Circumcision is a procedure to remove the foreskin from your penis. At birth, the foreskin is stuck to the head of your penis, but it gradually separates and can usually be pulled back by the age of three.
Circumcision may be done for medical reasons, for example if your foreskin is too tight and difficult to pull back over the head of your penis. This is called phimosis and is most common in boys around puberty. Circumcision can also be done if you have a condition called balanitis xerotica obliterans, which causes scarring of your foreskin and discomfort when passing urine. Occasionally, you may need to have a circumcision if you get repeated infections underneath your foreskin, known as balanitis.
Circumcision may also be done for cosmetic, religious or social reasons. This is called non-therapeutic (or ritual) circumcision.
It’s thought that circumcision may help to reduce the risk of certain sexually transmitted infections (STIs) and cervical cancer in female partners. However, having safer sex is the best way to prevent the spread of STIs.
Circumcision is most often carried out in babies and young boys, but it can be performed on adult men at any age.
We will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.
For Younger Children:
The Plastibell Circumcision Device is a clear plastic ring with handle designed for circumcision in younger children and newborn babies. It’s a minimally invasive surgical procedure to install the Plastibell device. The adhesions between glans and foreskin are divided with a probe. Then the foreskin is cut longitudinally to allow it to be retracted and the glans (the head of penis) to be exposed. The Plastibell comes in 6 sizes. The appropriate one is chosen and applied to the head. The ring is then covered over by the foreskin. A ligature is tied firmly around the foreskin, crushing the skin against the groove in the Plastibell. Then the excess skin protruding beyond the ring is trimmed off. Finally, the handle is broken off at the end of the procedure. The entire procedure takes five to ten minutes.
As with all circumcisions, the procedure will involve some adequate anaesthesia, using either cream, a penile nerve block, penile ring block, or a combination of these prior to operation. The ring falls off in 3 to 7 days leaving a small wound that will heal over the following week. Typically, the glans will appear red or yellow until it has healed fully.
For Older Children:
The foreskin is pulled forward using clamps, the extent of the traction determining the tightness of the resulting circumcision. A large pair of forceps (typically artery forceps) is then clamped across the foreskin at the place where the cut is to be made. Optionally, the smaller clamps are then removed before a scalpel is run across the top of the big forceps. Alternatively, sharp scissors can be used. This method doesn’t automatically result in a straight smooth line and there is no pre-sealing of the cut edges. Bleeding is more profuse and more stitches may be required than with other methods, especially in adults. This form of cutting is very similar in principle to the more traditional scalpel and shield method.