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Circumcision - Introduction

NHS Choices Medical Reference

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Male circumcision is the surgical removal of the foreskin. The foreskin is the fold of skin covering the end of the penis, which can be gently pulled back.

Circumcision may be performed for:

  • religious reasons - circumcision is a common practice in the Jewish and Islamic faiths
  • medical reasons, although alternative treatments are usually preferred to circumcision

This article focuses on the medical aspects of circumcision.

Routine circumcision

During the 19th century, many medical practitioners believed that being circumcised was more hygienic than not being circumcised.

As a result, the routine medical circumcision of all boys, regardless of religious faith, became a widespread practice in England. However, routine male circumcision gradually became less common as many members of the medical community began to argue that it had no real medical benefit in the vast majority of cases.

Routine circumcision may offer a number of potential benefits, such as reducing the risk of some types of infections. However, most healthcare professionals now agree that the risks associated with routine circumcision, such as infection and excessive bleeding, outweigh any potential benefits.

Read more about the advantages and disadvantages of circumcision.

NHS availability

The majority of PCT's do not fund routine circumcision or circumcision that is carried out for religious reasons.

The NHS mainly funds circumcision that is used to treat a small number of medical conditions (see below). In such cases, circumcision is usually regarded as a "treatment of last resort", when all other treatment options have failed.

It is important to note however that some PCTs in England do currently fund religious or ritual circumcision on the NHS. Each PCT takes decisions based on priorities that relate to its own local population.

Find your local PCT.

In rare cases, circumcision may be considered for the following health conditions:

  • paraphimosis - a condition where the foreskin gets trapped under the tip of the penis
  • balanitis xerotica obliterans - an uncommon condition causing hardening and inflammation of the tip of the penis

However, these conditions are extremely rare in children and other treatments are often preferred.

Circumcision may also be considered in some cases for adults with the following health conditions:

  • severe cases of phimosis - a tight foreskin that can't be retracted 
  • recurrent balanoposthitis - inflammation of the tip of the penis and foreskin 

Read more about why circumcision may be necessary.

How circumcision is performed

Circumcision for medical reasons is usually carried out on a day-patient basis. This means that you or your child will not have to stay overnight in hospital.

If a baby boy needs to be circumcised, he will usually be given a local anaesthetic because it is safer than a general anaesthetic. Local anaesthetic is a numbing medicine, which can be injected into the base of the penis or applied as a cream.

Older children and adults who are circumcised are usually given a general anaesthetic, where they are put to sleep.

The circumcision procedure is relatively simple. The foreskin is removed with a scalpel, scissors or a surgical clamp. Any bleeding is cauterised (closed using heat), and the remaining edges of skin are stitched together using dissolvable stitches.

After circumcision, there may be some pain and swelling, and the penis will be easily irritated until it heals. The healing process can take up to 7 to 10 days in babies, and up to 4 to 6 weeks in older boys and men. Read more about recovering from circumcision.

If there are signs of any bleeding or infection after a circumcision, speak to your GP. Complications are rare when circumcision is performed for medical reasons, but there are some risks of circumcision which should be considered.

Medical Review: January 24, 2012
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