CIRCUMCISION

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.