Circumcision

A circumcision is a surgical operation to remove all, or part of, your foreskin.

What is the foreskin?

The foreskin is the flap of skin that covers the head of your penis. This skin flap is usually loose enough to be pulled back over the top of the penis (the glans). The foreskin protects the head of your penis from damage.

If you're circumcised, the head of your penis is permanently exposed. Sensitivity will increase as your glans adjust to exposure, but once healed, should feel less sensitive than before the operation.

What does this procedure involve?

The procedure involves complete removal of the foreskin. It is usually performed for one or more of the following reasons:

• a tight, non-retractile foreskin - known as phimosis

• recurrent infections under the foreskin – known as balanitis

• skin disease on the foreskin and glans (head of penis) - such as chronic inflammation

• large warty lesions of the foreskin

• cancerous or pre-cancerous lesions of the foreskin.

What are the alternatives?

Topical creams and washes

Circumcision is usually necessary if topical agents fail.

A circumcision procedure takes about 30 minutes. You may be worried about how painful an operation on your penis might be. Your anaesthetist will make sure you feel no pain during the procedure.

Absorbable stitches are used which disappear after two to three weeks.

What happens on the day of the procedure?

Your urologist (or a member of their team) will briefly review your history and medications, and will discuss the surgery again with you to confirm your consent. If you are having a local anaesthetic, this will also be explained to you at this stage. An anaesthetist will see you to discuss the options of a general anaesthetic or spinal anaesthetic. The anaesthetist will also discuss pain relief after the procedure with you.

Your penis will look swollen and bruised and may feel sore for the first week. This is a normal reaction to the operation.

You should be able to go home the same day. If you had general anaesthetic or sedation, for the first 24 hours:

• You’ll need someone to take you home and stay with you overnight
• Don’t drive, operate machinery, or do any potentially dangerous activities (like cooking) until you’ve fully recovered feeling, movement and co-ordination
• You shouldn’t sign legal documents or drink alcohol.

Managing your recovery

You should get plenty of rest for the first 24 hours, but then it’s important to stay active to avoid blood clots. You should also follow the instructions from our healthcare team on medication or special compression stockings.

Here are a few things you can do to make sure you recover well:

• Take pain relief medication for the first few days
• Wear loose underwear
• Drink plenty of fluid
• Try to keep the area dry for 24–48 hours and avoid soaking in a bath
  
• After this time, a lukewarm bath may reduce the pain as well as help you pass urine
• Exercise regularly
• Don't swim for 3 weeks
• Adult patients shouldn't have sex for 4 weeks

Driving after circumcision

Don’t drive until you’re confident you can control your vehicle and always check your insurance policy and with your doctor first.

Time off work

You should be able to return to work after 7 to 10 days.

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If you're worried about anything, Please contact the patient liaison team who can help direct you to the most appropriate care.

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