Circumcision
Circumcision is the surgical removal of the foreskin of the penis. Despite the
lack of a medical indication for this operation in healthy newborn males with
normal penile and foreskin anatomy, it is often requested and performed for
personal or cultural reasons. Although it has been observed that circumcised
men rarely develop cancer of the penis, and that their sexual partners may be
less likely to develop cancer of the cervix, a cause-and-effect relationship
has not been established.
The most common medical indication for circumcision at any age is phimosis, a
narrowing of the foreskin over the end of the penis such that it cannot be
pulled back. Infection, swelling, scarring and in extreme cases, obstruction
to urination may result. When there is severe pain or infection, a tension-
releasing incision may be done as an emergency, with circumcision reserved for
a later date.
Procedure
Adults -- A urologist (specialist in surgery of the urinary tract) performs
this operation right in the office. After the penis is washed with an
antiseptic, the foreskin is injected with a numbing local anesthetic. The
excess skin is removed by a circumferential incision at the corona, the
ring-like prominence at the base of the glans. Bleeding is controlled by
electrocautery (electrical burning), and dissolvable stitches are placed around
the corona. Despite how it sounds, the surgery is not very painful and only
takes about fifteen minutes. Occasionally, short-term hospitalization and
general anesthesia may be required.
Newborns -- Circumcision may be done within 24-48 hours of birth. Local or
regional (an injection at the base of the penis that numbs the entire organ)
anesthesia may be used. The surgery is facilitated by employing a Yellin
clamp, a metal, ringed instrument that fits over penis around the corona. No
stitches are necessary.
Complications
Bleeding, infection and loss of skin occur rarely.
Postoperative Care
Sexual activity should be avoided until healing is complete-- about seven to
ten days.
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