Adult circumcision

Adult patient feedback from France

 "Excellent after service, called me late in the evening very quickly to respond to an email when I was expecting to a reply in the morning" 

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https://www.iwantgreatcare.org/doctors/mr-a-r-khan

Circumcision: 7 things about adult circumcision you did not know. You should know these before you decide to have the circumcision

what age can circumcision be done? 

There is no age restriction. Many babies have circumcision. It can be done as old as even seventies  

why do men ask for circumcision  

There are many reasons: tight foreskin, painful sex, BXO (Lichen scrolosis ), scarring, personal, hygiene, cosmetic, long foreskin and repeated infection  

How Painful is circumcision? 

Procedure after the local anaesthesia is pain free 

 

What are pros and cons? 

Pros : clean, no diseases of foreskin, good cosmetic look, less penile cancer, less sexual diseases transmission especially HIV  

Cons: risks of operation: like bleeding, infection, scaring , painful scar and revision surgery.  

 

What do women think about circumcision  

Sone women like more circumcised men as compare to uncircumcised men.  

 

Please contact to Dr. Khan directly +447527 314081 if you have further question.  

London circumcision Clinic, Leyton, London 

 

 

 

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