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CIRCUMCISION - WHAT, WHY AND HOW ? - Mar. 2002.

1. What is circumcision?
Circumcision is an operation where in the foreskin on the penis is removed.

2. When is a circumcision performed?
A circumcision would be performed for any one of the following reasons:
religious (in certain communities circumcision is performed on all boys as a religious ritual)
phimosis (a condition wherein the foreskin is tightly attached to the penis)
repeated infections of the foreskin
to prevent urinary infections in boys who are otherwise prone to develop urinary infections
social (in some societies, e.g. America, circumcisions are done as a routine for most boys)

3. What is phimosis?
Phimosis is a condition wherein the foreskin is tightly attached to the glans (head of the penis). It is not possible to retract the foreskin over the glans in these boys. This often results in repeated infections under the foreskin, ballooning of the foreskin when the boy tries to pass urine or dribbling of urine.

4. Is the foreskin always retractable?
No, in early childhood, upto 2-3 years of age, the foreskin is not retractable and this should not be attempted. As the boy grows older, this slowly loosens and retraction becomes possible. However, this physiological phimosis should not cause any of the above mentioned problems. The symptoms mentioned in question 3 are abnormal, at whatever the age they occur.

5. Is circumcision a major operation?
No, in most circumstances, it is a minor operation, often performed as a day care procedure - the child being allowed to go home the same day.

6. Is it very painful?
Any operation is associated with some discomfort. However, modern anaesthetic techniques and medicines can reduce this pain considerably. Most children are back to normal over a day or two. It is advisable to have the child in a loose garment till healing is complete - this takes about 7 days.

7. What are the complications of a circumcision?
A properly performed circumcision by a skilled surgeon should not be associated with any major complications. As with any operation, bleeding and infection are possible - however, in good hands these should occur in less than 2-3% children.

8. Are there any long-term problems?
None.

9. Are there any other advantages?
There is evidence that circumcision in early infancy can reduce the risk of penile cancer. However, this should be balanced with the risks of cancer and anaesthesia (however small these might be). Also good personal hygiene prevents penile cancer even in the non-circumcised.

DR.R. Sanjay Rao,

Consultant Paediatric Surgeon.
E-mail: sanjayrao98@hotmail.com

 

Updated on 01.03.2002.
 

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