This is excision of the prepuce (foreskin of penis).
Indications include
- Ritual (religious, traditional, personal)
- Phimosis
- Paraphimosis
- Recurrent herpes genitalis restricted to the prepuce
- Recurrent balanitis (inflammation of prepuce)
- Balanoposthitis (inflammation of prepuce and glans penis)
- Light frenulum
- long and adherent prepuce.
Method
For circumcision, the following are necessary:
- Clean and drape the perineum
- Use local anaesthesia, lignocaine 0.5% without adrenaline.
- Dilate the prepucial meatus with artery forceps.
- Retract foreskin and clean with warm saline.
- Make circular incision on inner skin approximately 3 cm from the corona,
taking care not to injure the urethra and the glans penis. - Pull foreskin over glands penis and make incision with surgical knife over the
coronal sulcus. Leave adequate penile skin. - Complete circumcision with scissors.
- Control all bleeders with clamps and ligatures.
- Suture incision with 3/0 vicryl on cutting needle.
- Use of Plastibel in circumcision of neonates is not recommended due to
frequent injuries and is best left for experienced surgeons. - Methods for infants, adolescent and adults are as described above. It can be
performed under local anaesthetic. - Do not use adrenaline.