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Men's Health

Circumcision, Vasectomy & Frenulectomy

1. Circumcision

Circumcision is a surgical procedure to remove the foreskin of the penis. It is used to treat phimosis, a condition in which the foreskin cannot be pulled back over the head of the penis (glans). Phimosis affects only boys and is normal in infants and toddlers. The foreskin typically separates between ages 2 and 6. In most cases, it will detach naturally on its own.

Circumcision is necessary to treat phimosis that results from scarring from previous injury.  It can also treat phimosis that causes frequent infections o the foreskin or the urinary tract.  Circumcision may be needed if the foreskin causes problems in urinating. If phimosis does not get better with the use of steroid cream, circumcision may be needed.

Circumcision is not an option for some patients who have:

  1. Active problems with heart or lung function or a bleeding disorder.

  2. Foreskin or glans that is actively infected.

  3. Birth defects of the penis.

  4. A penis that urinates through an opening on the underside rather than at the tip (Hypospadias)

A penis that is not visible or is inside the skin (buried penis, foreskin may be needed for reconstructive procedure).

How is circumcision performed?

The procedure can be performed under local anaesthesia or general anaesthesia.  To remove the foreskin, the surgeon holds it with a grasper and cuts the skin away from the penis.  The skin below the glans is stitched to the skin of the shaft to heal.  The wound is covered with gauze.

Does circumcision hurt?

In fact, circumcision is not a very painful procedure. Anaesthesia dulls the pain during surgery. Urination does not cause pain after surgery because the urethra (the tube that passes urine from the bladder) is not touched.

Benefits of adult circumcision

  • Prevention of infection and irritation

  • Improved hygiene

  • Reduced risk of urinary tract infections

  • Reduced risk of cancer

Recovery from circumcision

  • Infants, 12 – 24 hours

  • Young Children, 1 – 2 days

  • Older children and adults, 3 – 4 days.

Very few patients have problems or side effects after circumcision. Light bleeding or discharge 2 – 3 days after surgery will stop on its own.  Bruising or swelling of the penis skin can last for a few weeks.  Treat with cold packs and pain relievers (Non-Steroidal Anti-Inflammatory drugs, NSAIDs).  Sometimes not enough skin is removed, and another operation is needed.  More serious problems like damage of the penis or major bleeding are very rare.

Contact your doctor after surgery if:

  • Pus is coming out of the wound

  • Penis becomes red, swollen or painful

  • Bleeding that does not stop

  • Urination is very little or not at all

  • High fever.

Postsurgical care instructions

Pain from adult circumcision is typically mild. Your doctor may prescribe a mild pain reliever, but over-the-counter options may be sufficient to ease any discomfort.  Your doctor may also prescribe an antibiotic in order to prevent a possible infection.

Wear comfortable but supportive underwear that can hold the head of the penis toward the belly button lying flat.  Loose-fitting underwear allows for too much movement.  This can increase swelling and pain.

Within a day or two of the surgery, you should begin trying to walk.  Keep the movement low-impact and slow at first. Seek permission from your doctor before resuming normal physical activity.

As soon as your bandage is removed, you can take a shower.  Be careful not to swipe the incision with a washcloth or towel, and don’t use any scented soaps or gels for several weeks.  The fragrance and chemicals may irritate the sensitive skin as it heals.  Pat dry the area to reduce sensitivity.

2. Vasectomy

Our clinic specialises in No Needle, No Scalpel Vasectomy, offering a minimally invasive approach to long-term contraception.

Vasectomy is a small operation to cut the vas deferens. This is the tube that takes sperm from the testicles (testes) to the penis. Sperm are made in the testes. Once the vas deferens is cut, sperm can no longer get into the semen that comes out (is ejaculated) during sex.  Vasectomy is usually done under a local anaesthetic. This means you are awake but have an injection into the skin so that you do not feel pain. Local anaesthetic is injected into a small area of skin on either side of the scrotum above the testicles (testes). A small cut is then made to these numbed areas of skin.

The cut is so small you may not need any stitches. If you do, dissolvable stitches are used, or a special surgical tape. The operation takes about 15 minutes.

Self-care includes:

  • staying home and resting as much as you can for a few days after the procedure.

  • pain relief if needed.

  • avoiding heavy lifting, exercise or sexual intercourse for 7–10 days.

  • return to light work after 2 days.

You can expect some soreness and bruising around the operation site for a few days to weeks.

However, the following may happen:

  • there is a small risk of a wound infection after the surgery.

  • bruising around the operation site may occur but it will go in a week or so.

  • sometimes sperm may leak into the scrotum and form a swelling which may need treatment.

  • you may experience a dull ache in the scrotum for a few weeks or months after the operation.  This usually settles within 3 months.

3. Penile Frenulectomy

A frenulectomy is a procedure that can alleviate the pain often associated with a tight band of tissue between a penis’ shaft and the glans on its underside.  A tight frenulum can exist independent of whether a man has been circumcised and it can create a tight and curved section of the penis that is susceptible to micro-trauma, causing bleeding and painful erections.