What is Circumcision?

Circumcision is a surgical procedure in which the foreskin (prepuce) covering the glans of the penis is removed. It is one of the oldest and most common surgical procedures in the world.

Types of Circumcision

  • Complete circumcision: Removal of the entire foreskin, glans remains permanently exposed
  • Partial circumcision: Removal of only part of the foreskin
  • Cosmetic circumcision: Aesthetic adjustment of penis appearance

Reasons for Circumcision

Medical Indications

  • Phimosis: Narrowing of the foreskin, inability to retract it over the glans
    • Congenital phimosis (in children)
    • Acquired phimosis (after inflammation, injury)
  • Paraphimosis: Trapped foreskin behind the glans (urgent condition)
  • Recurrent infections: Balanitis (glans inflammation), posthitis (foreskin inflammation)
  • Urinary tract infections: Recurrent UTIs, especially in children
  • Short frenulum: Tight frenulum causing pain during erection
  • Lichen sclerosus: Chronic inflammatory disease of the foreskin
  • Prevention of penile cancer: Reduced risk (rare)

Non-Medical Reasons

  • Religious: Judaism, Islam
  • Cultural traditions: Common practice in some countries
  • Hygienic: Easier care and hygiene
  • Aesthetic: Appearance preference
  • STI prevention: Slightly reduced risk of some sexually transmitted infections (HIV, HPV)
  • Partner health benefits: Reduced risk of cervical cancer (HPV)

Benefits of Circumcision

  • Better hygiene: Easier cleaning, less smegma
  • Fewer infections: Lower risk of balanitis, UTI
  • Prevention of phimosis: Elimination of foreskin problems
  • Reduced STI risk: 40-60% lower risk of HIV, HPV
  • Partner protection: Lower risk of HPV and cervical cancer
  • Aesthetics: According to preferences
  • No foreskin care needed: Easier for children

Surgical Procedure

Pre-operative Preparation

  • Consultation with urologist
  • Penis examination, exclusion of contraindications
  • Explanation of technique and expectations
  • Laboratory tests (blood count, coagulation)
  • Shaving the area (day before surgery)
  • Fasting 6 hours before surgery

Surgical Technique

  1. Anesthesia (5-10 minutes)

    In adults: Local anesthesia (penile nerve block) + sedation. Patient is awake but feels no pain.

    In children: General anesthesia

  2. Marking the incision (2 minutes)

    The surgeon marks the incision site - determines how much foreskin will be removed. The frenulum is checked.

  3. Foreskin removal (15-20 minutes)

    We use modern techniques:

    • Dorsal slit method: Classic technique, incision and removal
    • Sleeve resection: Two circular incisions, removal of foreskin ring
    • Freehand: Free technique with precise incisions

    The foreskin is removed, frenulum may be shortened if needed.

  4. Hemostasis (5 minutes)

    Stopping bleeding with electrocauterization. Thorough check of all vessels.

  5. Suturing (10-15 minutes)

    The inner foreskin layer is sutured to the outer skin with fine absorbable stitches. Using absorbable material - stitches dissolve on their own in 2-3 weeks.

  6. Dressing (5 minutes)

    Application of sterile dressing with antibiotic ointment. Dressing protects the wound for the first 24-48 hours.

Total Surgery Duration: 30-45 minutes

In adults with local anesthesia. In children under general anesthesia, similar duration plus time for onset and waking from anesthesia.

After Surgery

First Day

  • Hospitalization: Outpatient (go home after 2-4 hours)
  • Pain: Mild to moderate, controllable with analgesics
  • Dressing: Leave for 24-48 hours
  • Activity: Rest, avoid walking

First Week

Recommended:

  • Remove dressing after 24-48 hours
  • Gently wash with lukewarm water and soap 2x daily
  • Apply antibiotic ointment
  • Loose cotton underwear
  • Walking allowed but gently
  • Take prescribed antibiotics and analgesics

Prohibited:

  • Sexual activity (4-6 weeks)
  • Masturbation (4 weeks)
  • Strenuous physical activity, sports (2 weeks)
  • Bathing in tub, pool (2 weeks) - shower only
  • Lifting heavy objects (1 week)

Healing Timeline

  • 2-3 days: Maximum swelling and glans sensitivity
  • 1 week: Swelling decreases, stitches begin dissolving
  • 2 weeks: Most stitches dissolved, mild itching (healing)
  • 3-4 weeks: Wound healed, scar pink
  • 6 weeks: Sexual activity possible
  • 3 months: Scar fades, final appearance
  • 6-12 months: Scar minimally visible, glans sensitivity decreased

