These notes give an overall guide to your stay in hospital. You may see some differences in the details of your treatment, since it is tailored to suit your own condition.

• What is a circumcision?
  
  
• What does the operation consist of?
  
  
• What happens before the operation?
  
  
• What happens after the operation?
  
  
• General advice

WHAT IS A CIRCUMCISION?

A circumcision is an operation to remove the foreskin. The foreskin is the sleeve of loose skin which covers the bulbous end of the penis (the glans). One end of the sleeve grows from the base of the glans. The other end lies freely over the glans to protect it.

Sometimes the foreskin is tight or thickened and will not pull back from the glans. This can cause discomfort and can lead to infection under the foreskin. Sometimes the foreskin pulls back and gets stuck causing severe pain and swelling of the bulb. Sometimes the foreskin needs to be removed to check that the underlying glans is healthy.

WHAT DOES THE OPERATION CONSIST OF?

Most of the foreskin, especially the free end, is removed. The remaining skin is stitched to the base of the glans so that there is no sleeve. The operation can be done under general or local anaesthetic. This will be discussed with you.

WHAT HAPPENS BEFORE THE OPERATION?

Reception

When registering at reception your medical aid details will be required. Your medical aid may require that you obtain an authority number from them for the hospital. Please check this. If you are not on a member of a medical aid you will be required to pay a deposit or to sign an indemnity form. As far as possible we will try to advise you about hospital costs before your admission.

Welcome to the ward

You will be welcomed to the ward by the nurses or the receptionist and will have your details checked. Some basic tests will be done such as pulse, temperature, blood pressure and urine examination. You will be asked to hand in any medicines or drugs you may be taking, so that your drug treatment in hospital will be correct. Please tell the nurses of any allergies to drugs or dressings. The surgeon will have explained the operation and you will be asked to sign your consent for the operation. If you are not clear about any part of the operation, then read this again and then ask for more details from the surgeon or from the nurses.

Visit by the anaesthetist

If you are having a general anaesthetic, the anaesthetist who will be giving your anaesthetic will interview and examine you. He will be especially interested in chest troubles, dental treatment and any previous anaesthetics you have had.

Diet

You will have your usual diet until 6 hours before the operation when you will be asked to take nothing by mouth. This will let your stomach empty to prevent vomiting during the operation.

Timing of the operation

The timing of your operation is usually arranged the day before so that the nurses will tell you when to expect to go to the operating theatre. Do not be surprised, however, if there are changes to the exact timing.

Transfer to theatre

You will be taken on a trolley to the operating suite by the staff. You will be wearing a cotton gown, wedding rings will be fastened with tape and removable dentures will be left on the ward. There will be several checks on your details on the way to the operating theatre where your anaesthetic will begin.

The operation is then performed.

WHAT HAPPENS AFTER THE OPERATION?

Coming round after the anaesthetic.

Although you will be conscious a minute or two after the operation ends, you are unlikely to remember anything until you are back in your bed on the ward. Some patients feel a bit sick for up to 24 hours after operation, but this passes off. You will be given some treatment for sickness if necessary.

Will it hurt?

There is discomfort on moving rather than severe pain. You will be given injections or tablets to control this as required. Ask for more if the pain is still unpleasant. The second day after operation you should be able to spend most of your time out of bed and in reasonable comfort. You should be able to walk slowly with a little discomfort. By the end of one week the wound should be virtually painfree.

Drinking and eating

You will be able to drink within an hour or two of the operation provided you are not feeling sick. The next day you should be able to manage normal food.

Passing urine

It is important that you pass urine and empty your bladder within 6-12 hours of the operation. The dressing will not interfere with this.

The wound and stitches

The wound has a dressing which may show some staining with old blood in the first 24 hours. This dressing will come off of its own accord when you bath or shower. After that you will not need another dressing.

The stitches in the wound are self absorbing and do not need to be removed.

Washing

You can wash the wound area. Salted water is not necessary.

How long in hospital?

This depends very much on your general condition. You can usually go home the same day. Very seldom you would need to stay for a day or two.

An appointment for a check up must be made with the surgeon about 10 days after the operation. Details will be finalised after the operation.

Sick notes

Please ask the doctor for sick notes, certificates etc.

After you leave hospital

You are likely to feel a little sore for a week or so. After 2 weeks you should be able to return to your usual level of activity.

Driving

You can drive as soon as you can make an emergency stop without discomfort i.e. after about 3 days.

What about sex?

You can start sexual relations within 4 to 5 weeks when the wound is comfortable enough.

Work

You should be able to return to a light job after a week or so and a heavy job within 2 weeks.

Complications

Complications are rare and seldom serious. If you think that all is not well please ask the nurses or doctors. You may get painful erections in the first 2 or 3 days. These can be controlled with painkillers. Infection is a rare problem and settles down with appropriate treatment. Aches and twinges may be felt for up to 2 months.

GENERAL ADVICE

The operation can be quite uncomfortable but improves rapidly.

If you have any problems or queries, please ask the nurses or doctors.