Circumcision is a surgical procedure followed to remove the foreskin that covers the glans (tip) of the penis. It is performed on newborn males within the first month of their birth. But, adult men may also undergo this surgery. The reasons for circumcision are:
Male circumcision or the removal of the genital foreskin
Foreskin covering the tip of the penis
In newborns, a local anaesthetic is applied (as cream) at the base of the cleaned penis. The child is then made to lie on his back, restricting his arm and leg movement. A metal bell, clamp, or plastic ring is fastened to the penis. This is performed to prevent bleeding by interrupting blood circulation while the foreskin is surgically removed using a scalpel. An antibiotic ointment is applied after the surgery, and the circumcised area is covered with gauze. The procedure takes around 30 minutes.
The procedure may take up to an hour for adults and older children. First, local or general anaesthesia is administered. The foreskin is not cut out but instead stitched back using dissolvable sutures. Later, the area is sterilized using antibiotic creams and dressed with a protective gauze bandage.
Getting ready for the surgery involves the following considerations:
A form needs to be signed, giving the patient’s approval for the procedure. In the case of newborns and minors, the parents’ or guardians’ consent is mandatory.
The area around the genitals should be thoroughly cleaned. Adults are advised to shave off the pubic hair so that the gauze stays in place properly post the surgery.
Tight or body-hugging clothes and underwear should be avoided before the surgery. For newborns, loose-fitting diapers are preferred.
Adults should avoid food and drinks at least six hours before the surgery. Alcohol consumption and smoking should be avoided at least 48 hours before the surgery.
The surgeons may advise not to consume certain medications like blood thinners and aspirin for a few days before the surgery.
Minimally invasive surgical procedure
After the procedure, the patient is kept under observation for 30 minutes. During this time, breathing, blood pressure, and pulse rate are closely monitored. The operated area is double-checked for any bleeding or infection. An analgesic like paracetamol may be offered in case of pain.
Newborns should be given only sponge baths till the circumcised area is properly healed. Older patients may start taking baths 24 hours after surgery. Antibiotic ointments are generally prescribed to ward off infections and crust formation.
Advice related to post-operative care is crucial and must be followed diligently. A follow-up appointment with the healthcare practitioner needs to be scheduled within two weeks after the surgery.
The chances of complications developing post-circumcision surgery are merely 1%. Even then, the possible risks are:
This may be indicated by bleeding, pus formation, and inflammation.
Nausea, vomiting, headache, and sleeplessness are some common side effects.
Itching and pain may be aggravated because of infection at the site of circumcision.
It means soreness and inflammation at the opening of the penis. It may occur in a newborn because of the constant rubbing of the circumcised area against the diaper or his skin.
Cutting the foreskin too short or leaving it too long may result in skin bridges or adhesions, discomfort, and injury.
A growing mass or cyst may develop in the circumcised area. This is one of the rarest complications.
The urethral opening might become narrower post-surgery, thus making it difficult to urinate.
It normally takes around 10 days for recovery. For newborns, the dressing bandage must be changed after every diaper change. The area should preferably be washed with warm water and soap. A petroleum-based jelly can also be applied.
Younger males should refrain from activities such as riding bicycles or tricycles, intense sports, and playing rough games for at least three weeks post-surgery. They should be taught to maintain proper hygiene.
Older men should make sure that the circumcised area is kept clean and dry. Once a week, at least, the dressing needs to be changed. Adequate rest is advised. One should start with moderate physical activities like playing sports, sexual intercourse, and strenuous activity should be avoided for at least four weeks after the surgery. Comfortable underwear should be worn.
By following the steps mentioned, one can be assured of rapid and simple recovery.