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In men, circumcision is sometimes considered a possible treatment option for the following conditions:
+ phimosis (tight foreskin) – this occurs where the foreskin is too tight to be pulled back over the head of the penis. This can be particularly painful when the penis is erect.
+ paraphimosis - where after being pulled back, the foreskin can't return to its original position, causing pain and swelling. In this case immediate treatment is needed.
+ recurrent balanitis – where the foreskin and head of the penis become inflamed and infected.
+ balanitis xerotica obliterans – a condition that causes phimosis.
+ cancer of the penis – a very rare type of cancer that can occur in men, where a red patch, wart-like growth or ulcer appears on the end of the penis or under the foreskin
In most cases, circumcision will only be recommended when other, less invasive and less risky treatments have been tried and haven't worked.
All circumcisions at the Cadogan Clinic are performed by our award-winning Consultant Uro-Andrologist, Mr Giulio Garaffa who has over 20 years’ international medical experience in this area. Mr Garaffa has a global reputation for his excellence in urology and is one of the leading experts in the treatment of foreskin diseases, including circumcision and frenuloplasty.
Male circumcision is the surgical removal of the foreskin. The foreskin is the retractable fold of skin that covers the end of the penis. It's a continuation of the skin that covers the whole penis. In the most common procedure, the foreskin is opened, adhesions are removed, and the foreskin is separated from the glans.
The procedure is usually performed under general anaesthetic, which means you'll be unconscious throughout the procedure, however if you prefer a local anaesthetic which will numb your penis and the surrounding area during the operation, this can be arranged.
We may give you an injection of antibiotics before the procedure, after you have been checked for any allergies to prevent post-operative infection, however this is decided on the day in consultation with your surgeon and anaesthetist.
Circumcision is a relatively simple procedure. An incision will be made just below the head of the penis and the foreskin will be removed using a scalpel or surgical scissors. This leaves the glans (head of the penis) completely. Any bleeding can be stopped using heat (cauterised) and the remaining edges of skin will be stitched together using dissolvable stitches. These stitches usually disappear within 2 - 4 weeks.
A circumcision should not be a painful procedure, however this depends on the individual. It is more a dull ache than a sharp pain once the feeling returns. At the Cadogan Clinic, a circumcision is performed under day case surgery with general anaesthesia. This means you'll be unconscious throughout the procedure and won't feel any pain.
You may experience some discomfort and swelling around the head of your penis for 3 - 4 days following the operation, however before leaving the clinic you will be painkilling medication to help manage this. You shouldn't feel any pain or discomfort while passing urine.
There are a few things which you need to do before undergoing circumcision, these include:
Avoiding eating or drinking at least 6 hours before surgery. You are allowed small sips of water up till 2 hours before.
Clean and shave the pubic area the night before your surgery and bring a pair fitted briefs to wear afterwards to keep the surgical dressing in place. Continue to wear these at home until the swelling and soreness has eased.
Arrange for someone to accompany you home after the operation.
You will need to stop smoking prior to surgery as this interferes with the healing of the wound. Smoking can also slow this down your recovery in general. Your surgeon will advise timeframes in your consultation.
You should not consume alcohol at least 48 hours before surgery as it may reduce the effectiveness of the anaesthetic and dehydrate you.
You should not need time off work unless absolutely necessary; but you may experience some pain and discomfort the first few days after surgery which can be a distraction, so arrange with your employer accordingly.
There may be some pain and discomfort following circumcision surgery which can be easily treated with painkillers such as ibuprofen or paracetamol.
Drink plenty of liquids as this will dilute the acidity of the and will also reduce any soreness or stinging when passing urine. The penis will be red, swollen and sore for the first few days after surgery but this will ease.
You may also experience:
Swelling – you can expect a little swelling and bruising at the wound site. There may also be a bit of oozing yellow coloured fluid. This is normal and nothing to worry about, although it may take about 3-4 weeks for your wound to heal completely.
Stitches – these will dissolve or fall out on their own about 14 to 21 days after the operation. Some of the last pieces may take four to six weeks to dissolve or disappear. They do not need to be removed.
Wound dressing – you will have a dressing on the penis following your operation. However, this will be removed before you go home or you will be instructed to remove it later that day if there has been no bleeding from the wound site. You should not require a dressing after that.
Bleeding - It is possible you may have some bleeding from the foreskin, although this is unusual. If bleeding does occur, use a clean cloth and press firmly on the area that is bleeding for 15 minutes. If the bleeding does not stop, get in touch with your surgeon.
Glans sensitivity – the glans (head of your penis) will feel extra sensitive for the first two weeks after the operation. This will then settle down and over time you will notice that the glans becomes less sensitive than it was before the operation.
Wound appearance – in the initial six weeks after the operation, the head of the penis and the skin around the wound site may appear swollen but this will settle down. By 6 months post-operation will have returned to normal.
Sexual activity – you should refrain from all sexual activity for four weeks after the operation.
A number of adults return to work as early as the next day so you should not need time off work unless absolutely necessary. You may experience some pain and discomfort the first few days after surgery which can be a distraction, so arrange with your employer accordingly. It is advisable to avoid heavy manual work for about a week.
A circumcised male may experience chafing and abrasion of the exposed glans against clothing, painful erections due to the tightened skin, scarring, and desensitisation. A circumcised penis may also be slightly smaller than it would otherwise have been.
Some sexually transmitted infections appear more common in uncircumcised men. Two particular concerns for circumcised men are that:
1. It's unclear whether male circumcision can help prevent sexually transmitted infections (STIs). While men are less likely to notice the symptoms of the STI chlamydia (an incidence which is increasing in the UK), heightens their risk of passing it on, there have been several studies into male circumcision and the risk of other STIs, but the evidence to date has been inconclusive and conflicting. Circumcised males also appear more likely to develop penile warts.
2. In regards to HIV/AIDS, there is conflicting advice. There have been several trials carried out in Africa that suggested that circumcised men have a lower risk of acquiring HIV from infected women, however the international not-for-profit health organisation the Cochrane Collaboration reviewed all the research into circumcision and HIV and concluded that there is insufficient evidence to support the idea that circumcised men have less chance of contracting HIV. To date there is no solid conculsion either way.
Evidence shows that men can reduce the risk of an STDs by using a condom.
A circumcision at the Cadogan Clinic starts from £2,000.
To enquire about a consultation with a Circumcision specialist, please complete the form below.
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