WHAT IS A CIRCUMCISION?
A circumcision is an operation to remove a male’s foreskin. The entire foreskin is removed to leave the head of the penis exposed. The foreskin is the shroud of skin that can be gently pulled back to uncover the head of the penis. As well as looking different, your penis may feel different at first after the procedure.
The surgery is relatively simple and the wound is either cauterized and stitched with dissolvable sutures. We usually carry out the procedure under a general anaesthetic, but local or spinal anaesthetic may be used instead. We use local anaesthetic nerve blocks, regardless of the type of anaesthetic, to provide post-operative pain relief. The incision is just below the head of the penis and we remove the whole foreskin; this leaves the glans (head of the penis) completely exposed
A circumcision may be recommended for some of the following circumstances:
- Phimosis – the inability to pull back the foreskin, leading to pain and urinary problems. It can occur if a male is born with a tight foreskin, or because of scarring, infection or inflammation.
- Paraphimosis – when the foreskin is stuck behind the head of the penis and difficult to pull forward. This restricts the blood flow to the end of the penis causing swelling.
- Balanitis – when the head of the penis becomes inflamed or swollen, due for example to a skin irritation, skin conditions, thrush or sexually transmitted infections. Circumcisions can help prevent a recurrence.
WHAT CAN I EXPECT WHEN I GET HOME?
- You will get some swelling and bruising of the penis which may last several days
- Some minor bleeding from the suture line is normal and can occur after erections
- It can take up to six weeks before the penis returns to its final cosmetic appearance
- The exposed glans of the penis may feel very sensitive for the first two weeks. Once the hypersensitivity has settled, your penis will feel a little less sensitive than before the operation
- The exposed glans may dry out and scab over; applying a little Vaseline will help this and can also help decrease the sensitivity after the operation. Do not use any antiseptic cream or other creams / lotions / solutions that have not been prescribed by your doctor, as this can interfere with the healing process and increase the risk of infection and scarring
- All your stitches will dissolve, usually within two to three weeks
- Simple painkillers such as paracetamol are helpful if you have any discomfort
- Any dressing should fall off within 48 hours; if not or it becomes soaked with urine, remove it
- Try to keep the area dry for 24 to 48 hours; avoid soaking in a bath
- You should not swim for one-two weeks
- Wear loose-fitting clothing for two-three days
- Any antibiotics or other tablets you may need will be arranged & dispensed from the hospital pharmacy
- You will continue to get erections as normal after the procedure but you should refrain from any sexual activity (intercourse or masturbation) for four weeks
- When you first get erections, you may feel some tightness around the scar tissue; this will regain its normal elasticity within a few months
- The procedure will have no effect on your ejaculation and fertility
WHAT ARE THE POSSIBLE COMPLICATIONS?
A circumcision is a relatively safe procedure but complications / risks include:
- Foreskin cut too short or left too long
- The wound does not heal properly
- Bleeding and bruising
- Wound infection
- The foreskin left behind might attach to the penis and require further minor surgery
- Meatal stenosis – the urinary stream may be reduced or deflected, making it difficult to aim
- Damage affects the urethra, the tube that carries urine through the penis, making urination difficult
- Permanent altered or reduced sensation in your glans (head of the penis)
NOTIFY GEELONG UROLOGY or your GP if you experience any of the following:
- Heavy bleeding or any wound discharge
- Redness soreness or pus around the wound
- Wound coming undone
- Increased discomfort, severe pain and burning when passing urine
- Fevers (temperatures over 37.5 degrees), sweats or shakes
FOLLOW UP APPOINTMENT
Your will generally have a post-operative appointment approximately 4 weeks after your surgery (made prior to the operation). If an appointment time is not given to you on discharge from hospital, you will need to phone Geelong Urology to make an appointment.
If you have any queries please contact Geelong Urology on 03 5229 9105 during business hours OR leave a message on the After Hours Urology Paging Service 03 9387 1000