Adult circumcision by Experienced Surgeon
Dr Khan has performed more than 2000 adult circumcisions in the UK. He is at the top of his field with excellent results for glue, revision and redo adult circumcisions.
Dr Khan is an expert in methods of circumcision such as sleeve, sutureless (Glue), free hand, forceps guided method, stitches, dorsal slit, revision, redo circumcision, preputioplasty and frenuplasty (release/division of a short tight frenulum which causes the head of the penis to tilt down during erections also called “frenulum breve.”). Phimosis ( tight foreskin caused by balanitis xerotica obliterans in 20% adults in our experince. Dr Khan can discuss the characteristics of high and low cut, tight and loose cut types or styles of circumcision.
Please stop taking any medication such as anti-platelets or any blood thinning tablets 5 days before the operation. Please consult your doctor (GP) before stopping these medications.
A local anaesthetic is injected into the base of the penis and all around the shaft of the penis with a single injection, but 2-3 pricks. This provides safe and effective pain-relief during the operation. This is used as the sole form of anaesthesia around the wound and the patient is not put to sleep during the procedure. This minimises post-operative pain as well for 1 hour. The entire foreskin is removed using an incision just behind the head of the penis. This leaves the head of the penis completely exposed permanently.
Dr Khan also has vast experience of phimosis (tight foreskin) due to a condition called Balanitis Xerotica obliterans (BXO).
MALE ADULT CIRCUMCISION
What is the cost of circumcision or alternative to circumcision?
- Consultation only £150
- Full circumcision (stitches) £550
- Full circumcision (Glue) £625
- Frenuloplasty of prepuce of penis £475
- Preputioplasty: an alternative to circumcision £475
- Revision or Redo circumcision £800
- Biopsy if required £130
Where can I go to get circumcision?
- London Circumcision Clinic : Leyton Healthcare, 4th floor, 75 Oliver Rd, London E10 5LG
- Thornhill Circumcision Centre, 1-3 Thornhill Road, Luton, Bedfordshire, LU4 8EY
ADULT MALE CIRCUMCISIONS
Adults require circumcision and alternative treatment for foreskin problems. This information is only for guidance and does not replace professional consultation.
Circumcision may be performed for the following reasons:
Hygiene, cultural or religious
Tight foreskin due to Balanitis Xerotica Obliterans (BXO)
Tight foreskin during sexual activity
Balanitis or Balanoposthitis (infection of foreskin or glans)
Tight or short frenulum causes the head of the penis to tilt down during erections
FULL OR PARTIAL CIRCUMCISION
Full circumcision means moderate cutting of inner and outer foreskin to expose the head of the penis. Partial circumcision leaves some loose skin which might partially cover the head of the penis and is very similar to loose circumcision. Full circumcision might give a false impression of loose/partial circumcision when the penis is in a flaccid state. Partial circumcision is possible but it has a few complications in the long term. These can be discussed with our specialist.
1. High and low “cut” circumcision
This concept is due to the scar line from the groove (sulcus) of the head of the penis (corona of the glans) and also depends upon how much inner skin is removed. High “cut” means excess outer skin along with shaft of penile skin is cut, leaving long inner skin. Low “cut” means to cut more inner skin so that the scar line is very close to groove of the head of the penis. Some men think completely opposite to this concept. They may think “cut” or scar line is taken in relation to the base of the penis. These high or low styles are not possible in all men. To put a scar line in the middle of the shaft or close to the base of the penis is not recommended as it leaves too long inner skin which can swell up due to lymphatic drainage (lymphoedema) and also over time, the inner skin stretches to become a loose fold of skin which gives unsatisfactory results in the long term. This also involves cutting too much shaft of penile skin.
2. Tight versus loose circumcision
This might depend upon many factors such as how much total foreskin is removed, the mobility of penile shaft skin and attachment of the skin at the base of the penis at the abdomen (penoscrotal junction). Tightness of skin around the penis is sometimes not possible, no matter how much foreskin is removed during the circumcision. This is due to loose attachment of skin at the shaft of the penis. This might be caused by congenital reasons or the aging process. Tight circumcision should not be confused with quality of erection which depends upon many factors. Erection is not affected by circumcision. Loose circumcision may also be similar to partial circumcision. These concepts should be taken according the flaccid and erect state of the penis. Tight circumcision is not possible for those who have a considerable difference in size between fully flaccid and fully erect penis. They might have a painful erection during sexual activity if a tight circumcision is performed.
Religious and cultural circumcision
Expectations for people who have circumcision due to religious and cultural reasons is to expose the whole head (glans) of the penis. This is possible in most cases. Some people have very short penile shaft skin, mobile shaft of penis skin and partially buried penis due to many factors. To expose the head of the penis is not the best option for these patients as they may require some extra-skin for normal erections.
