Adult Circumcision in London

Before Operation Assessment

Before your surgery, we must know if you have any of the following conditions:

1. Family history of bleeding disorders
2. Medication such as anti-platelet or blood-thinning medication
3. Allergy to any medication
4. Urinary problems
5. Diabetes
6. Heart surgery
7. An artificial joint or any other implanted foreign body
8. A neurosurgical shunt

Please inform the doctor or nurse if you have any of these conditions during the consultation. This is important for a good outcome during the surgery.

What are the Reasons for Men Circumcision?

Circumcision may be performed for the following reasons:

• Hygiene, cultural or religious
• Tight or cracked foreskin 
• Balanitis Xerotica Obliterans (BXO),
• frenulum breve or  tight frenulum 
• Paraphimosis
• Tight foreskin causing pain during sexual activity.
• Phimosis
• Balanitis or Balanoposthitis (infection of foreskin or glans)

Video Consultation Before Circumcision or Other Procedures

You can now have a video consultation before adult circumcision and other procedures, which eliminates the need for an extra visit and saves you the associated costs of travel, missed work and time. This also helps to answer all questions before the procedure.

Please note that a separate fee of £150 will be charged for the video consultation.

Local Anaesthesia and Needles Anaesthesia 

At our clinic, we perform circumcision under local anaesthesia while the patient is awake. You are welcome to bring your own headphones or earphones to listen to music during the procedure.

Additionally, we also offer no-needle local anaesthesia for adult male circumcision for patients who are needle-phobic. This can be arranged separately.

Full or Partial Circumcision

It is important to understand the difference between full and partial circumcision.

Full circumcision involves the complete removal of the inner and outer foreskin. In contrast, partial circumcision only removes some of the foreskin, leaving some loose foreskin that may partially cover the glans.

However, it should be noted that full circumcision can sometimes give the false impression of partial circumcision when flaccid or if the penis is buried inside. While partial circumcision is possible, it can lead to some complications in the long term.

Our specialist can provide you with more information about these complications and help you make an informed decision about partial circumcision.

The Revision or Redo of Previous Circumcision

We offer revision or redo of previous circumcisions to correct issues with scarring or appearance, including uneven skin, scarred frenulum, excessive and uneven circumcision scars, and excess scarring.

A second opinion for previous circumcision is provided to ensure the best outcome for patients.

Alternative to Full Circumcision

There are different alternatives to full circumcision, including medical treatments, partial circumcision, excision of the frenulum, frenuloplasty, and a V-Y plasty operation known as preputioplasty.

Personal preferences can be discussed further with our specialist.

Religious or Cultural Circumcision 

Expectations for people who have circumcision due to religious and cultural reasons are to expose the whole head (glans) of the penis. This is possible in most cases. Some people have a very short penile shaft skin, a mobile shaft of penis skin and a partially buried penis due to many factors. Exposing the head of the penis is not the best option for these patients as they may require some extra skin for normal erections.

Styles of Circumcision 

There are different styles of circumcision in men, which involve the removal of inner and outer foreskin. The high/low and loose/tight styles are ways of expressing how much outer or inner foreskin is removed, and they can vary depending on factors such as anatomy, disease of foreskin, and body mass. Styles can also be different in circumcision with or without frenuloplasty, with the buried penis or mobile penoscrotal junction, with penoscrotal web, or with Balanitis Xerotica Obliterans (BXO).

It’s important to discuss the styles of circumcision with a urologist before the operation to have a realistic expectation of the outcome.

Procedure

During the procedure, a local anaesthetic is injected into the base of the penis and surrounding area with 2-3 pricks. This injection provides safe and effective pain relief and is used as the only form of anaesthesia around the wound. The patient does not undergo general anaesthesia during the procedure. This anaesthetic injection helps to minimize postoperative pain for a few hours. The foreskin is removed using an incision located just behind the head of the penis. This results in the glands being completely and permanently exposed.

Aftercare for Adult Circumcision

It is crucial to adhere to the following guidelines for aftercare following an adult circumcision procedure. Discomfort is expected, but painkillers can help alleviate symptoms. If absorbable stitches are used, stitches can fall off naturally within 2-3 weeks. Vaseline must be applied to the tip of the penis. A dressing should be applied around the wound line to prevent the wound from sticking to your underclothes, which should stay in place for three days in the case of glue circumcision. It is highly recommended that you wear light clothing for 2-3 days. The operation usually does not affect passing urine. 

If the circumcision is performed with the Glue method (Dermabound Advanced™ or Derma+flex®), please follow these instructions strictly:

• Keep the wound dry for three days.
• Refrain from scratching, rubbing, or picking at the wound or glue, which can loosen the film before the wound fully recovers.
• Gently remove the bandage after three days; you may take a brief shower. After showering, gently blot the wound dry with a soft towel. Caution! Do not peel off the glue with the bandage.
• Do not soak or scrub your wound or swim until the adhesive film has fallen off naturally.
• Stay out of direct sunlight and avoid using tanning lamps.
• Do not apply liquid, ointment medications, or any other product to the wound while the glue is in place. Such actions could loosen the film before the wound is fully healed.
• You may have 2-3 stitches underneath the penis (at the frenulum); these will dissolve in 3-4 weeks. There is no need to remove the stitches using the glue method.

Please make sure to follow these instructions carefully to ensure proper healing and recovery.