The foreskin is the retractable fold of skin that covers the tip of the penis called glans. It's a continuation of the skin that covers the whole of penis. Circumcision may be carried out for a number of reasons.
Circumcision is most commonly carried out when the foreskin is tight and won't pull back (retract), which is known as phinosis. This is the commonest reason for male circumcision. Usually foreskin can be retracted at birth only but in few it may take longer. If by use of ointments and gentle manipulation if we are unable to get the skin retracted by 1 year, it may result in increased back pressure resulting in recurrent uti cystitis and in few occssion it may lead to infection of kidneys with reduced renal function thus requires formal circumcision.
In adults particularly in diabetics it may lead to balanoposthitis thus resulting in scarring and cause phimosis.
Even in chronic balanoposthitis which is due to fungal infection circumcision will result in chronic cure.
Other indication are BXO Or balanitis xerotic oblitrans which is precancerous lesion requires circumcision.
Circumcision is a common practice in the Jewish and Islamic communities, and it's also practised by many African communities.
Most non-medical circumcisions are carried out on kids.
Medical reasons for men to have a circumcision
In men, circumcision is sometimes considered a possible treatment option for the following conditions.
Tight foreskin (phimossis) is where the foreskin is too tight to be pulled back over the head of the penis (glans).
This can sometimes cause pain when the penis is erect and, in rare cases, passing urine may be difficult.
Recurrent balanitis is where the foreskin and head of the penis become inflamed and infected.
Paraphimosis is where the foreskin can't be returned to its original position after being pulled back, causing the head of the penis to become swollen and painful. It's a possible complication of a tight foreskin (phimosis).
Immediate treatment is needed to avoid serious complications, such as restricted blood flow to the penis.
Balanitis xerotica obliterans
This condition causes phimosis and, in some cases, also affects the head of the penis, which can become scarred and inflamed. It presents as white patches over the skin. It is a premalignant condition.
Cancer of the penis restricted to the prepuce
Penile cancer) is a very rare type of cancer, where a wart-like growth or ulcer appears on the end of the penis or under the foreskin, or there is bleeding, discharge or changes in the skin of the penis or foreskin.
In most cases, circumcision will only be recommended when other, less invasive and less risky treatments have been tried and haven't worked.
Mild cases of phimosis particularly if it is physiological can be treated with topical steroids to help soften the skin and make it easier for the foreskin to retract. It is used for 4 to 6 weeks not more than that.
In paraphimosis, a healthcare professional may rub xylocain gel onto the glans to help reduce pain and inflammation.
They may then apply pressure to the head of the penis while pushing the foreskin forward.
In severe cases of paraphimosis, local anaesthetic gel can be applied to the penis and a small slit is made in the foreskin to help relieve the pressure.
Potential advantages of ritual circumcision
There's evidence from several trials carried out in Africa that circumcised men have a lower risk of acquiring HIV.
But it's unclear whether circumcision can help prevent other sexually transmitted diseases such as syphilis or gonorrhoia.
There have been several studies into circumcision and the risk of other STIs, but the evidence to date has been inconclusive and conflicting.
Reduced Risk of Cancer
Neonatal circumcision is postulated to reduce to risk of penile cancer but evidence is inconclusive
Types of circumcision
Circumcision is usually carried out on a day patient basis. This means you'll be admitted to hospital on the same day you have surgery and won't have to stay overnight.
You'll be asked not to eat and drink for 6 hours before surgery if you're having a general anasthesia. But most of the time it is done under penile block
After you have been admitted to hospital, you'll be seen by the members of the medical team carrying out the procedure, including your surgeon and anaesthetist.
This is a good opportunity to discuss any concerns you have and ask questions about anything you're not sure about.
Circumcision is a relatively simple procedure. In sleeve resection The foreskin is removed just behind the head of the penis using a scalpel or surgical scissors.
Any bleeding can be stopped using heat (cauterisation), and the remaining edges of skin will be stitched together using dissolvable stitches.
In laser circumcision laser is used to cut the excess foreskin thus there is no bleeding and healing is precise and faster
Stapler circumcision involves no sutures and cutting thus there is mininal pain and patient can get back to his work on same day
Recovering after circumcision
When you're discharged from hospital, you'll be given advice about your recovery at home, including when you can drive, return to work and have sex.
It usually takes at least 10 days for your penis to heal after circumcision in open type.
You'll probably be advised to take at least 1 week off work to recover.
You don't need to tell the DVLA if you have had a routine circumcision and don't have any other medical conditions that affect your ability to drive.
But it's your responsibility to ensure you're fit to drive after having surgery.
You should avoid having sex for at least 4 weeks after your operation.
Cost of circumcision
At our hospital Surgiderma Hospital circumcision is done by our plastic surgeon Dr. Ranganath V S . We do stapler or laser circumcision in the majority of clients.
Cost range from 25000 to 35000 INDIAN RUPEES
WE HAVE ALMOST ZERO COMPLICATION RATES OVER PERIOD OF LAST 15 YEARS WITH MORE THAN 1000 HAPPY PATIENTS