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Circumcision

Published by Bupa’s Health Information Team, October 2011.

This factsheet is for men and boys who are having a circumcision, or for anyone who would like information about it.

Circumcision is an operation to remove the foreskin from the penis. The foreskin is the sleeve of skin that surrounds the head of the penis.

This factsheet is relevant for both men who are having a circumcision and parents of boys who are having the procedure. However, for simplicity we will refer to 'you' throughout.

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About circumcision

Circumcision is a procedure to remove the foreskin from your penis. At birth, the foreskin is stuck to the head of your penis, but it gradually separates and can usually be pulled back by the age of three.

Circumcision may be done for medical reasons, for example if your foreskin is too tight and difficult to pull back over the head of your penis. This is called phimosis and is most common in boys around puberty. Circumcision can also be done if you have a condition called balanitis xerotica obliterans, which causes scarring of your foreskin and discomfort when passing urine. Occasionally, you may need to have a circumcision if you get repeated infections underneath your foreskin, known as balanitis.

Circumcision may also be done for cosmetic, religious or social reasons. This is called non-therapeutic (or ritual) circumcision.

It's thought that circumcision may help to reduce the risk of certain sexually transmitted infections (STIs) and cervical cancer in female partners. However, having safer sex is the best way to prevent the spread of STIs.

Circumcision is most often carried out in babies and young boys, but it can be performed on adult men at any age.

What are the alternatives?

If you have a non-retractable foreskin, this can sometimes be treated with creams containing steroids. Alternatively, your surgeon may suggest a procedure called preputioplasty. This involves him or her making one or two small slits in your foreskin to help it stretch.

Preparing for a circumcision

Your surgeon will explain how to prepare for your procedure.

Babies are usually given a local anaesthetic, either by injection or as a gel, which completely blocks pain from the area. Your baby will stay awake during the procedure.

For older children and adults, circumcision is usually done as a day case under general anaesthesia. This means you will be asleep during the procedure.

If you’re having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your surgeon’s advice.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

Older boys can sign their own consent form, providing they understand what they are being asked to do, otherwise, parents will be asked for consent. Some boys may say they don't want to be circumcised. If this happens, the surgeon will take their wishes into account. Both parents must give consent for non-therapeutic circumcision in children.

What happens during a circumcision

The operation usually takes around 20 to 30 minutes.

Your surgeon will remove your foreskin using surgical scissors, a surgical knife or clamp. The edges of your skin will be closed using dissolvable stitches and/or special glue.

Your penis may be wrapped in a paraffin-based dressing to protect it. The dressing is usually removed after 48 hours.

What to expect afterwards

After a local anaesthetic it may take several hours before the feeling comes back into your penis. Take special care not to bump or knock the area.

If you had a general anaesthetic, you may need to rest until the effects have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

You will usually be able to go home when you feel ready.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon’s advice.

Your nurse will give you some advice about caring for your healing wounds before you go home. You may be given a date for a follow-up appointment.

Recovering from a circumcision

It usually takes about two weeks to make a full recovery from a circumcision, but this varies between individuals, so it's important to follow your surgeon's advice. You may prefer to wear loose-fitting clothing until the soreness goes away.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and if you have any questions, ask your pharmacist for advice.

It's important to keep the tip of your penis clean. Gently wash the wound for the first week after the procedure. You should then be able to shower as usual.

The length of time your dissolvable stitches will take to disappear depends on what type you have. However, for this procedure they should usually disappear in about 14 days but this is variable.

Contact your GP or the hospital if the healing wound bleeds heavily or starts to weep yellow or white discharge.

Having an erection will be painful for a while after your operation, so you should usually not have sex or masturbate for four to six weeks after the procedure. Follow your surgeon's advice.

You will usually be able to return to work, and children return to school or playgroup, seven to 10 days after the procedure.

What are the risks?

As with every procedure, there are some risks associated with circumcision. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

Common side-effects of circumcision include pain, bruising and swelling of the skin around your penis, which may last up to a week after the procedure.

Complications

Complications are when problems occur during or after the operation.

The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or infection. Bleeding is usually stopped by applying pressure. Very rarely, heat (diathermy) or fine stitches are used to seal your blood vessels. If this happens, you may need to stay in hospital overnight for observation.

Specific complications of circumcision are rare, but can include:

  • removal of too little or too much of your foreskin
  • difficulty passing urine
  • formation of abnormal scar tissue – it may be possible to correct this with further surgery
  • damage to your urethra (the tube that carries urine from the bladder and out through the penis)
  • damage to the end of your penis
  • formation of an ulcer on the end of your penis

 

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.


  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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  • Publication date: October 2011