Translate
Circumcision
Circumcision is a surgical procedure that removes the foreskin (prepuce) — performed to treat phimosis, recurrent balanitis, paraphimosis, or lichen sclerosus — providing a definitive cure and preventing recurrence of symptoms with a straightforward and well-tolerated surgical procedure.
Overview
Circumcision removes the redundant foreskin through a precisely placed circumferential incision distal to the glans, eliminating the pathological tissue causing recurrent foreskin infections, painful tightness (phimosis), or the risk of paraphimosis. The procedure is performed under general or regional anaesthesia with a penile block providing excellent post-operative analgesia, and the wound is closed with fine absorbable sutures that dissolve spontaneously without removal. Circumcision provides a definitive, permanent solution to recurrent phimosis and balanitis — conditions that cause significant pain, urinary difficulty, and sexual dysfunction — and eliminates the risk of future paraphimosis episodes.
Types of Circumcision
Several circumcision techniques are available, each producing a slightly different aesthetic result depending on the amount of inner and outer foreskin removed.
- Sleeve Resection (standard technique — circumferential foreskin removal with preserved frenulum)
- Guillotine Technique (historical method — less common in modern practice)
- Plastibell Device (primarily for neonatal circumcision — device left to necrose the prepuce)
- Preputioplasty (foreskin widening — alternative to circumcision for mild phimosis)
- Dorsal Slit (emergency or staged approach for paraphimosis — full circumcision planned later)
Risk Factors for Phimosis and Foreskin Conditions
These conditions predispose to phimosis, recurrent balanitis, and other foreskin pathology requiring circumcision.
- Lichen sclerosus — the most common cause of acquired phimosis in adults
- Recurrent episodes of posthitis (foreskin inflammation) causing progressive cicatricial phimosis
- Poor glycaemic control in diabetes — strongly associated with recurrent candidal and bacterial balanitis
- Forceful retraction of the foreskin in boys causing scarring and secondary phimosis
- Penile cancer in situ requiring circumcision as part of treatment
- Recurrent sexual partner transmission causing recurrent foreskin infections
Phimosis and Foreskin Symptoms Requiring Circumcision
These symptoms indicate pathological phimosis or recurrent foreskin disease requiring surgical assessment and consideration of circumcision.
- Inability to retract the foreskin over the glans — physiological in young boys, pathological in adults
- Painful tightness during erection from phimotic band
- Recurrent balanitis — redness, swelling, and discharge of the glans and foreskin
- Paraphimosis — emergency situation where a retracted tight foreskin cannot be reduced
- White ring of lichen sclerosus visible on the foreskin or glans
- Urinary stream difficulty from a very tight phimotic opening obstructing urine flow
- Ballooning of the foreskin during urination from severely tight meatal phimosis
- Post-coital pain and foreskin splitting from a tight or inflamed foreskin
Key Benefits
Discover the advantages of choosing our circumcision services.
Permanent cure of pathological phimosis eliminating all associated pain and recurrent infections
Removes the tight scarred foreskin that cannot be retracted and causes recurrent problems
Relieves painful restriction during erection and reduces recurrent balanitis episodes to zero
Penile block ensures minimal post-operative pain on waking from anaesthesia
Absorbable sutures dissolve naturally — no return visit for suture removal required
Clinical Features
The technology, techniques and clinical approach behind our circumcision.
Dorsal penile block with long-acting local anaesthetic provides 8 to 12 hours of post-operative analgesia
Surgical marking before excision ensures symmetrical cosmetically precise skin and mucosal removal
Sleeve resection technique removes inner mucosal and outer skin layers as a single controlled specimen
Frenular artery individually suture-ligated to prevent haematoma from this consistent vessel
Fine interrupted absorbable sutures provide a smooth regular closure dissolving without removal
Preparation Instructions
After Circumcision, bathe the wound gently in salt water twice daily from day 2 and allow the absorbable sutures to dissolve over 3 to 4 weeks — do not attempt to remove them. Wear loose cotton underwear and avoid tight trousers for 2 weeks. Sexual activity and vigorous exercise should be avoided for 4 weeks until the wound is fully healed. Contact your urology team for signs of wound infection — increasing redness, discharge, or fever — or for any bleeding from the wound after discharge.
The Procedure
Step-by-step guide to what you can expect during your circumcision procedure.
Pre-Operative Assessment and Indication Confirmation
Your urologist confirms the clinical indication for circumcision — whether lichen sclerosus, pathological phimosis, recurrent balanitis, or paraphimosis risk — and discusses the planned technique, expected cosmetic outcome, and the post-operative care programme before consent.
Penile Block and General Anaesthesia
For adults, a dorsal penile nerve block with long-acting local anaesthetic is administered at the base of the penis before general anaesthesia is induced — providing 8 to 12 hours of post-operative analgesia and ensuring you wake from anaesthesia with minimal discomfort.
Circumferential Skin Marking
The planned incision lines — both on the shaft skin and on the inner preputial mucosa — are marked carefully with a surgical marker to ensure a symmetrical, appropriately placed excision that achieves the desired cosmetic result and does not leave excess skin on either side.
Foreskin Excision with Haemostasis
The foreskin is excised using a sleeve resection technique — both the outer skin and inner mucosal layers divided at the marked lines and the prepuce removed as a single sleeve specimen. Each bleeding vessel is individually controlled with bipolar diathermy throughout.
Frenular Reconstruction
The frenulum is preserved where possible or reconstructed if involvement requires division — the frenular artery is individually suture-ligated to prevent post-operative haematoma from this consistently present vessel.
Fine Suture Closure and Dressing
The mucosal edge and skin edge are approximated with interrupted fine absorbable 4-0 sutures placed at regular intervals around the entire circumference. A non-compressive dressing is applied and you receive clear written instructions on wound bathing before discharge.
What to Expect
Circumcision is performed under general anaesthesia or regional penile block and takes 30 to 45 minutes. A carefully placed circumferential incision removes the foreskin at the precisely planned level, haemostasis is achieved, and the wound is closed with multiple fine absorbable sutures. A penile block provides excellent post-operative analgesia and most patients go home within 2 to 3 hours of surgery with minimal discomfort.
Frequently Asked Questions
Common questions about circumcision.
Related Services
Explore other services in our Urology department.
Nephrectomy Open
Optical Urethrotomy
Nephrectomy Laparoscopic
Ready to Get Started?
Schedule your consultation today and take the first step towards better health.
