Adult Male Circumcision

What you should know

Circumcision is surgery to remove the foreskin of the penis. The foreskin is the fold of skin that covers the tip of the penis.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • Adult male circumcision is usually a common and safe procedure, though there are always risks with this procedure. Your penis, prostate, other parts of the urinary tract, blood vessels, or nerves may get injured during the procedure. This may cause you to have problems when passing urine or having sex. You may also have swelling, pelvic pain, or a numb feeling in your penis. You may bleed more than usual or get an infection. You may have an erection before you have completely healed. This may cause your sutures or the adhesive to break and your incision to open up. You may need more surgery if this happens. Your penis may not have as much feeling as it did before. It also may not look the way you expected it to look like after the procedure.

  • Without this procedure, the conditions affecting your penis may continue and your symptoms may get worse. You may have serious medical problems, such as a severe infection or an increased risk of getting a STD, HIV, or penile cancer. Ask your caregiver if you are worried or have questions about your procedure, condition, or care.

Getting Ready

The week before your procedure:

  • Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.

  • Ask your caregiver how many days before the procedure you need to stop having sexual intercourse.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Tell your caregiver if you have other known diseases. These diseases may include diabetes, bleeding disorders, or heart or kidney problems. If you have wounds or sores in the genital area, or an infection, you may need to be treated before having the procedure. Your caregiver may also need to know if you have had other surgeries in the past. These may include a penile prosthesis, or procedures on your abdomen or lower genital tract.

  • You may need to have blood and urine tests. You may also need other tests, such as a chest x-ray or electrocardiogram (ECG). Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your procedure:

  • Ask caregivers about directions for eating and drinking.

The day of your procedure:

  • Write down the correct date, time, and location of your procedure.

  • What to bring: You may want to bring items such as a toothbrush and bathrobe.

  • If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.

  • Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your surgery. Tell your caregiver if you or any member of your family has had a problem using anesthesia in the past.

  • You or a close family member will be asked to sign a consent form. It gives your caregiver permission to do the procedure. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

Treatment

What will happen:

  • You may be given medicine one hour before the procedure to help you relax. You will be taken on a stretcher to the operating room and then moved onto a special bed. Caregivers may give you local, regional, or general anesthesia to numb the surgical area or put you to sleep. If you are given general anesthesia, an endotracheal tube (ET) may be put into your mouth or nose. It will help you breathe during your surgery.

  • A numbing cream may be applied to the skin of your penis 30 to 60 minutes before the procedure. This may decrease the pain when anesthesia is injected into your penis during the procedure. Soap, water, and antiseptics (germ-killing liquids) will be used to clean your abdomen and genital area. Sheets will be put over you to keep the procedure area clean. When your skin becomes numb, a local anesthesia will be injected in the procedure area.

  • In the dorsal slit technique , your caregiver will grasp the foreskin with forceps. He will make an incision on the top part of the foreskin. Scissors or a special knife may be used in making an incision. After making the slit, the foreskin will be pulled back to expose the glans. Your caregiver will cut off the foreskin and use pressure or electrocautery (electric current) to control any bleeding. Your incision will be closed with stitches or an adhesive (glue-like substance). A bandage with petroleum jelly on it will be placed over the incision.

  • In the sleeve technique , a line will be drawn around the base of the foreskin. This line will serve as a marker where the incisions will be made. It will also be used to measure the correct amount of foreskin to be removed. Your caregiver will make two cuts around the base of the foreskin and the inside of the foreskin. This releases a sleeve (tube) of foreskin, which will be removed by pulling it over the glans. The cut edges of the ring-like gap that is left will be filled in by pulling up the remaining foreskin. Pressure or electrocautery (electric current) may be used to control any bleeding. Your incision will be closed with stitches or an adhesive (glue-like substance). A bandage with petroleum jelly on it will be placed over the incision.

After your procedure:

You may lie in bed and rest for a while since the procedure may be tiring. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is OK. When your caregiver sees that you are OK, you will be allowed to change clothes and go home. If your caregiver wants you to stay in the hospital, you will be taken back to your hospital room. The bandages used to cover your stitches help keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your procedure to check your wounds. Ask your caregiver for information on how to take care of your wound.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You cannot make it to your appointment on time.

  • You have a fever.

  • You have a skin infection or an infected wound near the area where the procedure will be done.

  • You have questions or concerns about your procedure.

Seek Care Immediately if

  • You have new symptoms since the last time you saw your caregiver, or your symptoms are getting worse.

  • You have problems passing urine, or it becomes red, very cloudy, and bad smelling.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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