Circumcision Circumcision

Circumcision

Circumcision is a simple procedure to remove the foreskin that covers the head of the penis.

  • Duration:
    40 min
  • Sessions:
    1 round

CIRCUMCISION FOR ADULT MEN

Though traditionally associated with newborns, circumcision can be performed on men of any age. There are several reasons why men may choose an adult circumcision procedure. For some it’s a response to a medical condition, such as phimosis, for others, it may be a for cosmetic choice or other personal reasons.

The procedure involves complete removal of the foreskin. It is usually performed for one or more of the following reasons:

  • A tight, non-retractile foreskin – known as phimosis
  • Recurrent infections under the foreskin – known as balanitis
  • Skin disease on the foreskin and glans (head of penis) – such as chronic inflammation (balanitis xerotica obliterans, BXO)
  • Cancerous, pre-cancerous or other abnormal lesions of the foreskin.

Topical creams (including short-­‐term use of steroid cream) – for phimosis, these may decrease inflammation and relieve some tightness but symptoms often return once the treatment is stopped. They are not suitable, or effective, in all patients and your urologist will be able to advise you accordingly. Circumcision is usually necessary if topical agents fail.

Steinberg Urology is focused on high-quality care to ensure that all our circumcision patients have a comfortable and positive experience.

Circumcision is a personal decision but research shows there are health benefits to the procedure. Foreskin can trap bacteria and other infectious agents; its removal may improve genital hygiene and reduce risk of disease over the lifetime of a man and his sexual partners.

Steinberg Urology is focused on high-quality care to ensure that all our circumcision patients have a comfortable and positive experience.

Circumcision is a personal decision but research shows there are health benefits to the procedure. Foreskin can trap bacteria and other infectious agents; its removal may improve genital hygiene and reduce risk of disease over the lifetime of a man and his sexual partners.

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HOW IT WORKS

Our doctors include some of the most experienced and highly reputable professionals in Montreal and Canada.

What does this procedure involve?

  1. We carry out the procedure under local anaesthetic.
  2. We also use  local anaesthetic nerve blocks, to provide post-­‐operative pain relief.
  3. We make an incision just below the head of the penis and remove the whole foreskin; this leaves the glans (head of the penis) mostly exposed.
  4. We use dissolvable stitches to attach the skin of your penis to below your glans; these stitches usually disappear within two to three weeks.

Benefits

Circumcision can have positive health outcomes through the various stages of life.

  • Improved hygiene: The incidence of balanitis is twice as high as those who are uncircumcised.
  • Reduced risk of urinary tract and bladder infections: Studies suggest an over 10-fold decrease in risk of urinary tract infection in circumcised infants.
  • Reduced risk of phimosis: Circumcision eliminates the risk of phimosis, which affects 1 in 10 older boys and men.
  • Reduced risk of penile cancer: Studies have shown an a significant reduction in the risk of invasive penile cancer. Invasive penile carcinoma is highly associated with a history of phimosis.
  • Reduced risk of prostate cancer: Uncircumcised men have a higher incidence of prostate cancer.
  • Reduced risk of HIV/AIDS: This is because the HIV virus enters through the inner lining of the foreskin which is thin and vulnerable.
  • Reduced cervical cancer in women: The human papillomavirus can adhere to foreskin.
  • Circumcision reduces risk of cervical cancer in a female partner by 5.6 times.

Risks

As with any medical procedure, circumcision carries some risks but serious complications are extremely rare.

  • Swelling of the penis which usually lasts a few days
  • Bleeding: in 1 in 500 circumcision there may be some bleeding that is usually stopped with pressure or less commonly with stitches.
  • Infection: there is a rare possibility that there could be a generalized infection
  • Erectile dysfunction should not occur because we are not altering the mechanism of erections but psychogenic ED is possible in the early postoperative course.
  • Concealed penis: when there is a good amount of fat around the penis (pubic fat), the penis may retract inward and increase the chances the penis gets partially buried and requiring medical intervention.
  • Meatal stenosis: this is a narrowing of the urethra that may occur after the procedure requiring medical intervention.
  • Trauma: resulting in permanent damage to the head of the penis (never in our practice)

COMPREHENSIVE UROLOGICAL CARE AT YOUR FINGERTIPS

We pride ourselves on our compassionate and approachable nature. We understand the need to take the time to explain complex medical conditions in simple terms to ensure that you and your family are properly informed throughout your patient journey.

Book a consultation with Dr. Steinberg online or call us at 514-312-2821.

Circumcision CAN BE ONE OF THE EFFICIENT TOOLS TO DIAGNOSE THE FOLLOWING CONDITIONS

Condition

Phimosis

Condition

Tight frenulum

PROCEDURE INFO

  • The day of your circumcision, you should eat as usual before your procedure. Men that don’t eat tend to get dizzy during or after the procedure.
  • No alcohol is permitted 48 hours before the procedure.
  • Please shave the pubic area around the base of the penis the day before the procedure.
  • Shower and wash the penis and around the area the morning of the procedure to help prevent infection.
  • Avoid anti-inflammatory drugs (Advil, Motrin, Aspirin, Naroxen and blood thinners) a week before the procedure.
  • Arrange to have somebody to bring you home to minimize effort and movement that can worsen swelling or bleeding
  • Please advise us if you are instructed by your doctor to take antibiotic before a surgical or dental procedure.

