Adult Circumcision in London UK is performed due to medical and non-medicals reasons for over 16 year old boys and men. Medical indications include phimosis (tight foreskin), paraphimosis (foreskin stuck beyond the glans), recurrent balanitis or posthitis (infection of the prepuce) and scarring due to lichen sclerosis atrophicus (Balanitis Xerotica Obliterans). Non-medical reasons could be religious, personal or cultural. Our surgeon Dr Khan with discuss circumcision cons and pros with you. Adult circumcision can be done under local, regional or general anaesthesia. Adult circumcision in London is commonly performed by glue or stitches using the forceps guided or the dorsal slit methods. Cost of adult circumcision in the UK starts from £550. Penile block with circumferential block by injection will give virtual pain free men circumcision at London Circumcision Clinic. Informed consent must be taken. Adult circumcision recovery may take from 2-6 weeks. Possible risks of adult circumcision are bleeding, infection, poor cosmetic result and change in sensation during sexual activities.
Circumcision is a common procedure with minimum risks of complications by trained professional doctors. There are different opinions whether there is a need for a male to be circumcised.The benefits of infant circumcision include prevention of urinary tract infections (a cause of renal scarring), reduction in risk of inflammatory foreskin conditions such as balanoposthitis, foreskin injuries, phimosis (tight foreskin) and paraphimosis ( foreskin stuck behind the head of penis) When the men later becomes sexually active he has substantial protection by circumcision against risk of HIV and other viral sexually transmitted infections such as genital herpes and oncogenic human papillomavirus, as well as penile cancer. The risk of cervical cancer in his female partner(s) is also reduced.
Annual audit has improved outcomes of circumcisions with disposable rings in children in a community clinic under local anaesthesia - Thornhill clinic and Leyton clinic, London
To evaluate the early postoperative complications particularly impaction of disposable devices in children’s circumcision procedures under local anaesthesia in a community clinic in this year’s audit versus previous 3 audits.
MATERIAL AND METHODS
In our current audit cycle, the outcome of circumcisions (n=1222) was prospectively studied over a 1-year period (May 2017 to April 2018) and were compared with the last 3 audit cycles. Circumcision was performed under local anaesthesia, by trained doctors in a community clinic using Circumplast (CC)(n=310) and Plastibell (PC)(n=912). Early postoperative complications especially ring impaction were compared among the four audits. Follow-up was arranged if required.
The mean age was 4.4±0.3 months (median 1.5). Complication rate in this year’s audit was 5.1%(62/1222). There is no significant difference in overall complications rate in CC(6.8%n=21/310) versus PC(4.5%n=64/979)(p>0.5). Delayed ring separation/impaction is significantly lower in CC (1% n=3/310) versus PC (2.4% n=22/912) (p<0.05) and has significantly improved from the previous three audits. In current year, 202 (16.5%) children were followed and mean duration was 10±2.6 days (median 6).
The annually conducted audit has shown improved outcomes of circumcisions with disposable rings in children in a community clinic under local anaesthesia over successive years.
Ref: Accepted as presentation and poster in ESPU 30th Meeting, Lyon, France.