Definition and Indications:
A circumcision is performed for many reasons including Phimosis where the foreskin cannot be fully retracted over the glans penis, Balanitis which is an inflammation of the glans (the rounded head) of the penis and Posthitis which is inflammation of the foreskin. It can also be performed for cosmetic or religious reasons.
Many of the patients I see in consultation for circumcision have in fact, been circumcised previously. They present for revision surgery with complaints of incomplete circumcisions, skin bridges and difficulty with erections secondary due to too much penile skin being removed during the prior circumcision resulting in the scrotum being pulled up onto the penile shaft. All of these problem are correctable. In addition, I have modified the standard procedure with several innovative techniques to assure the best cosmetic result.
- For any elective surgery you should be in the best of health. It is important to let my office know if you have any other health problems which might necessitate consultation with an internist prior to your surgery.
- Avoid aspirin and aspirin products for a week before your surgery.
- You will normally be operated on as an out-patient at an Ambulatory Surgical Center. The week before surgery you will be asked to report to the Ambulatory Surgical Center at which time a medical history, complete examination and necessary laboratory tests will be performed.
- On the day of your surgery, you will be asked to report to the Ambulatory Surgical Center at least one hour before surgery and must be accompanied by someone capable of driving you home. You will not have eaten nor drunk anything since dinner the night before. I will meet with you during the hour prior to surgery to examine you and answer any questions.
- The circumcision will take about 45 minutes. The procedure is performed under a general anesthesia.
- You will remain in the recovery room for a minimum of one hour and as long as you need until you feel comfortably alert for travel.
Most patients experience minimal discomfort during the first 24 to 48 hours after the procedure. Usually, only acetaminophen is utilized after the procedure. Most likely your penis will be tender and sensitive to physical contact for 1 to 2 weeks. However, your ability to urinate should not be affected.
Although every person’s recovery time is different, you should be able to resume most of your daily activities within 2 to 3 days after the procedure. Sexual relations can be resumed usually 3 weeks after the procedure. Remember to be patient, and try not to rush your recovery time. Should any problems occur after your procedure, immediately contact me. This is especially important if you have a high temperature, or if your penis becomes excessively swollen, painful, red or inflamed. Please see specific instructions below:
- The penis is wrapped with a compressive dressing. You should keep it on until you take a shower which is usually 36 hours after the procedure. However, if you have difficulty urinating or you notice the tip (glans) of the penis is dark blue or white you can loosen the dressing. A small amount of bright red blood is to be expected. DO NOT be alarmed if you feel that the amount is excessive–call my office. There might also be swelling of the penis which will decrease over several days. Please keep the penis pointing to your belly for a few days after the procedure to minimize the swelling that occurs normally.
- At the time of discharge from the Ambulatory Surgical Center you will have been given prescriptions for pain medication and, occasionally, antibiotics. When taking pain medication, be careful as you walk or climb stairs. Dizziness is not unusual.
- Do not drive the first week after the surgery, but you can ride in a car if someone else is driving.
- The dressing may be removed 36 hours after surgery, before you shower. Keep the dressing dry until then. You may shower 36 hours after the surgery.
- Swelling and black and blue are normal. Both will resolve in 3-4 weeks.
- If your job involves only desk work and very light activity, you may return 2 or 3 days after the surgery. It is likely that you will have some discomfort for 3-6 weeks after surgery.
- No heavy work or sports are allowed for 2 weeks post-operatively.
- No sexual intercourse is allowed for 3 weeks post-operatively.
- You may resume normal activities as you feel up to it.
If you would like more information please contact:
Bruce R.Gilbert, M.D., Ph.D. at 516-487-2700 or info@BruceGilbertMD.com