What is it?
A circumcision is an operation to remove the foreskin. The foreskin is the sleeve of loose skin which covers the bulgy end of the penis (the glans). One end of the sleeve grows from the base of the glans. The other end lies freely over the glans to protect it. Sometimes the foreskin is tight, or thickened, and will not pull back from the glans. This can cause discomfort and can lead to infection under the foreskin. Sometimes the foreskin pulls back and gets stuck causing severe pain and swelling of the bulb. Sometimes the foreskin needs to be removed to check that the underlying glans is healthy.
Most of the foreskin, especially the free end, is removed. The remaining skin is stitched to the base of the glans, so that there is no sleeve. The operation can be done as a day case, meaning that you come into hospital on the day of the operation and go home the same day, or as a non-day case, where you will spend one or two nights in hospital.
If you leave things as they are the problems may well get worse. Stretching the foreskin does not usually work. Slitting the narrow path of the foreskin using a local anaesthetic injection is easy to do, but this leaves the foreskin very untidy. Many patients ask for a circumcision after this operation.
Before the operation
Stop smoking and get your weight down if you are overweight. (See Healthy Living). If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control. Check you have a relative or friend who can come with you to hospital, take you home, and look after you for the first week after the operation. Bring all your tablets and medicines with you to hospital.
On the ward, you may be checked for past illnesses and may have special tests, ready for the operation. Many hospitals now run special preadmission clinics, where you visit for an hour or two, a few weeks or so before the operation for these checks.
After - In Hospital
There is some discomfort rather than severe pain. You will be given injections or tablets to control this as required. Ask for more if the pain is still unpleasant. By the end of one week the wound should be virtually pain-free. You will be able to get out of bed after an hour or two despite the discomfort. A general anaesthetic will make you slow, clumsy and forgetful for about 24 hours. Do not make important decisions, drive a car, use machinery, or even boil a kettle during that time.
If your operation is a day case you should feel fit enough to go home after an hour or two on the ward. If it is not a day case, usually you will be able to leave hospital the day after the operation. The wound has a moist dressing which can be removed after 12 hours or so. You may be wearing net elastic pants to hold the dressing in place. There are stitches in the wound which soften and drop out after 7 days or so. There may be some purple bruising around the wound which spreads downwards by gravity and fades to a yellow colour after 2 or 3 days. It is not important. There may be some swelling of the surrounding skin which also improves in 2 or 3 days. After 7 to 10 days crusts on the wound will drop off. Occasionally minor matchhead sized blebs form on the wound line. These settle down after discharging a blob of yellow fluid for a day or so. You can wash the wound area as soon as the dressing has been removed. Soap and tap water are entirely adequate. Salted water is not necessary.
You can shower or take a bath as often as you want. Wear a dressing to keep your underpants clean. Please ask the nurses about sick notes, certificates etc.
After - At Home
You are likely to feel a little sore for a week or so. By the time 2 weeks has passed you should be able to return to your usual level of activity. You can drive as soon as you can make an emergency stop without discomfort i.e. after about 3 days. You can start sexual relations within 2 to 3 weeks, when the wound is comfortable enough. You should be able to return to a light job after a week or so and a heavy job within 2 weeks.
Complications are rare and seldom serious. If you think that all is not well, please ask the nurses or doctors. You may get painful erections in the first 2 or 3 days. These can be controlled with painkillers. Infection is a rare problem and settles down with antibiotics in a week or two. Aches and twinges may be felt for up to 2 months.
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