Circumcision
 
Having a circumcision
 
Your specialist has recommended that you have a circumcision and this leaflet provides some standard information and advice about the procedure. However, you should always follow the instructions of your own specialist.

If you have any unanswered questions or concerns, please do not hesitate to ask your specialist or nurse for more information. It is natural to feel anxious, but often knowing what to expect can help.
 
What is circumcision?
 
Circumcision is a simple operation to remove the foreskin from the penis. The foreskin is the sleeve of skin around the tip (glans) of the penis.

The procedure is routinely carried out as a day case, with no overnight stay. It is usually performed under a general anaesthetic - this leaflet describes this method. For more details on general anaesthesia, please see a separate leaflet.

Circumcision can also be successfully performed under local anaesthetic. You do not have to fast beforehand and can generally go home sooner than after a general anaesthetic.
 
Preparing for your operation
 
Your specialist or hospital will give you some information about when and how to check into hospital.

In some cases, you may be invited to attend a pre-admission clinic for some routine tests.

Before you come into hospital your circumcision, you will be asked to:
  • Have a bath or shower at home on the day of your admission
  • Remove any jewellery
  • Follow the fasting instructions given by your specialist or hospital. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours before

When you arrive at the hospital, a nurse will explain how you will be cared for during your stay and will perform some simple tests such as checking your pulse and blood pressure and testing your urine. Your surgeon and anaesthetist will also visit you. This is a good time to ask any outstanding questions about your treatment.
 
Consent
 
You will be given a consent form to sign. By doing this, you confirm that you understand what the procedure involves, including the benefits and risks, and give your permission for it to go ahead.

Please see the back of this leaflet for further information about the possible side-effects and complications of this procedure. You need to know about these in order to give your informed consent.
 
About the operation
 
Once you are soundly asleep, the foreskin is pulled forward and cut so that it can be removed. The skin is stitched together, and a loose dressing is applied. The stitches are dissolvable and do not need to be removed. The operation usually takes 10 to 20 minutes.

At the end of the operation, and before you wake up, the surgeon will give you a long-acting local anaesthetic, either by injection, or by applying gel to the area. This makes the operation site pain-free for a few hours after surgery.
 
Back on the ward
 
You will need to rest on your bed until the effects of the anaesthetic have passed. The local anaesthetic will last for up to eight hours. If you are sore after this, you may require painkillers, which can usually be taken every four to six hours. Please discuss this with your nurse, surgeon or anaesthetist.

When you feel ready, you can begin to drink and eat, starting with clear fluids such as water or apple juice.
 
Going home
 
If your operation has been planned as a day case, you will be able to go home once you have made a full recovery from the anaesthetic. It is also best if you try to pass urine before you go home.

You will need to arrange for someone to drive you home and then stay with you for the first 24 hours. If you stay overnight following your operation, you will asked to be ready to leave your room the next morning.

Before you are discharged, the nurse will advise you about caring for surgical wounds, hygiene and bathing. The nurse will also give you a contact telephone number for the hospital, in case you need to ask for any further advice.
 
After you return home
 
If you need them, continue taking painkillers as advised by the hospital. A general anaesthetic can temporarily affect your coordination and reasoning skills, so you should avoid driving, drinking alcohol, using power tools, making any vital decisions or signing legal documents for 24 hours after the operation.

As you will be quite sore, you need to be prepared to take it easy for a few days. DoníŽt do any strenuous exercise, lifting or carrying.

The day after your operation, try to get out of bed and take regular walks around the house. It is most comfortable to wear loose clothing such as boxer shorts, or a dressing gown with no underpants or trousers, because the rubbing of clothing may make the wound sore. To stop clothes sticking to the operation site, you can apply a little Vaseline.

You should try to keep the area dry for 48 hours after the operation. After this, take warm baths, without adding bubble bath or oils, once or twice a day. It is important to keep the tip of the penis clean to stop it crusting over, which can prevent you from passing urine.

The stitches will dissolve and drop out in the bath over a period of up to three weeks. The wound may bleed slightly or ooze until all the stitches have dissolved, and will take about two weeks to heal.

You should avoid driving for five to seven days, or until you feel could perform an emergency stop without feeling discomfort.
 
What are the risks?
 
Circumcision is generally a safe surgical procedure. For most people, the benefits in terms of improved symptoms are greater than the disadvantages. However, all surgery does carry some element of risk. This can be divided into the risk of side-effects and the risk of complications.
 
Side-effects
 
Examples of short-lived side-effects include nausea or vomiting as a result of the general anaesthetic. There is also likely to be some pain, swelling and bruising of the skin around the penis, which may last for several weeks. There may also some be bleeding.
 
Complications
 
This is when there are problems during or after the operation. Most people are not affected.

The main possible complications of any surgery are bleeding during or very soon after the operation, infection, and an unexpected reaction to the anaesthetic.

Specific complications of circumcision are uncommon but can include infection, which can usually be treated with antibiotics, and excessive bleeding from the operation site, which may require further treatment in theatre.

The chance of complications depends on the exact type of operation you are having and other factors such as your general health. You should ask your surgeon to explain how these risks apply to you.
 
Further information
 
NORM íV UK
http://www.norm-uk.org/

American Academy of Family Physicians
http://familydoctor.org/handouts/042.html

Circumcision Information and Resource Pages
http://www.cirp.org/
 
Healthwise (Health Information Resource Centre)
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : info@healthwise.org.hk
Homepage : http://www.healthwise.org.hk/

This leaflet is for information only. For a detailed opinion or personal advice, please consult with your own doctor
 
 
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