Instructions to follow before the operation

Please bring a pair of well-fitting clean underpants to wear after the operation. They will hold the wound dressing in place for the first day or two. A day or two after the operation, once the dressing has been removed, it is better to wear loose underwear.

On the morning of the operation, wash the genital area and the penis carefully with water and mild soap, giving special attention to the area under the foreskin.

If you have long pubic hair, it is a good idea to clip this with scissors before the operation, so that is does not interfere with the dressing that will be put on after the circumcision. There is no need to shave you pubic hair in advance of the operation.

You will be more comfortable if you empty your bladder before the operation.

Problems and Complications after the operation

Immediate Problems

Some swelling and discomfort can be expected after the operation, but this normally gets better after the first day or two. No special treatment is needed.

One of the possible complications is bleeding or accumulation of blood under the skin. This is because the skin of the penis is less tight than other part of the body and has a very good blood supply. If a large blood clot forms, it is sometimes necessary to perform another small operation to remove it.

The wound can become infected, particularly in men with diabetes. The operation s performed in sterile conditions, but the penis is in an area that is not as clean as other parts of the body. The first signs of infection are increasing pain, redness and swelling at the site of the operation. If this happens, you should return to the clinic for follow up, as antibiotic treatment may be needed. Antibiotics are not given routinely and antibiotic ointment should not be used, as this may make things worse. The actual risk of having a complication, such as bleeding or infection, is about one for every fifty men who have the operation.

If you are unable to pass urine or have difficulty in doing so, you should return to the clinic for assessment.

Most men get erections during the night while sleeping. If this occurs after the circumcision operation, you may experience some minor discomfort because of pulling on the stitches. This is nothing to worry about and will settle down after 1-2 weeks.

Other Complications

Occasionally the head of the penis may remain very sensitive after the operation. This increased sensitivity will become less over the first few weeks, as the skin of the glans becomes slightly thicker. 

Instructions to follow after the operation

In the first three days after the operation, it may help to rest at home. Lying on your back means that the penis is at its highest point in your body and this takes the pressure off the area. However, you should also walk about regularly, for example to get meals or visit the toilet. You should not ride a bicycle for the first five days after the operation.

Keep the area of the operation dry until the next day; keep the area clean; do not use any antiseptic cream, ointment or any other substances. Do not remove the bandage until told to do so by the clinic staff.

The circumcision wound is closed with absorbable stitches. These dissolve by themselves and it is not necessary to return to the clinic to have them removed.

You should return to the clinic if any of the following complications occur:

• Continued bleeding from the wound
• Formation of a large bleed clot under the skin near the site of the operation
• Pain (you will feel some pain when the local anaesthetic wears off, but this should settle down over the first few hours. However, if the pain comes back, return to the clinic)
• Swelling (after the procedure some swelling is normal and this will settle down over the first few days. If the swelling gets worse, return to the clinic)
• Discharge of fluid or pus; this may indicate infection

Avoid any sport or other strenuous activity for 4-6 weeks. The healing process will be well advanced after 7 days, but it takes 4-6 weeks for the wound to become strong. Full healing takes longer (3 to 4 months). It is best to avoid sexual intercourse or masturbation for the first four to six weeks after circumcision. It is very important to use a condom during sexual intercourse to protect the healing wound for at least six months after the operation.

 Postoperative Instructions for Adult Circumcision

• After the operation, rest at home for three days. This will help the wound to heal
• You may bathe on the day after surgery, but do not let the dressing get wet
• Remove the dressing 24 – 48 hours after surgery
• Do not pull or scratch the wound while its healing
• Do not have sexual intercourse or masturbate for 4 – 6 weeks and use condoms to protect the wound for every act of sexual intercourse at least six months until the wound has healed completely. (Your health care provider will advise you about this during your follow up visit)
• You may have a little pain or swelling around the wound. This is normal. Check occasionally to make sure that it does not get worse. Take any medications provided or recommended by the clinic. Be sure to follow the instructions given to you.
• Return to the clinic of call:
• If you notice increased bleeding from the surgical wound
• If the pain or swelling a the surgical wound gets progressively worse
• If you have difficulty passing urine
• If you develop a fever within one week of surgery
• If you have severe pain in the lower abdomen
• If the wound is discharging pus
• If you have any of these problems, call us to make an appointment immediately

Return to the clinic for a follow-up visit in 48 hours and 7 days after the operation, to see how the wound is healing