Partial circumcision

Partial circumcision leaves some foreskin which partially or fully covers the head of the penis (glans).  Full circumcision might give a false impression of partial or incomplete circumcision when the penis is in a flaccid state in case of buried or hidden penis. Partial circumcision is possible for over 16-year boys and adult, but it has a few complications in the long term.

What is difference of partial and full circumcision?

Full circumcision means adequate cutting of foreskin to expose the fully head of the penis. In the case of partial circumcision, remaining foreskin partially or fully covers the head of the penis (glans).

Procedure

A local anaesthetic is given by injections, which provide effective pain-relief during the partial circumcision. The inner part of the foreskin (mucosa) is excised circumferentially with excision of part of outer foreskin. Inner mucosal skin and outer foreskin are joined mainly with glue and a few stitches. The glue will give waterproof layer and also wound has less chances of infection. Scar line is the best outcome with glue.

Price of partial circumcision

Cost of adult partial circumcision is £750 under local anaesthesia.

Benefits of partial circumcision

The foreskin may be helpful in normal sexual function. Moreover, the exposed head of the penis becomes normal keratinised skin with possible reducing sensitivity. Medical research investigating sexual functioning for post-circumcision has reported mixed results and outcome. Partial circumcision retains the part of the foreskin (prepuce). Adult may like to keep their part of the foreskin.

Disadvantage of partial circumcision

Partial Circumcision is not recommended by the British Association of Urological Surgeons because of scarring and recurrent phimosis. Scarring may return in the foreskin and the cosmetic results may not be unacceptable by the men.

We do not know the real benefits of partial circumcision as compared to full circumcision.  There is no medical literature have been reported to compare partial circumcision to full circumcision for adults with tight foreskin or BXO or for men who request circumcision for personal or hygienic reasons. This technique is reported in children with a recurrence of phimosis occurred up to 5.5%. (References 1 and 2)

Risks

Partial circumcision has a potential for side-effects like bleeding, infection, prolong swelling and recurrent phimosis (tight foreskin) and significant scarring. Revision of circumcision is required in case of development of tight foreskin due to scarring. Some adult is not suitable for this operation because of the structure (anatomy) of the penis and foreskin.

Recovery

There will be significant swelling of the foreskin for a few days after the operation. This will settle down within 10-15 days and will then decrease gradually.

A wound will take 2-4 weeks before healing occurs.  You may return to work when you are comfortable enough. Most people require at least 2-3 days off work. You should abstain from any sexual activity for 4 to 6 weeks.

Outcome

Partial circumcision is preserving the part of the foreskin which seems well accepted by men, once the wound is healed. Moreover, using this special technique with partial circumcision, the scar line lies on the internal part of the foreskin with a very good appearance of the penis. However, there is a potential risk of phimosis, which may require full revision circumcision.

Please contact us for further information. Our Specialist Mr A R Khan will discuss about the suitability of partial circumcision.  

 

References:

  1. https://www.baus.org.uk/patients/conditions/13/tight_foreskin_phimosis/

  2. Modified partial circumcision for phimosis: techniques and surgical outcomes: Annals of Pediatric Surgery 2018, 14:151–156