Circumcision: Surgical Procedure Overview — No Non-Surgical Alternative

Circumcision is the surgical excision of the prepuce (foreskin) covering the glans penis. It is a surgical procedure — there is no non-surgical method to achieve circumcision.

Procedure Basics

• Anesthesia: Local (dorsal penile nerve block, ring block) ± topical; sedation/GA for older children/adults.
• Techniques: Gomco clamp, Mogen clamp, Plastibell device, freehand dorsal slit, sleeve resection. Choice by provider training/preference.
• Duration: 10–30 minutes.
• Setting: Newborn nursery, office, clinic, OR.

Indications

• Elective/Cultural/Religious: Neonatal (common in US, Muslim, Jewish communities).
• Medical: Phimosis (pathologic), recurrent balanitis, paraphimosis, BXO (lichen sclerosus), urinary tract infection reduction (controversial).

Risks & Benefits (AAP Summary)

• Benefits: ↓ UTI infancy, ↓ heterosexual HIV/STI acquisition (African trials), ↓ penile cancer (rare), ↓ balanitis.
• Risks: Bleeding, infection, meatal stenosis, insufficient/excess skin removal, adhesions, pain, cosmetic dissatisfaction. Serious complications <0.5%.
• Ethical Note: Non-therapeutic neonatal circumcision debated; AAP: benefits > risks but not sufficient for universal recommendation. Parental decision.

Postoperative Care

• Petrolatum gauze to diaper; keep clean.
• Heals 7–10 days (Plastibell ring falls off).
• Monitor for bleeding, infection, urinary obstruction.

Discuss with pediatrician/urologist. Decision should be informed, voluntary, and culturally respectful.