Circumcision

Circumcision is a surgical procedure that involves the total or partial removal of the foreskin, the fold of skin that covers the glans of the penis. It can be performed at Sismer of the Nefrocenter group for patients aged 15 and over. Circumcision is a fairly simple surgical procedure that can be performed on newborns, children and adults. Up to age 15, you need to see a pediatric surgeon. It consists of removing the foreskin using a scalpel or a laser, and it usually takes about 30-40 minutes. The operation is performed under regional anesthesia, but in some specific cases general anesthesia may be chosen, especially for very young patients or in situations of particular sensitivity.

After the procedure, the glans remains completely uncovered. The area is treated with antibiotic or anesthetic ointments and covered with sterile gauze.

Circumcision is performed for clinical, hygienic and cultural reasons. There are many reasons for deciding to have a circumcision. Some of them are clinical in nature, while others involve hygienic, religious or cultural aspects.

Medical indications for circumcision

Circumcision is performed for strictly medical reasons when there are clinical conditions that make removal of the foreskin necessary to improve health or resolve functional problems.

• Phimosis. One of the main clinical reasons for circumcision is phimosis, which occurs when the foreskin is too tight to be retracted properly over the glans. Phimosis can be congenital or can develop over time as a result of infections, chronic inflammation or trauma.
• Recurrent balanoposthitis. These are frequent inflammations of the glans and foreskin that do not improve with conventional treatments.
• Recurrent urinary tract infections. Especially in children, circumcision may be recommended to prevent urinary tract infections from coming back.
• Prevention of sexually transmitted infections (STIs). Several studies have shown that circumcision can reduce the risk of transmission of some STIs, including the HIV virus.
• Premature ejaculation. In some specific cases, the procedure can help prolong the duration of intercourse by reducing the sensitivity of the glans.

Hygienic reasons

Without the foreskin, the genital area is easier to clean, which helps reduce the risk of smegma buildup (a whitish substance produced by the sebaceous glands) and of infections. In cases of balanoposthitis, smegma causes pain, swelling, itching and difficulty retracting the foreskin (secondary phimosis).

Cultural and religious aspects

Although it is a very ancient practice, circumcision is still very common today, for medical reasons as well as for cultural or religious ones. It is, in fact, a ritual practice in many cultures and religions. For example, in the Jewish religion it is a fundamental rite (Brit Milah), usually performed on the eighth day of life. In Islam, on the other hand, it is practiced for cultural and religious reasons, although it is not always mandatory. In some African and Asian populations, circumcision is part of rites of passage into adulthood.

How to prepare for the procedure

Circumcision is often performed as a day hospital procedure, so a prolonged hospital stay is not necessary. Before the procedure, the patient must undergo a urological or andrological examination. In the days before, it may be necessary to avoid blood-thinning medications such as aspirin or other NSAIDs. It is important to maintain good intimate hygiene and, for adults, it is advisable to shave the genital area locally.

For small children and newborns, preparation is handled by the pediatricians and the parents, and the child can usually go home on the same day as the procedure.

Post-operative course

After circumcision, the patient remains under observation for a few hours. If there are no complications, he can be discharged the same day.

What to expect after the procedure

After circumcision, pain and redness may appear. It is normal for the penis to be sore and red in the days immediately following. The pain can be relieved with anesthetic ointments or oral pain relievers. As for the daily dressing, the bandage must be changed every day, keeping the area clean and dry.

In the first 2-3 days, local swelling and slight bleeding may occur, which usually go away on their own.

Care and precautions

It is advisable to avoid intense physical activity and sports for at least 7-10 days. In addition, it is best to abstain from sexual intercourse for at least 4 weeks (for adults), to ensure complete healing. Following your doctor’s instructions carefully is essential, especially regarding dressings and the use of creams or antibiotics.

Healing time and results

Usually, complete healing takes place within 2-4 weeks, depending on the patient’s age and the technique used. In general, no obvious scars form, and the appearance of the penis changes permanently: the glans always remains uncovered.

The procedure has a high success rate, and complications are rare. Possible complications, although uncommon, include:

• Post-operative infections
• Bleeding
• Scar adhesions
• Altered sensitivity of the glans

For this reason, it is always important to go to specialized health care facilities and to experienced surgeons, as in the case of the Sismer specialists.

• Learn more about assisted reproduction (ART) and the services of Sismer by visiting the website Sismer – NefroCenter Group