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Circumcision

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. 

Your specialist has recommended that you have a circumcision and this factsheet provides some standard information and advice about the procedure. However, you should always follow the instructions of your own specialist.
If you have any unanswered questions or concerns, please do not hesitate to ask your specialist or nurse for more information. It is natural to feel anxious, but often knowing what to expect can help.

 

Circumcision is a simple operation to remove the foreskin from the penis. The foreskin is the sleeve of skin around the tip (glans) of the penis.

The procedure is routinely carried out as a day case, with no overnight stay. It is usually performed under a general anaesthetic - this leaflet describes this method.

Circumcision can also be successfully performed under local anaesthetic. You do not have to fast beforehand and can generally go home sooner than after a general anaesthetic.

Your specialist or hospital will give you some information about when and how to check into hospital.

In some cases, you may be invited to attend a pre-admission clinic for some routine tests.

Before you come into hospital your circumcision, you will be asked to:

  • Have a bath or shower at home on the day of your admission
  • Remove any jewellery
  • Follow the fasting instructions given by your specialist or hospital.
  • Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours before

When you arrive at the hospital, a nurse will explain how you will be cared for during your stay and will perform some simple tests such as checking your pulse and blood pressure and testing your urine. Your surgeon and anaesthetist will also visit you. This is a good time to ask any outstanding questions about your treatment.

Consent

You will be given a consent form to sign. By doing this, you confirm that you understand what the procedure involves, including the benefits and risks, and give your permission for it to go ahead.

Please refer to further information below regarding the possible side-effects and complications of this procedure. You need to know about these in order to give your informed consent.

About the operation

Once you are soundly asleep, the foreskin is pulled forward and cut so that it can be removed. The skin is stitched together, and a loose dressing is applied. The stitches are dissolvable and do not need to be removed. The operation usually takes 10 to 20 minutes.

At the end of the operation, and before you wake up, the surgeon will give you a long-acting local anaesthetic, either by injection, or by applying gel to the area. This makes the operation site pain-free for a few hours after surgery.

Back on the ward

You will need to rest on your bed until the effects of the anaesthetic have passed. The local anaesthetic will last for up to eight hours. If you are sore after this, you may require painkillers, which can usually be taken every four to six hours. Please discuss this with your nurse, surgeon or anaesthetist.

When you feel ready, you can begin to drink and eat, starting with clear fluids such as water or apple juice.

Going home

If your operation has been planned as a day case, you will be able to go home once you have made a full recovery from the anaesthetic. It is also best if you try to pass urine before you go home.

You will need to arrange for someone to drive you home and then stay with you for the first 24 hours. If you stay overnight following your operation, you will asked to be ready to leave your room the next morning.

Before you are discharged, the nurse will advise you about caring for surgical wounds, hygiene and bathing. The nurse will also give you a contact telephone number for the hospital, in case you need to ask for any further advice.

After you return home

If you need them, continue taking painkillers as advised by the hospital. A general anaesthetic can temporarily affect your coordination and reasoning skills, so you should avoid driving, drinking alcohol, using power tools, making any vital decisions or signing legal documents for 24 hours after the operation.

As you will be quite sore, you need to be prepared to take it easy for a few days. Don’t do any strenuous exercise, lifting or carrying.

The day after your operation, try to get out of bed and take regular walks around the house. It is most comfortable to wear loose clothing such as boxer shorts, or a dressing gown with no underpants or trousers, because the rubbing of clothing may make the wound sore. To stop clothes sticking to the operation site, you can apply a little Vaseline.

You should try to keep the area dry for 48 hours after the operation. After this, take warm baths, without adding bubble bath or oils, once or twice a day. It is important to keep the tip of the penis clean to stop it crusting over, which can prevent you from passing urine.

The stitches will dissolve and drop out in the bath over a period of up to three weeks. The wound may bleed slightly or ooze until all the stitches have dissolved, and will take about two weeks to heal.

You should avoid driving for five to seven days, or until you feel could perform an emergency stop without feeling discomfort.

Circumcision is generally a safe surgical procedure. For most people, the benefits in terms of improved symptoms are greater than the disadvantages. However, all surgery does carry some element of risk. This can be divided into the risk of side-effects and the risk of complications.

Side-effects

Examples of short-lived side-effects include nausea or vomiting as a result of the general anaesthetic. There is also likely to be some pain, swelling and bruising of the skin around the penis, which may last for several weeks. There may also some be bleeding.

Complications

This is when there are problems during or after the operation. Most people are not affected.

The main possible complications of any surgery are bleeding during or very soon after the operation, infection, and an unexpected reaction to the anaesthetic.

