Circumcision

post circumcision

Last Updated January 15th, 2022

Overview

Circumcision is a common procedure performed on new born boys. It involves surgery to remove the skin that covers the penis tip.

Medical, religious, and cultural reasons are some of the main motives behind circumcision. Medically, circumcision is performed to remedy a condition called ‘Phimosis’, when the foreskin becomes too tight to be pulled back over the head of the penis. In certain regions of Africa, older boys undergo circumcision to reduce the danger of sexually transmitted infections.

Further, circumcision is also performed as a way to maintain personal hygiene or to prevent future health issues. The surgery appears to be more complex if it is performed much later during the growing years.

In certain cases, circumcision is driven with a religious purpose. For instance, many aboriginal tribes in Australia and Africa perform this procedure on new born boys as a cultural or religious ritual. This is the case with many Islamic and Jewish families too. It can also be a tradition in the family, which dictates such a practice for new born boys.

The procedure does not have any impact on fertility. Further, there is nothing to suggest that circumcision can positively or adversely impact sexual pleasure for men or their partners.

When is circumcision necessary?

circumcision
  • In some boys, a very tight foreskin may mean that it cannot be retracted over the glans. Medically termed as phimosis, the problem can be rectified with circumcision.
  • Circumcision surgery is also recommended to treat paraphimosis, a condition where the foreskin is stuck after its retracted behind the glans of the penis.
  • Circumcision also helps treat a condition medically termed balanitis, where the head of the penis is inflamed either due to infection or some other cause.
  • Doctors may advice circumcision to treat certain urology conditions that can affect the foreskin leading to pain ad infection.

Treatment options

Three treatment options are available to those that suffer phimosis. In some cases, patients may want to wait and give it some time to check if the problem remedies on its own. Some patients find benefit with the use of a steroid cream that helps stretch the foreskin.

If none of these works, circumcision is a good way to do away with the foreskin either completely or partially.

What are some of the perceived health benefits of circumcision?

Better hygiene

Circumcision helps maintain hygiene and is easier for circumcised boys to wash their penis easily. Uncircumcised boys will need to take extra care to observe good hygiene and avoid infection in their private parts.

Low incidence of urinary tract infections

Uncircumcised males do carry a higher risk of suffering urinary tract infections.

Reduced chances of sexually transmitted infections

Circumcision may offer some protection against sexually transmitted infections, although there is no absolute guarantee in the absence of safe sexual practices.

Swelling of the foreskin

Sometimes, the foreskin may be impossible to pull back. This can cause swelling of the foreskin or penis head. Circumcision remedies this problem.

Reduced risk of penile cancer

Incidence of penile cancer is extremely rare, more so among men who have undergone circumcision.

Protection against cervical cancer

It appears women do have some protection against cervical cancer if their male partner is circumcised.

Types

Circumcision is performed using the following three techniques.

  • Traditional circumcision or open surgery
  • Laser circumcision
  • Stapler circumcision

The open surgery technique, which is the traditional or standard method, involves removing the foreskin using scissors. The incision is closed using stitches that dissolve on their own.

Laser technique for circumcision involves use of laser energy that targets the foreskin and cuts it without damaging any of the surrounding tissues.

Stapler circumcision is a procedure where the stapling instrument cuts the foreskin and also stiches the wound using stainless steel staples.

Risks of circumcision

Some patients undergo complications after circumcision is performed using the traditional method. Adverse side effects associated with the use of anaesthesia is a possibility. Other complications with open surgery for circumcision are bleeding and infection.

Although extremely rare, there could be some problems with the length of the foreskin (inappropriately cut either too long or short) after circumcision. If the healing does not take place properly, then it might result in infection. Some patients may need minor surgery if the remaining foreskin has attached to the end of the penis.

Laser circumcision is a quick procedure that is completed in 15-20 minutes. It is a minimally invasive procedure, with a very small incision. Therefore, there is hardly any risk of pain, bleeding and infection.   

Stapler circumcision is better as the chance of infection and complications is much lower compared to open surgery.

Preparation

laser circumcision

The doctor explains the complete procedure as well as the benefits and risks of each type of circumcision.  A written consent for the new born or for the adult patients is a must before performing the procedure.

If the patient is an adult, all the information regarding medical history, medications and supplements being taken, will need to be shared with the doctor.

Procedure

Circumcision for new born male children is performed in the hospital usually during the ten days following birth. Doctors usually perform this procedure in 10 minutes.

