Circumcision
Circumcision for boys older than one year and for adults, performed in theatre in Johannesburg — with honest advice on when it is, and isn’t, needed.
About circumcision
Circumcision is the surgical removal of the foreskin. It may be recommended for medical reasons, or requested for personal, cultural or religious reasons. At a consultation we will examine your son (or you), discuss whether circumcision is appropriate, and answer your questions.
Is your son’s foreskin normal?
Almost all boys are born with a foreskin that does not pull back. This is normal — not a disease. The foreskin separates from the head of the penis gradually during childhood, and most boys can retract it by about age 10. Until then, some ballooning of the foreskin when passing urine, and small white “pearls” under the skin, are part of normal development. Never force the foreskin back: this causes tearing and scarring.
When circumcision is medically recommended
- Scarring of the foreskin (balanitis xerotica obliterans / lichen sclerosus) — a white, firm, scarred ring that does not loosen with time
- Repeated, severe infections of the foreskin (balanoposthitis)
- Recurrent urinary tract infections with fever in boys with an underlying abnormality of the urinary tract
A tight foreskin without scarring can often be treated first with a steroid cream applied for a few weeks. We will discuss whether that is worth trying before surgery.
Personal, cultural or religious reasons
Parents may also request circumcision for non-medical reasons. We will talk through the benefits and risks so that you can make an informed decision.
When circumcision should not be done
If the opening of the urethra is in the wrong place (hypospadias), or there is another abnormality of the penis, the foreskin may be needed for a later repair. We examine every boy carefully before any decision.
Circumcision for adults
I also perform circumcision for adult men — for example for a tight or scarred foreskin, repeated infections, or by personal choice. The procedure, anaesthetic and recovery are discussed at your consultation.
How it is done
- Performed in theatre under general anaesthetic, for boys older than one year
- A penile block (local anaesthetic) is given while your son is asleep, for pain relief afterwards
- Dissolvable stitches — sometimes skin glue — so nothing needs to be removed
- A hydrocolloid dressing protects the wound for the first week
- Usually a day procedure: your child goes home the same day
Recovery and aftercare
- The hydrocolloid dressing stays on for about a week, then is soaked off in the bath
- Some swelling and bruising is normal for the first few days
- Give regular pain relief, as advised, for the first few days
- Most boys are back at school after about one week
- Avoid bicycles, straddle toys and rough play for three weeks
- No routine follow-up visit is needed if healing goes well
When to contact us
Complications are uncommon, but include bleeding, infection, narrowing of the urine opening (meatal stenosis), and too much or too little skin being removed. Contact Sister Yolandé on 011 796 6673 if there is bleeding that does not stop with gentle pressure, a fever, or if your son cannot pass urine. In an emergency, go to your nearest hospital emergency unit.
Questions parents ask
Why only after the age of one?
Because the procedure needs a general anaesthetic, and the anaesthetic risk is lower once a child is older than one year.
Will my son be in pain?
A penile block — local anaesthetic given while he is asleep — numbs the area for several hours after surgery. After that, regular simple pain relief is usually enough.
Will the stitches need to be removed?
No. The stitches dissolve on their own; sometimes skin glue is used instead.
Is a follow-up visit needed?
Not routinely. If you have any concern about healing, contact the rooms and we will see your son.
Book a consultation
To discuss circumcision for your son or for yourself, call 011 794 3549 or email appointment@urology.joburg.
This information is general in nature and is not a substitute for a consultation.