Circumcision Open Treatment | PristynCare

Risk Factors

Factors that increase the likelihood of requiring circumcision include:

• Congenital phimosis — tight foreskin from birth that does not improve with age
• Recurrent balanitis or balanoposthitis due to poor hygiene or diabetes
• Lichen sclerosus (BXO) — a progressive scarring condition affecting the foreskin
• Diabetes mellitus, which increases the risk of foreskin infections
• Poor genital hygiene leading to recurrent inflammation
• Anatomical predisposition to foreskin problems

Who Needs Circumcision?

Circumcision is recommended for adults and children with medical conditions such as phimosis, recurrent balanitis, paraphimosis, or lichen sclerosus that have not responded to conservative treatments such as topical steroid creams. It is also performed electively for religious, cultural, or personal hygiene reasons. A urologist will evaluate the foreskin condition and recommend circumcision after discussing non-surgical alternatives where appropriate.

Diagnosis

Diagnosis before circumcision includes:

• Clinical examination: Assessment of the foreskin for phimosis grade, signs of infection, scarring, or skin conditions
• Urine culture: To identify any active urinary tract infection requiring treatment before surgery
• Skin biopsy: For suspected lichen sclerosus (BXO) to confirm the diagnosis before surgery
• Blood glucose testing: To screen for diabetes in adults with recurrent balanitis

Circumcision Treatment

Open circumcision is performed under local anesthesia (penile block) for adults or general anesthesia for children. The surgeon removes the foreskin circumferentially, leaving sufficient inner mucosal skin for comfortable healing. Bleeding is controlled with electrocautery or sutures. The procedure takes 20 to 45 minutes. Pristyn Care provides adult and paediatric circumcision by experienced urologists using precise technique to ensure a clean cosmetic result and optimal healing.

Circumcision Procedure Steps

1. Anesthesia: Local anesthesia (penile block) for adults or general anesthesia for children is administered
2. Preparation: The operative area is cleaned and draped; the foreskin is inspected
3. Marking: The amount of foreskin to be removed is marked carefully to preserve adequate mucosal skin
4. Excision: The foreskin is removed circumferentially using a scalpel or scissors (sleeve resection technique)
5. Hemostasis: Bleeding is controlled with electrocautery or absorbable sutures
6. Suturing: The edges of the inner mucosal skin and outer penile skin are sutured with absorbable stitches
7. Dressing: A sterile dressing or paraffin gauze is applied and the patient is discharged within a few hours

Recovery After Circumcision

Recovery after open circumcision typically takes 2 to 4 weeks:

• Mild to moderate swelling and bruising around the penis for 1 to 2 weeks is normal
• Pain and discomfort managed with prescribed pain medications for the first few days
• The wound should be kept clean and dry; follow the doctor wound care instructions
• Avoid sexual activity and strenuous exercise for at least 4 to 6 weeks
• Absorbable sutures dissolve on their own within 2 to 4 weeks

Complications of Circumcision

Circumcision is a safe procedure but may rarely involve the following complications:

• Postoperative bleeding requiring surgical intervention in rare cases
• Wound infection requiring antibiotic treatment
• Excess or insufficient skin removal affecting cosmetic outcome
• Meatal stenosis (narrowing of the urethral opening) in rare cases
• Adhesions forming between the residual inner skin and the glans
• Temporary or permanent altered penile sensation