Adult circumcision

This involves the surgical of removal of the male foreskin. The foreskin is the retractable part that covers the whole of the penis. There are different reasons as to why a male would opt for this procedure which include medical for issues such as the foreskin not retracting (phimosis) or recurrent infection (balanitis) or for suspected cancer or pre-cancerous conditions.

This is usually carried out as a day case therefore the patient will be able to return home the same day. The procedure can be performed under either a general or local anaesthetic. For a local anaesthetic an injection will be used to numb the penis and the surrounding area. This is a quick procedure, the foreskin is removed just behind the head of the penis with a scalpel or surgical scissors, if bleeding occurs this will be stopped using heat (cauterised) and dissolvable stitches will be used to stitch the edges of the skin.

At the Royal Free PPU our expert Urology consultants and allow us to provide a rapid and efficient service for and treatment of a range of peno-scrotal procedures, tailored to the individual patient, with the full support of the latest equipment and clinical expertise available.

Please see the British Association of Urological Surgeons (BAUS) patient information leaflet: View Leaflet

Reasons for circumcision

While circumcision surgery is mostly carried out for cultural-religious reasons during early childhood, the surgery can be performed in adult males for a number of medical reasons, often as a last resort when conservative treatments haven’t helped.

These most commonly include issues such as the foreskin not retracting properly (phimosis), which can cause ongoing irritation and discomfort and difficulty with sexual intercourse, or recurrent infections on the head of the penis (balanitis). Adult circumcision may also be recommended in men when cancer or pre-cancerous conditions are suspected.

The procedure

The procedure is often carried out on a day case basis, meaning you’ll be able to go home later the same day – although if general anaesthetic is used, you may need to stay overnight. During the surgery, the whole foreskin will be carefully removed, leaving the head of the penis exposed. The skin just below the head of the penis will then be stitched closed, with dissolvable stitches that should disappear within 2-3 weeks. Your consultant will discuss with you in advance whether general anaesthetic is required, although the procedure can sometimes be carried out with spinal anaesthetic (to temporarily numb the lower body) or local anaesthetic injections. Whichever method is used, you won’t experience any pain during the procedure and additional pain relief will be provided afterwards.

Aftercare

Swelling and soreness for a few days is normal afterwards, and it can take up to six weeks for the area to heal completely. It’s usually advised that you wait at least four weeks before having sex. Many men experience a slight reduction in sensitivity in the head of the penis following adult circumcision surgery, but find the benefits of the procedure outweigh any cons. It shouldn’t affect your fertility or erectile function.