Circumcision for Phimosis

Circumcision is the procedure for removal of the foreskin from the tip of the penis. A circumcision can be done at birth up to 4 to 6 weeks of age in clinic with a local anesthetic. If a circumcision is not done in that timeframe, it can be done later under general anesthesia. There are multiple reasons why a circumcision may not have been done at birth including prematurity, illness or the identification of an abnormality in the penis.

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Circumcision can be performed under local or general anesthesia and the procedure would take hardly 30 minutes. There is minimum pain and the procedure is done as day surgery. Patients are discharged with tablet pain-killers and antibiotics for 1-2 days only. The procedure can be easily performed for children of above 2 years old as well as for adult and elderly males. The excess foreskin is removed. A couple of stitches placed to bring the edges of the skin together after removal of the excess skin. These stitches are self absorbable and do not require removal in a later date.

Circumcision helps in preventing cancer as penis can be kept clean however sexual excitement is decreased after keratinisation of mucosa of glans. Since throughout life, the foreskin keeps the glans soft and moist and protects it from trauma and injury.

Postoperative bleeding is the most common complication. It usually occurs when a scab is pulled off as the dressing is being removed. However, sutures can also be torn by erections before healing is completed. Bleeding can often be controlled with direct pressure. Rarely, electrocautery or ligature is required.Infection after circumcision is uncommon and, if encountered, may be treated with local or oral antibiotics.

The patient is discharged on the same day of surgery. They will be prescribed pain-relief, antibiotics and anti-inflammation medications. The wound would require a dressing cover for the initial 2-3 days only. As the procedure only involves removal of the foreskin and not affecting the urinary tube, passage of urine is normal after surgery. Most patients can return to work within 2 -3 days. Children recover much quicker from the procedure.The wound will heal within 7-10 days.

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