Adult male circumcision - London clinic patient feedback

Adult patient feedback 27 June 2018 about adult circumcision due to tight foreskin - phimosis BXO 

"Dr Khan was amazing. I am 35 years old and was rather worried about getting circumcised as you could imagine! I needed to get it done and I di not trust what my NHS doctor said as he was rushed and not really paying attention in the consultation.  So considering we are talking about my most prized possession, I decided to pay for it privately! Dr Khan was highly recommended and the operation was really pain free and very relaxed considering the circumstances.  I healed very well and the results are amazing. If any adults are wondering - circumcised is better!  Dr Khan gave me his mobile and answered text messages any time during healing and gave me a lot of support - so above and beyond the NHS - I was so pleased and could not recommend him enough - thank you for everything Dr Khan!"

VARIFIED BY I WANT GREAT CARE

Adult male circumcision - London clinic patient feedback

Adult patient feedback 27 June 2018 about adult circumcision due to tight foreskin - phimosis BXO 

"Dr Khan was amazing. I am 35 years old and was rather worried about getting circumcised as you could imagine! I needed to get it done and I di not trust what my NHS doctor said as he was rushed and not really paying attention in the consultation.  So considering we are talking about my most prized possession, I decided to pay for it privately! Dr Khan was highly recommended and the operation was really pain free and very relaxed considering the circumstances.  I healed very well and the results are amazing. If any adults are wondering - circumcised is better!  Dr Khan gave me his mobile and answered text messages any time during healing and gave me a lot of support - so above and beyond the NHS - I was so pleased and could not recommend him enough - thank you for everything Dr Khan!"

VARIFIED BY I WANT GREAT CARE

The Use of Tissue Glue for Circumcision in Children: Systematic Review and Meta-analysis 2018

 OBJECTIVE

To evaluate the efficacy of tissue glue in pediatric (children) circumcision.

 MATERIALS AND METHODS

A systematic review and meta-analysis of the English literature (1997-2017) was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement on children who underwent circumcision with tissue glue. Meta-analysis was conducted using RevMan 5.3, Comprehensive Meta-Analysis 2, and MedCalc 18. P values <.05 were considered significant.

 RESULTS

The search returned 15 studies for a total of 4567 circumcisions, of which 3045 (66%) were performed with tissue glue. The systematic review indicated that overall complication rates were 4.3% (tissue glue) and 5.9% (sutures). The use of tissue glue was associated with reduced postoperative pain, better cosmetic results, and reduced cost. Meta-analysis showed that there was no difference between the incidence of total postoperative complications (relative risk [RR] 0.86 [95% confidence interval {CI}: 0.62-1.19], P = .36) and wound infection and dehiscence between the 2 groups (RR 0.95 [95% CI: 0.59-1.56], P = .85). Postoperative bleeding and hematoma formation were reduced with the use of tissue glue (RR 0.55 [95% CI: 0.32-0.95], P = .03). Tissue glue also significantly shorten the operative time (mean difference −0.22 [95% CI: −0.39 to −0.05], P = .01).

 CONCLUSION

The incidence of postoperative bleeding and hematoma formation in pediatric circumcision is reduced with the use of tissue glue. Tissue glue has reduced operative time; furthermore, it might be associated with reduced postoperative pain, less overall cost, and superior cosmetic results.

Ref: UROLOGY 115: 21–28, 2018. © 2018 Elsevier Inc.

CQC published the case study- London Circumcision Clinic fulfils 95% standards

Case study – good practice for Newborn or Baby circumcision

This case study is taken from a GP practice that has conducted traditional circumcision for 28 years. ( published CQC website)

In this practice, parents receive written information and advice in advance of the procedure. This includes a consent form and information about aftercare. The practice requires both parents to give consent to the procedure.

Parents are advised not to feed the infant for two hours before the procedure. This ensures that the baby feeds immediately afterwards to provide comfort.

The doctor assesses the level and type of local anaesthesia appropriate for each infant, taking account of their age and weight and the requirements of the procedure. Pain relief is proportionate and appropriate for the individual needs of the infant.

If the doctor concludes that the procedure cannot be safely conducted in his GP practice, he advises parents of this and suggests alternative options (for example, referral to hospital care).

During the procedure, the infant is held comfortably still. Another person is always present to assist and respond to the infant’s needs if they are in any distress.

The family is advised to remain at the practice for at least an hour after the procedure and once the doctors is certain that the baby is not bleeding.

The doctor is available for aftercare and the arrangements for follow up are clear.

Written instructions for parents include a request to text or ring the doctor after their first check. The parents are advised to contact the doctor at any time by text or phone if they have any concerns. If this happens, the doctor will visit the baby at home or see him at the surgery, as is most appropriate.

The doctor encourages good practice among other providers by offering training in the procedure.

Ref: 

Advice for inspectors

Circumcision of male children

January 2016 Care Quality Commission