  • The new born male infant is made to lie on his back. The legs and arms are restrained and the doctor cleanses the complete genital area. An anaesthetic injection is given at the base of the penis. Sometimes an anaesthetic cream is used
  • The surgeon attaches a clamp or plastic ring to the penis and removes the foreskin. Once the procedure is completed, the penis is covered with an antibiotic ointment and gauze is wrapped around it
  • The procedure is the same for adult boys. General anaesthesia is used during this procedure for older boys. When performed in adulthood, circumcision will take longer to heal and the risk of complication is also higher

Laser and stapler circumcision are the latest procedures, which are fairly simple, with fewer risks and better recovery, as compared to open surgery.

Stapler circumcision

Stapler circumcision is known to be a reliable and safe procedure that results in much less discomfort and pain. The procedure is completed in a short time of 30 minutes.

A stapling instrument is used to cut the foreskin. The minor incision is sealed using the same instrument and stainless-steel staples. There is minimal or almost nil bleeding in patients that undergo stapler circumcision. Patients may be given either local or general anaesthesia, and can go home the same day of the procedure.

The recovery period post stapler circumcision is much less and with fairly simple post op care. Patients completely recover in four of five days. They are able to resume their normal activities usually within seven days of the procedure.

Stapler circumcision is thus a better choice compared to open surgery.

Laser circumcision

Another minimally invasive, effective and painless procedure is laser circumcision, where there are no major cuts on the penis. The surgeon focuses a high intensity laser beam on the layer of foreskin. This does not adversely impact the tissues surrounding the area.

Laser circumcision is safe for males of any age group including infants. The procedure gets done quickly and is extremely safe with no stitches that needs healing.

Therefore, post op care is also simple with no major changes to lifestyle. Patients experience very less discomfort in the first 2 or 3 days after the surgery.

This procedure takes only about 30 minutes, performed using anaesthesia. There is no significant loss of blood with this procedure. There is no hospital stay needed for patients.

Additionally, negligible postoperative complication with laser circumcision, is a huge advantage compared to open surgery.

Post op care and things to keep in mind

foreskin penis
  • Post-surgery, new-borns are likely to face discomfort of some sort. Hold them in a proper way without allowing force or pressure on the genital area.
  • Patients may experience soreness at the tip of the penis which may have a slight yellow colour fluid discharge.
  • Further, the usual healing time is about seven to ten days and the redness and swelling will gradually decrease during this period.
  • For new-borns, always change the bandage each time there is a diaper change. Light application of petroleum jelly at the tip of the penis prevents it from sticking to the bandage.
  • Importantly, patients can wash the penis during the healing period.
  • If there is a plastic ring in place of a bandage, the ring usually falls off on its own.
  • It is good to wash the area with soap and water.

Complications

Although extremely rare, few symptoms post circumcision may necessitate urgent medical attention. The symptoms are:

  • Continuous bleeding
  • The plastic ring does not fall off on its own even after two weeks of circumcision
  • Urination does not resume even after 12 hours of the procedure
  • Foul smelling discharge from the penis tip

Cost of circumcision

The cost of circumcision differs from individual to individual in India. Further, the significant factor that influences the cost of circumcision is mainly due to the type of circumcision the patient chooses, the type and location of hospital.

Broadly some of the factors that influence the cost of circumcision in India are:

  • Cost varies according to type and location of hospital. For instance, the cost of circumcision in a multi-specialty hospital in a metro will be much more than compared to tier 2 cities. If it is a mid-scale hospital the cost may be much lesser.
  • Type of circumcision
  • Anaesthesia type
  • Consultation fee including all pre- and post-surgical sessions
  • Presence of any underlying medical condition
  • Cost of medicines
  • Diagnostic test costs

In India, the average cost of open circumcision surgery is INR 47,000. The average cost of stapler circumcision surgery is in the range of INR 30,000 – INR 45,000. Patients may need to spend in the range of INR 25,000 to INR 65,000 for laser circumcision procedure in India.

Best option

Finally, the advanced techniques for circumcision using laser, are certainly safe, effective and minimally invasive.

There are many hospitals offering the advanced techniques of stapler and laser circumcision. Undoubtedly, having access to all the services such as pre-surgery consultation, assistance with diagnostic tests, support during surgery, post-op support under one roof will help patients.

goficure brings all the above services as a complete solution package for patients that wish to undergo circumcision. Additionally, the service also takes care of transportation for the patients pre- and post-surgery as well as processing insurance claims on behalf of the patient.

 

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