Partial Circumcision

Partial circumcision leaves some foreskin which partially or fully covers the head of the penis (glans).

Full circumcision might give a false impression of partial or incomplete circumcision when the penis is flaccid in case of a buried or hidden penis. Partial circumcision is possible In a small number of adults, but it has a few long-term complications.

Difference Between Partial and Complete Circumcision

Full circumcision means adequate cutting of the foreskin to expose the head of the penis. In the case of partial circumcision, the remaining foreskin partially or fully covers the head of the penis (glans).

Procedure

A local anaesthetic is given by injections, which provide effective pain relief during partial circumcision.

The inner part of the foreskin (mucosa) is excised circumferentially with the excision of part of the outer foreskin. The inner mucosal skin and outer foreskin are joined mainly with glue and a few stitches.

The glue will give a waterproof layer, and the wound has fewer chances of infection. Scar line is the best outcome with glue.

Cost of Partial Circumcision

The cost of partial adult circumcision is £780 under local anaesthesia.

Benefits of Partial Circumcision

The foreskin may be helpful in normal sexual function. Moreover, the exposed head of the penis becomes normal keratinised skin with possible reduced sensitivity.

Medical research investigating sexual functioning for post-circumcision has reported mixed results and outcomes. Partial circumcision retains the part of the foreskin (prepuce).

The adult may like to keep the part of the foreskin.

Disadvantage of Partial Circumcision

The British Association of Urological Surgeons does not recommend partial Circumcision because of scarring and recurrent secondary phimosis. Scarring may return in the foreskin, and the cosmetic results may not be unacceptable to the men.

We do not know the benefits of partial circumcision compared to complete circumcision. No medical literature has been reported to compare partial circumcision to full circumcision for adults with tight foreskin or BXO or for men who request circumcision for personal or hygienic reasons.

This technique is reported in children with a recurrence of phimosis that occurred up to 5.5%. (References 1 and 2)

Risks

Partial circumcision has the potential for side effects like bleeding, infection, prolonged swelling, recurrent phimosis (tight foreskin), and significant scarring. Revision of circumcision is required in case of the development of tight foreskin due to scarring.

Some adults are unsuitable for this operation because of the structure (anatomy) of the penis and foreskin.

Recovery

There will be significant swelling of the foreskin for a few days after the operation. This will settle down within 10-15 days and decrease gradually.

A wound will take 2-4 weeks before healing occurs.  You may return to work when you are comfortable enough. Most people require at least 2-3 days off work. You should abstain from any sexual activity for 4 to 6 weeks.

Outcome

Partial circumcision is preserving the part of the foreskin, which seems well accepted by men once the wound is healed. Moreover, using this special technique with partial circumcision, the scar line lies on the internal part of the foreskin, with a very good appearance of the penis. However, there is a potential risk of recurrence of phimosis ( tight foreskin after scar shrinkage ), which may require complete revision circumcision.

Please contact us for further information. Our Specialist, Mr A R Khan, or Consultant Urologists, will discuss the suitability of partial circumcision.  

References

1. https://www.baus.org.uk/patients/conditions/13/tight_foreskin_phimosis/
2. Modified partial circumcision for phimosis: techniques and surgical outcomes: Annals of Pediatric Surgery 2018, 14:151–156