ALTERNATIVE TO CIRCUMCISION
There are alternatives to full circumcision, such as excision of frenulum, V-Y plasty operation called preputioplasty, frenuloplasty, partial circumcision or medical treatments. These are personal preferences and can be discussed further with our specialist.
BEFORE OPERATION ASSESSMENT
You will usually attend the clinic on the same day for the consultation and for your surgery. After consultation, you will meet the nurse and Dr Khan. Before surgery we need to know if you have any of the following:
- Family history of bleeding disorders
- Medication such as anti-platelet or blood thinning medication
- Allergy to any medication
- urinary problems
- heart surgery
- an artificial joint or any other implanted foreign body
- a neurosurgical shunt
Consider starting vitamin C, 500 mg 3 times a day a week before surgery.
FREQUENTLY ASKED QUESTIONS
What is forceps guided method?
This is the surgical removal of the foreskin (skin covering the head of the penis) guided by special forceps.
What is the price of adult circumcision
Cost of adult circumcision starts from £550
Do I have to come for consultation separately?
You usually attend the clinic on the same day for the consultation and your surgery.
What type of anaesthesia is used?
A local anaesthetic is injected into the base of the penis and all around the shaft of the penis with a single injection, but 2-3 pricks. This provides safe and effective pain-relief during the operation. This is used as the sole form of anaesthesia around the wound and the patient remains awake during the procedure.
What are the risks and side-effects?
Any procedure has a potential for side-effects. You should be reassured that the majority of patients do not suffer any problems after circumcision. Bleeding and infection rarely happen.
What should I expect after the operation?
You might experience discomfort for a few days after the procedure but painkillers help to decrease the discomfort. Passing urine is painless and is not affected by the operation. There will be swelling and bruising of the penis for a few days after the procedure. This will last 7-10 days and will then subside gradually and should not be a cause for alarm.
How do I care for the wound?
A dressing is applied around the stitch line to prevent the wound from sticking to your underclothes and this will stay for 4 days with two anchoring stitches. It is advisable to wear light clothing for 2-3 days.
What should I expect when I get home?
It will be at least 7- 10 days before healing occurs and you may return to work when you are comfortable enough. Most people require at least a week off work. You should refrain from any sexual activity for a minimum of 4 weeks.
What should I look for at home?
If you develop a temperature, increased redness, throbbing or drainage at the site of the operation, please contact us for advice.
Do I need follow up?
Patients do not normally require a follow-up appointment after circumcision unless this is felt necessary by the surgeon. We are happy to see you free of change after the operation within the first 6 months.
After care for adults circumcision
You might experience discomfort for a few days after the procedure but painkillers help to reduce this. Absorbable stitches are normally used which can be removed after 10 days to minimise the stitch marks or can be allowed to fall off after 2-3 weeks. Vaseline should be applied to the tip of the penis. A dressing is applied around the wound line to prevent the wound from sticking to your underclothes and this stays in place for 24 hours in the case of glue circumcision. It is advisable to wear light clothing for 2-3 days. Passing urine is painless and is not affected by the operation.
If the circumcision is done with the Glue method (Dermabound Advanced™ or Derma+flex®). The glue contains 2-octylcyanoacrylate or Octyl and Butyl cyanoacrylates, please follow the following instructions.
- Please keep the wound dry for 24 hours
- Do not scratch, rub, or pick at the wound or glue; doing so may loosen the film before the wound is fully healed
- Please gently remove the bandage after 24 hours; you may take a brief shower or bath. After showering or bathing, gently blot the wound dry with a soft towel. Caution! Do not peel off the glue with the bandage
- Do not soak or scrub your wound; do not swim until the adhesive film has fallen off naturally
- Stay out of direct sunlight and do not use tanning lamps
- Do not apply liquid or ointment medications or any other product to the wound while glue is in place. It could loosen the film before the wound is fully healed
- You may have 1-2 stitches underneath the penis (at frenulum); these will dissolve in 3-4 weeks. There is no need to remove the stitches with the glue method
WHAT SHOULD I EXPECT WHEN I GET HOME
It will be at least 7 to 14 days before healing occurs and you may return to work when you are comfortable enough. Most people require at least a week off work. You should refrain from any sexual activity for a minimum of 4 to 6 weeks. When you leave the clinic, you will be given a GP letter if you have a condition called Balanitis Xerotica Obliterans (BXO) and need to send a biopsy of foreskin. This contains important information about your operation and BXO. Please take this letter and biopsy with you to allow the doctors to see details of the condition for further management. This is particularly important if you need to consult a urologist due to BXO foreskin or urethra after four weeks of your circumcision.
CARE AT HOME
There will be swelling of the penis for a few days after the procedure. This will last 5-7 days and will then subside gradually and should not be a cause for alarm. However, if you develop a temperature, increased redness, throbbing or discharge at the site of the operation, please contact us for advice. Patient story- Read more
CALL US IF YOU HAVE ANY QUESTIONs
Dr Khan will contact you the same working day.
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