Circumcision

Why circumcision is done

Circumcision is only available on the NHS for medical reasons. It's used to treat men and boys. Anyone with a penis may need it.

It's usually only offered when other treatments have not worked or it's the only option.

A circumcision may be needed if you:

• keep getting a swollen, itchy or sore foreskin or head of your penis, or infections of your foreskin (balanitis)
• have a tight foreskin (phimosis) and it's causing problems, such as painful erections or difficulty peeing
• cannot pull back your foreskin
• have scarring or tightness and it's led to problems with your foreskin – this could be caused by conditions such as lichen sclerosis
• have other problems with the way your penis has grown, such as having a very curved penis

Circumcision may also be recommended as part of treatment for cancer of the penis (penile cancer), although this is rare.

If you think your child has a problem with their foreskin

It's normal for boys under 5 not to be able to pull back their foreskin.

The foreskin usually separates from the head of the penis by itself over time. It can sometimes take until puberty to separate fully.

Never force your child's foreskin back, as this may be painful and cause damage.

Your child's foreskin may also swell when they pee (ballooning). This happens when the foreskin starts to separate from the head of the penis. It should stop by itself, but if it does not, it can be a sign of a tight foreskin.

Speak to a GP if you think there may be a problem with your child's foreskin.

What happens during a circumcision

A circumcision is usually done in hospital. You should be able to go home on the same day.

You may not be able to eat or drink for a certain amount of time before the operation. The hospital will give you information about this.

Circumcision is usually done under general anaesthetic (you're asleep). But sometimes it may be done using:

• local anaesthetic, where you will not be able to feel anything in the area around your penis
• anaesthetic where you will not be able to feel anything from the waist down (epidural)

Your doctor will discuss this with you and answer any questions you have.

You may also be given an injection of antibiotics to lower the chances of getting an infection.

During a circumcision:

1. The surgeon makes a circular cut around your foreskin just below the head of your penis.
2. The foreskin is removed.
3. Dissolvable stitches are used to attach the skin to the shaft below the head of your penis. These stitches should dissolve after 2 to 6 weeks.

The procedure takes about 30 minutes and is the same for adults and children.

After the operation

You will spend some time in the recovery room and be given painkillers to help with pain and swelling.

There will be a dressing on your penis. The dressing may be removed or come off by itself before you go home, or it may come off by itself later.

Before you go home, you will be told how to look after the area, including how to keep it clean, whether it needs a dressing and when you can go back to normal activities.

If you've had a general anaesthetic, someone needs to take you home from hospital. Do not drive for at least 24 hours.

You're also recommended to have someone stay with you at home overnight after a general anaesthetic.

Recovering from a circumcision

It takes 4 to 6 weeks for your penis to heal after a circumcision, although sometimes it may take longer.

It's normal to have swelling, bruising and some minor bleeding for 1 to 2 weeks.

The head of your penis will usually be very sensitive after the operation. This can be uncomfortable but should ease after a few weeks.

You may also feel tightness or discomfort when you get an erection. This usually goes away within a few months as the scar tissue stretches, but sometimes it can cause bleeding.

You should be able to drive if you can do an emergency stop without any pain or discomfort. Check your insurance policy to see if there are any rules about driving after surgery.

There are things you can do to help your or your child's recovery.

Complications of a circumcision

As with any operation, complications can happen during or after a circumcision. Your doctor will explain the risks to you before the procedure.

Most people only have minor complications, such as bleeding.

Circumcision usually leads to loss of sensitivity of the head of your penis, which may be noticeable during sex. The lack of foreskin also means the skin of your penis will not move in the same way as before.

These changes may make your experience of sex or masturbation different, but they should not have a major effect on your sex life in the long term.

Sometimes, you may need another operation after a circumcision. This might be to:

• stop bleeding
• remove more skin because of swelling
• improve how your penis looks after it has healed, if you're concerned

Rarely, having a circumcision may lead to narrowing of or damage to the tube that carries pee out of your bladder (urethra). This can cause difficulty peeing and may need surgery to fix.