Criteria to be fulfilled in performing circumcision (Royal College of Surgeons of England, 2000)
- The operation should be performed by, or under the supervision of, doctors trained in children's surgery
- The child must receive adequate pain control during and after the operation
- The parents and, where competent, the child, must be made fully aware of the implications of this operation as it is a non-reversible procedure
- This operation must be undertaken in an operating theatre or an environment capable of fulfilling guidelines for any other surgical operation
- The person responsible for the operation must be available and capable of dealing with any complications which may arise
- There should be close links with the patient's GP and community services for continuing care after the operation
Accurate records of all procedures and audit of results are essential.
According to the Royal College of Surgeons of England guidance, the one absolute indication for circumcision is pathological phimosis. This is scarring of the opening of the foreskin, making it non-retractable. Other indications also involve the removal of an abnormal foreskin, including penile malignancy, traumatic foreskin injury, and severe recurrent attacks of balanoposthitis
Royal College of Surgeons of England. Male Circumcision: guidance for Healthcare Practitioners. RCSENG - communications; 2000.