Specific complications of circumcision are uncommon but can include infection, which can usually be treated with antibiotics, and excessive bleeding from the operation site, which may require further treatment in theatre.

The chance of complications depends on the exact type of operation you are having and other factors such as your general health. You should ask your surgeon to explain how these risks apply to you.

1. My son is being circumcised. Will the foreskin grow back?

No, your son's foreskin wont grow back.

The foreskin is the sleeve of skin that surrounds the head of the penis. At birth, your son's foreskin will be stuck to the head of his penis, but it gradually separates and can usually be pulled back by the time he is three.

If you choose for your son to have a circumcision, his foreskin will be removed. Once it has been taken away, it can't grow back.

2. Will circumcision protect me against sexually transmitted diseases?

No, having a circumcision won't stop you from getting STIs.

STIs are passed from person to person through unprotected sex. It's thought that having a circumcision may help to reduce the risk of:

  • certain STIs being passed on through heterosexual intercourse (sexual intercourse between a man and woman)
  • passing the human immunodeficiency virus (HIV) infection from a woman to a man
  • passing the genital herpes virus on
  • passing the human papilloma virus (HPV) on – the virus that causes cervical cancer

 

Although circumcision may reduce the risk of you getting certain infections, it doesn't guarantee complete protection. It's therefore important to practise safer sex. You should always use a condom when having sexual intercourse with a new partner.

3. Will circumcision affect my ability to have an erection?

Circumcision shouldn't affect your ability to have an erection, but you may find it painful to start with after the procedure.

Circumcision involves removing the foreskin from your penis. Your penis may feel painful and swollen for about a week after the procedure but it shouldn't affect your ability to have an erection. However, having an erection will be painful for a while because of your healing wound. You should usually wait for around four to six weeks after the procedure before having sex or masturbating. It's also important to know that the nerve endings on your penis that are responsible for sexual arousal won’t be affected after the circumcision.

If you're having problems achieving or sustaining an erection (known as impotence), it's important to look at other factors that could be causing this. Psychological problems such as feeling anxious, stressed or depressed can influence your sex drive and performance. Also, after a circumcision it's possible that you may be concerned about how your penis looks or worried about your partner's reaction.

Lifestyle factors such as smoking and drinking too much alcohol can also affect your ability to get and keep an erection. Alternatively, there may be physical causes such as diabetes, high blood pressure or high cholesterol.

If you have impotence after your circumcision, talk to your GP. He or she will be able to advise you about suitable treatments.

4. Will circumcision cause premature ejaculation?

No, a circumcision shouldn't cause premature ejaculation.

Premature ejaculation is when a man ejaculates sooner then he, or his partner, would like, usually within two minutes. Circumcision shouldn't cause premature ejaculation.

If you're experiencing premature ejaculation and it's causing problems in your relationship, then it's important to look at other factors that could be causing this.

There are medical conditions that can interfere with ejaculation such as changes in your prostate gland, diabetes and neurological disorders. Psychological problems such as feeling anxious or stressed can also influence ejaculation. For example, you may ejaculate sooner than you want to if, during sex, you're in a hurry or scared of being discovered or heard by other people.

If you ejaculate prematurely and it's affecting your relationship with your partner, speak to your GP. He or she will be able to advise you about suitable treatments.

Further information

 

Resources

  • Johnson P. Childhood circumcision. Surgery 2005; 23:338-40. doi:10.1383/surg.2005.23.9.338
  • Manual for early infant male circumcision under local anaesthesia. World Health Organization. www.who.int, published 2010
  • Management of foreskin conditions. British Association of Paediatric Surgeons. www.baps.org.uk, published 2007
  • Male circumcision: guidance for healthcare practitioners. The Royal College of Surgeons of England. www.rcseng.ac.uk, published May 2000
  • The law and ethics of male circumcision – guidance for doctors. British Medical Association. www.bma.org.uk, published November 2007
  • Circumcision (child). British Association of Paediatric Surgeons. www.baps.org.uk, published 2007
  • Lane T, South M. Preputioplasty. J R Soc Med 2003; 96(12):619. doi:10.1258/jrsm.96.12.619
  • Holman JR, Stuessi KA. Adult circumcision. Am Fam Physician 1999; 59(6):151–48. www.aafp.org
  • Impotence or erectile dysfunction. Sexual Advice Association. www.sda.uk.net, published August 2011
  • Ejaculation problems. Sexual Advice Association. www.sda.uk.net, published June 2011
  • Personal communication, Mr Raj Persad, Consultant Urologist, Spire Bristol Hospital, 29 September 2011

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