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Circumcision in Adults

Circumcision

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Soe Ko
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73 views

Circumcision in Adults

Circumcision

Uploaded by

Soe Ko
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Circumcision in Adults

Patient Information – Urology Service

What is a circumcision?
Males are born with a covering of skin over the penis, called the prepuce or the foreskin.
Circumcision is done to remove the foreskin.
Circumcision is usually performed under a general anaesthetic. Occasionally, it can also be offered
under local anaesthetic.

Indications for circumcision


The most common indication for circumcision is a foreskin that is too narrow to retract over the
head of the penis (called phimosis). The procedure is also performed for cultural, social or religious
reasons, although not in the public health system.
An uncommon medical condition, Balanitis Xerotica Obliterans (BXO), results in scarring and
thickening of the foreskin, preventing it from retracting over the penis. This is one of the few
situations where circumcision is strongly recommended.
An abnormal urinary tract with recurrent urinary tract infections is another medical indication for
circumcision.

What happens before my operation?


The surgery and outcomes will be explained to you by your surgeon before the surgery. When you
feel comfortable that you understand what is to be done and have had all your questions

Authoriser: Clinical Director, Urology Service Ref: 2401438

Issue date: 2 November 2022 Page 1 of 4


answered, you will be asked to sign a consent form. This consent form should be signed by both
yourself and your surgeon and forwarded to the hospital prior to your admission.
A blood test will need to be performed and a urine sample may need to be taken a few days prior
to your surgery.
If you are over 60 years of age or have other medical conditions, you may also have an
electrocardiogram (ECG) prior to surgery to check the health of your heart.
You will be advised when to stop eating and drinking before surgery. This includes water and
chewing gum. You can swallow tablets with a small sip of water.
You should bring your own medications with you to hospital.
It is important to avoid constipation. Try to establish and maintain a regular, soft bowel habit
leading up to your surgery. Identify the foods that can help you maintain a regular bowel habit for
your post-op period.

Please inform your surgeon if you are taking anti-coagulant (blood thinning) medication (e.g.
warfarin, clopidogrel, dabigatran, rivaroxaban or ticagrelor), or any medication for diabetes.
Your surgeon will advise when to stop and restart these medications. If you are taking aspirin, it
is okay to continue taking this.

What happens on the day of my operation?


You will go to Christchurch Hospital on the day of your surgery. Be aware that this is a day surgery.
On arrival, the staff will guide you through what is required prior to your surgery.
You will have a clean hospital gown and protective stocking fitted.
An IV (intravenous) line will be placed in a vein in your arm or hand that will be used to supply
fluids or medications during the surgery.
You may be given a medication to prevent blood clots.
You will be encouraged to commence deep breathing and coughing exercises pre-operatively. This
prevents any breathing complications or chest infection from occurring, following the surgery and
anaesthetic.
The choice of spinal (lower half of your body is numbed) or general (you are completely asleep)
anaesthesia will be decided after a discussion with the anaesthetist. If you’re having a general
anaesthetic you will need someone with you, so they can take you home and stay with you
overnight. A tube may be inserted into your throat to help you breathe while you are in a sleep-
like state.
Just prior to your surgery, you may be given a pre-medication tablet to relax you.

What happens during my operation?


The foreskin is removed and dissolving stitches, or sometimes skin glue, are used to close the skin.
Afterwards, the penis will be covered with an ointment, such as a topical antibiotic.
The procedure generally takes about 30 minutes.

Authoriser: Clinical Director, Urology Service Ref: 2401438

Issue date: 2 November 2022 Page 2 of 4


What to expect after my operation?
It usually takes four to six weeks for the penis to heal. The tip of the penis is likely to be sore at
first, and the penis might look red, swollen or bruised. You might notice a small amount of yellow
fluid on the tip of the penis as well.
It is okay to gently wash the penis with soap and water during normal bathing.
Instructions for care at home
• Rest for the first 12-24 hours after discharge and take paracetamol as directed for pain
relief.
• Keep your wound clean and dry for 24 hours, and then you may shower.
• Use the ointment we give you to keep the wound site supple to support healing.
• Bruising and swelling is common and will disappear after a couple of weeks.
• You will have stitches in the wound that will dissolve on their own. The stiches do not need
to be removed.
• Wearing supportive underwear while the stitches are in place is often helpful but avoid
wearing constrictive clothing.
• Do not resume sexual activity until six weeks after surgery.
Return to work when you feel comfortable to do so.
Avoid heavy lifting and contact sports for two weeks as this puts strain on the wound that will be
uncomfortable.
Please contact your GP if you have any further problems.

Possible complications
All procedures have a potential for side effects. You should be reassured that, although these
complications are well-recognised, the majority of patients do not suffer any problems after a
urological procedure.
The most common complications associated with circumcision are bleeding and infection. Side
effects related to anaesthesia are possible as well.
Rarely, circumcision might result in foreskin problems. For example:
• The foreskin might be cut too short or too long
• The foreskin might fail to heal properly
• The remaining foreskin might reattach to the end of the penis, requiring minor surgical
repair.
Problems after circumcision are uncommon.
Please contact your GP immediately if:
• Normal urination doesn't resume within 12 hours of the circumcision
• There is persistent bleeding

Authoriser: Clinical Director, Urology Service Ref: 2401438

Issue date: 2 November 2022 Page 3 of 4


• There is foul-smelling drainage from the tip of the penis.
Swelling and bleeding
• If the wound appears swollen, red and painful or has a discharge, this may indicate a
wound infection. Seek your GP’s advice.
• If you have severe bleeding that you cannot stop, please go to the Emergency Department
at Christchurch or Ashburton Hospitals.
• If excessive swelling occurs place a clean dry cloth over the swollen area and put an icepack
on top. If the swelling continues to increase after 30 minutes of icepack treatment seek
medical advice.

Contact information
If you have any concerns or questions regarding this procedure, please contact the Urology Unit at
Christchurch Hospital, on (03) 364 4307.

For more information about:


• Hospital and specialist services, go to www.cdhb.health.nz
• Your health and medication, go to www.healthinfo.org.nz

For information on parking, how to get to the hospital, and visiting hours, please visit
www.cdhb.health.nz

Authoriser: Clinical Director, Urology Service Ref: 2401438

Issue date: 2 November 2022 Page 4 of 4

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