Wound Care

  1. Dressing removal: After 24-48 hours, soak in lukewarm water, gently remove
  2. Cleaning: 2x daily wash with lukewarm water and mild soap, gently dry
  3. Ointment: Apply antibiotic ointment (Betadine, Baneocin) 2x daily for 1 week
  4. Stitches: Self-dissolving, don't pull them! They dissolve on their own in 2-3 weeks
  5. Morning erection: Normal and expected, may be uncomfortable first few days

Risks and Complications

Circumcision is a safe procedure, but like any surgery has certain risks:

Common Side Effects (Normal)

  • Swelling: 3-7 days (normal)
  • Bruising: 1-2 weeks
  • Sensitive glans: First weeks, gradually decreases
  • Itching: During healing (2-3 weeks)

Possible Complications (Rare)

  • Bleeding: 1-2% (usually mild, stops on its own)
  • Infection: Less than 1% (prevented with antibiotics)
  • Unsightly scar: 2-5% (hypertrophic, keloid)
  • Asymmetry: Slight healing differences (rare)
  • Glans damage: Very rare (less than 0.1%)
  • Excessive skin removal: Very rare, may require reconstruction
  • Meatal stenosis: Urethral narrowing (0.5-1% in children)

When to Contact Doctor Immediately:

  • Heavy bleeding (doesn't stop with pressure)
  • Fever above 38.5°C
  • Significant redness, pus
  • Unable to urinate
  • Severe pain uncontrolled by medication
  • Odor from wound

Circumcision in Children vs. Adults

In Children (Newborns, Infants)

  • Age: Ideally 1-6 months (simpler surgery)
  • Anesthesia: General anesthesia or local block
  • Duration: 10-20 minutes
  • Healing: Fast, 7-10 days
  • Advantages: Faster healing, less pain memory
  • Disadvantages: Child cannot decide for themselves

In Adults

  • Age: Anytime (most commonly 18-40 years)
  • Anesthesia: Local + sedation or general
  • Duration: 30-45 minutes
  • Healing: 3-4 weeks
  • Advantages: Own decision, better cooperation
  • Disadvantages: Longer healing, more pain, sexual abstinence

Will Circumcision Affect Sexual Life?

This is one of the most common questions from men considering circumcision.

Sensitivity and Pleasure

  • Short-term: Glans is more sensitive first weeks (uncomfortable)
  • Long-term: Glans sensitivity slightly decreases (keratinization)
  • Sexual pleasure: Most studies show no difference or slight improvement
  • Erection and orgasm: No change
  • Intercourse duration: May be prolonged (lower sensitivity = longer to ejaculation)

For Partner

  • Most women perceive no difference in pleasure
  • Some prefer the appearance
  • Reduced infection risk (HPV, bacterial)

Frequently Asked Questions

Is the surgery painful?

The surgery itself is painless due to anesthesia. Post-operative pain is mild to moderate (2-4 days), manageable with common analgesics (ibuprofen, paracetamol). Morning erections are worst the first few days - may be uncomfortable but normal.

When can I have sex?

We recommend waiting at least 4-6 weeks until the wound is completely healed. Earlier sex may cause wound tearing, bleeding, and prolonged healing.

Will it look natural?

Yes. After healing (3 months), the circumcised penis looks natural. The scar is circular, usually barely visible. Skin color gradually evens out.

How long does healing take?

Basic healing 3-4 weeks. Complete scar maturation 3-6 months. Glans sensitivity gradually decreases 6-12 months.

Can I choose how much skin is removed?

Yes, during consultation you'll discuss with the urologist what appearance you prefer - "high and tight" (less skin, glans completely exposed) or "low and loose" (more skin). We'll show you photos of different styles.

Can I have circumcision for aesthetic reasons?

Yes. We offer circumcision without medical indication, for personal, aesthetic, or hygienic reasons. In this case, you pay for the procedure yourself.

Is it covered by health insurance?

Yes, if there is a medical indication (phimosis, recurrent infections, paraphimosis). For non-medical reasons (aesthetic, cultural), you pay for the procedure yourself.

Is it better to circumcise a child at a young age or wait?

It depends on the reasons. For medical problems (phimosis, infections), it's better to address them early. For non-medical reasons (cultural, religious), some parents prefer early circumcision (easier healing), others leave the decision to the adult son.

Considering Circumcision?

Schedule a discreet consultation with our urologist. We'll answer all questions and help you with your decision.

Schedule Consultation