We carry out the procedure under local anaesthetic. We also use local anaesthetic nerve blocks, to provide post-operative pain relief.

  • You will get some swelling and bruising of the penis which may last several days
  • You may also see blisters on the glans in the first few days.
  • It can take up to six weeks before the penis returns to its near final cosmetic appearance
  • The exposed glans penis may feel very sensitive for the first two weeks
  • Once the hypersensitivity has settled, your penis may feel a little less sensitive than before the operation
  • The exposed glans may dry out and scab over; applying a little vaseline will help this and can also help decrease the sensitivity after the operation
  • All your stitches will dissolve, usually within two to three weeks
  • You will continue to get erections as normal after the procedure but you should refrain from any sexual activity (intercourse or masturbation) for four to six weeks
  • When you first get erections, you may feel some tightness around the scar tissue; this will regain its normal elasticity within a few months
  • The procedure should have no long-­‐term effect on your, erections, ejaculation and fertility
  • Patients will come back 48 hours after the procedure for the first dressing change, instructions and 6 weeks after. Both visits are included in the price.
  • Take Tylenol (as needed) or prescribed medications if pain more severe.
  • Remove dressing 48 hours after surgery.
  • If dressing falls off before 48 hours, there is no need for concerns. Place gauze or dressing for your comfort.
  • To remove dressing, please soak with lukewarm water.
  • Put antibiotic cream 2 times daily with a dry dressing until no more draining from incision.
  • Do not worry if any swelling or bruising if any swelling or bruising around circumcision.
  • Sutures will fall out after 14 days (approx.)
  • No bath for 1 week, shower is allowed after dressing is removed.
  • You should not swim for two weeks
  • Please advise your doctor if you have a fever or any other concerns.
  • The patient should be restricted to calm and peaceful activities for 1 week.
  • No sport or strenguath physical activity for 2 weeks

The procedure itself will take about 30 minutes once the penis has been anesthetized. You may be kept for observation for an hour after surgery.

Follow-up is required the next day and 3 days for dressing changes, etc. Some men return to sedentary work as soon as 2 – 3 days after circumcision. You will need to wait longer before returning to physical work. The doctor will provide detailed instructions for after care in the post recovery period.

Swelling of the penis which usually lasts a few days. If you have an abnormal reaction, such as fever, redness, excessive pain, important swelling.

It can several months before the penis returns to its near final cosmetic appearance. The exposed glans penis may feel very sensitive for the first two weeks.

You will continue to get erections as normal after the procedure but you should refrain from any sexual activity (intercourse or masturbation) for four to six weeks. When you first get erections, you may feel some tightness around the scar tissue; this will regain its normal elasticity within a few months. The procedure should have no long-term effect on your, erections, ejaculation and fertility.

FAQ

How long does the procedure take?

The procedure itself usually takes about 15 minutes once the anesthetic has kicked in. Generally, plan to be in our office for about 1.5 hours.

Does adult circumcision hurt?

We employ a highly effective local anesthetic to ensure you are numb prior to proceeding.

How long does the recovery take?

In all cases, the minimum length of time will be 6 weeks before the wound heals.

When can I go back to work after an adult circumcision?

For those with an office job, you may return in 2-3 days. For those who work physical jobs, we suggest you rest for 5-7 days.

What kind of activities can I do or not do?

After your first week of taking it really easy you may resume regular activities as long as you are pain free, including sports or going to the gym. You should avoid any activity that puts pressure on the penis or scrotum for at least 3 weeks (biking etc.). No contact sports for 6 – 8 weeks.

When can I have sex or masturbate?

You should not have sex or masturbate for 6 weeks after getting circumcised as an adult.

How much pain should I expect during recovery?

Most adult circumcision patients find that there is minimal pain post operatively. Expect some mild discomfort after your procedure for a couple days just like with any surgery, after which there may be some discomfort during the first 2 weeks with nocturnal erections but they are generally mild and relieved with paracetamol or ibuprofen.

How long after circumcision will it hurt to have an erection?

About 1 – 2 weeks.

The images and/or videos are not presented as a guarantee of result. The results may vary. Patients gave their consent for the publication of images and/or videos.

LET'S START TALKING !

At Steinberg Urology we pride ourselves on our compassionate care we offer to those facing challenges that affect their quality of life. Our urologists have years of experience and a commitment to excellence.

If you need to discuss this sensitive medical concern, schedule a consultation at our clinic in a safe confidential environment. Let us help you achieve optimal health and wellness in a professional setting.

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