Circumcision: Procedure, Recovery, and Considerations

Circumcision is surgical removal of the foreskin (prepuce) covering the glans penis. Performed for medical, cultural, or religious reasons.

Procedure (Typical Adult/Adolescent)

1. Anesthesia: Local (dorsal penile nerve block ± ring block) or general.
2. Prep: Antiseptic skin preparation.
3. Techniques: Dorsal slit, sleeve resection, forceps-guided (Gomco, Mogen), or device-based (Plastibell for infants).
4. Hemostasis: Electrocautery or sutures.
5. Closure: Absorbable sutures (4-0/5-0 chromic/vicryl) or tissue adhesive.
6. Dressing: Petroleum gauze + compressive wrap.

Recovery

• Pain: Mild-moderate; NSAIDs ± opioids PRN. Resolves in 3–7 days.
• Swelling/bruising: Peaks day 2–3; resolves 1–2 weeks.
• Hygiene: Gentle cleansing; avoid submersion 24–48 hrs. Apply petroleum jelly to prevent adhesion to dressing.
• Activity: Avoid strenuous exercise, sexual activity 4–6 weeks.
• Healing: Complete epithelialization 4–6 weeks; final cosmetic appearance at 3–6 months.

Benefits & Risks

• Benefits: Reduced UTI (infancy), HIV/STI acquisition (heterosexual men), penile cancer, balanitis, phimosis.
• Risks: Bleeding, infection, meatal stenosis, cosmetic dissatisfaction, pain, rare severe injury.

Decision-Making

AAP: Benefits outweigh risks but not sufficient for universal recommendation. Parents should decide based on cultural, religious, medical factors. Discuss with pediatrician/urologist.