as well.
kindly bring all your current medication.
If you take Aspirin, Warfarin, Clopidogrel, please ensure that your surgeon is aware, as these medications should to be stopped before the operation, this information will be given to you in details prior surgery.

sign a surgical consent form giving the medical team permission for your procedure to take place, and showing that you understand what is to be done and confirming that you wish to proceed after knowing all benefits and risks of this procedure.

This procedure is performed as a day case surgery, rarely some patients require staying for one night.

Your admission will be on the same day of operation.

How is the circumcision performed?

The operation is performed under a:

local anesthesia: penile block
general anesthesia.
spinal block: numbs the pelvic region.

The surgery takes approximately 30 minutes.

The surgeon exposes the head of the penis by making a dorsal slit and removing the foreskin.

A small interrupted dissolvable stitches are left around the end of the penis.

After surgery:

Patient will have a Vaseline gauze dressing around the penis with exposing the glans which allow patient to pass urine normally.

Intra venous drip will keep the patient hydrated until starting oral intake.

Patient may feel numb at the penis due to local anesthesia in penile block.

Patient can discharge a few hours later after:

Full conscious in case of general anesthesia.
Pain free
Passing urine normally.
Checking operation site: no bleeding, no tight dressing.
Good tolerating diet.

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At Home:

Patient is advised not to drive at least 24 hours post-surgery.
The penis may be swollen or bruised for a few days post-surgery.
May be an oozing or slight bleeding from the stitch line first day post-surgery.
In case of pain: paracetamol or non-steroidal anti-inflammatory drugs are usually effective.
urination will be painless and urine stream will not be affected by the operation.
48 hours post-surgery: Soak and remove the penile Vaseline gauze (if it is hard to remove, kindly visit your surgeon to do it).
Vaseline or Cream can be applied to the glans and over the stitch line to prevent sticking with patients’ underpants.
Genital hygiene care to keep wound clean by having a quick daily bath using only water or unscented products.
Erections will be painful during the first week after surgery.
Usually patients are advised not to have sex for one month, until the wound has completely healed.
It is better to wear loose comfort underpants next to the penis.
Patient should avoid hard exercise or heavy activities for 2 weeks, to allow the wound to heal well.
The surgical stitches are dissolvable and no need to be removed, it dissolves within 3-4 weeks depending on the stitches used.
patient can return to work when feel comfortable, most patients experience some discomfort and require a few days off work.
In case of: developing a temperature, increased redness, drainage at the site of the circumcision, open wound, urination disorder please contact your surgeon immediately.

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What the circumcision side-effect?

All procedures have a potential for side-effects. patient should be reassured that, although all complications are well-recognized, but the majority of patients do not have any significant problems after a circumcision procedure.

All procedures have a potential for side-effects.

patient should be reassured that, although all complications are well-recognized, but the majority of patients do not have any significant problems after a circumcision procedure.

Common side effect (greater than 1 in 10):

Swelling of the penis lasting several days.
bruising under the penile skin

Occasional side effect (between 1 in 10 and 1 in 50):

bleeding from the wound which sometimes requires additional treatment.
Infection of the wound which requires additional care.
A change in the penis's head sensation.
After three to four weeks, the Persistent absorbable stitches need to be removed.