Circumcision

What is circumcision?

Circumcision is a surgical procedure in which the foreskin (prepuce) is removed from the penis. It is most commonly performed for medical reasons affecting the foreskin or the skin of the penis, though it may also be chosen for personal, cultural, or religious reasons.

The procedure involves careful removal of the foreskin along a planned circumferential line, followed by meticulous closure of the wound edges with fine dissolving sutures. The surgical technique is adapted to address the specific condition present — for example, in lichen sclerosus, care is taken to remove all affected tissue.

Who benefits from circumcision?

The main medical indications for circumcision are:

• Phimosis: A foreskin that is too tight to retract over the glans, causing difficulty with hygiene, sexual activity, or urination, and that has not responded to topical steroid treatment.
• Lichen sclerosus (BXO): A chronic inflammatory skin condition that causes white, scarred, inelastic skin of the foreskin and sometimes the glans. Left untreated, it can extend to the urethral opening. Circumcision removes the affected tissue and typically halts progression.
• Recurrent balanitis or posthitis: Repeated infections or inflammation of the glans or foreskin that have not resolved with hygiene measures or topical treatments.
• Paraphimosis: A situation in which the foreskin becomes trapped behind the glans and cannot be returned to its normal position; circumcision prevents recurrence.
• Personal choice: Circumcision for non-medical reasons is also performed in adults who request it.

What to expect: before, during, and after

Before the procedure

Pre-operative assessment includes blood tests. You will be asked to fast before the procedure. Any skin condition affecting the foreskin may be biopsied or treated medically before proceeding to surgery if not already diagnosed.

During the procedure

The procedure is performed under general anaesthesia as a day case, typically taking 20–30 minutes. The foreskin is removed and the wound is closed with fine dissolving sutures. A dressing is applied.

After the procedure

You will go home the same day. Swelling, bruising, and discomfort at the surgical site are normal for the first one to two weeks. Keep the area clean and dry as directed. The dissolving sutures do not need to be removed. Sexual activity and strenuous exercise should be avoided for four to six weeks.

Results and recovery

Circumcision is a well-established procedure with reliable results for the medical conditions described. In phimosis, it resolves the obstruction completely. In lichen sclerosus, it removes the active disease from the foreskin and typically prevents further progression, though surveillance is recommended as the condition can occasionally affect the glans or urethra even after surgery.

Most men are satisfied with the functional and cosmetic outcome. Wound healing is usually complete within four to six weeks. A follow-up appointment is arranged to ensure satisfactory healing and to review any tissue sent to the pathology laboratory.