DR. VIVEK VENKAT

Circumcision is the removal of the foreskin or prepuce which covers the tip (glans) of the penis.

• Recurrent infections of the area – balanitis. Very common in diabetic men.
• Inability to retract the prepuce with difficulty maintaining hygiene – phimosis. This can predispose to penile cancer.
• Biopsy or treatment of a suspected cancerous lesion.
• Religious reasons are a special indication when circumcision is done in childhood.

• The doctor may recommend certain blood tests to assess the bleeding risk.
• A urine sample may be needed to look for infection.
• Medicines which increase the risk of bleeding need to be stopped for 5-7 days prior to the biopsy.

HOW IS A CIRCUMCISION PERFORMED?

• Circumcision is a day care procedure performed under local anesthesia in most cases.
• You will be in the operating room and awake throughout the procedure.
• After cleaning and preparing the area, the doctor will inject a local anesthetic around the base of the penis. At this point you will feel the needle of the injection and this may sting. Following this there will be no pain or sensation in the area.
• The foreskin is removed and the shaft skin is sutured to the corona of the glans.
• You will be aware of the entire procedure going on, however there is no pain.
• The entire procedure takes 30-45 minutes.
• You will be observed in the recovery room to make sure there is no bleeding.
• You will be allowed to go home once you have passed urine.

WHAT TO EXPECT AFTER THE PROCEDURE?

• You will be prescribed some antibiotics and painkillers for the next 2-3 days.
• Avoid strenuous activity.
• You will need to wear loose fitting clothing like short pants or a dhoti/lungi for 7-10days to avoid friction with the operated area.
• Your doctor will call you for a follow-up after 2-3 days to assess the wound and do a dressing.
• Please contact your doctor if you develop fever, inability to pass urine, bleeding or worsening pain.

• Is circumcision painful? You will be aware of the procedure but pain should be minimal after the local anesthesia.
• Infection – The surgical area can rarely get infected. Precautions, including giving you antibiotics before and after the procedure, are taken in order to minimize this risk. Most infections are mild.
• Bleeding from the site can be seen and may need additional stitches or cautery if severe.
• Some patients (especially elderly, diabetic men) have difficulty passing urine following circumcision and may need a catheter temporarily.