Jared J Wallen MD is a board-certified urologic surgeon and men’s sexual health specialist. Book an appointment online or give us a call!
What are the Benefits of Circumcision?
Circumcisions can be performed for a variety of reasons:
- Hygiene and ease of cleaning
- Decreased rate of STD, HIV, and possibly even penile cancer as well as
- Prevention of Paraphimosis, which is where blood flow is cut off to the head of the penis due to a tight bymonic band
Theory of Surgery
Essentially two incisions are made during this surgery. One is approximately one to two centimeters behind the head of the glans penis. This incision is carried circumferentially around the skin behind the head of the penis. The second incision is made in the foreskin as the foreskin is covering the glans penis. This incision is made in an area that it is meant to match our other incision. It is very important during this step that we stretch the penis to match the maximum length during an erection to ensure that we do not shortchange the amount of skin remaining on the shaft of the penis.
The Morning of the Procedure
The morning of the circumcision you should do take the following steps to help ensure a successful procedure:
- Eat a light breakfast and drink approximately 20 ounces of water
- Take your normal medications unless you had planned to stop your blood thinners with your surgeon
- Arrive approximately 45 minutes early with your ride home
During the Circumcision
- The first step of the procedure is to put the penis on stretch and evaluate the redundant foreskin to ensure that we keep enough shaft skin for when the penis is fully engorged with an erection. Dr. Wallen will approximate the amount of tissue to remove and mark the areas where incisions will be made. Again, the first incision is made approximately two centimeters behind the head of the penis. The patient is fully numb and also has a muscle relaxer sedative on board.
- The incision is carried around the circumference of the penis. At this point, the underlying soft tissue called Archos fascia is dissected carefully with the electrocautery tools to ensure hemostasis and adequate removal of the tissue.
- Dr. Wallen will then make a second incision as the foreskin is pulled over the top of the glans penis. Again we approximate this incision in the same area, approximately two centimeters behind the glans penis’ shadow circumferentially around the penis. One of the benefits of having Dr. Wallen as your surgeon is that he is ambidextrous and able to use instruments in both hands fluidly.
- Dr. Wallen will then use a scissor to tunnel underneath the foreskin between the two incisions and connect them by opening up the foreskin. He will then sequentially remove the underlying soft tissue from the foreskin and the phallus. The foreskin is then completely released from the penile shaft tissue.
- Dr. Wallen will then irrigate and clean the wound bed and examine the cosmetic result while obtaining hemostasis of any minor bleeding underneath the skin.
- Reapproximation of the skin edges is performed with a dissolvable suture that dissolves approximately seven to ten days after your procedure.
- Sutures are placed circumferentially to completely close the skin incision.
- The penis is then cleaned and dried and skin glue is applied to the head of the glans penis.
The penis is then placed in a compressive and patty to wrap and this should be left in place for approximately 48 hours.
After your procedure, taking the following steps are recommended:
- A normal, healthy diet
- Light duty activity and non-vigorous activity for approximately two weeks
- Eight to ten glasses of water daily
- Eight hours of sleep at night
- No alcohol intake for 24 hours
Incision care includes:
- No masturbation, intercourse or other friction inducing activity until the skin incision is fully healed
- Refrain from baths, pools, hot tubs, and soaking your penis in water during this time
- When the sutures dissolve, apply Vaseline approximately three times daily until your incision has fully healed
- Once the incision has fully healed patients can return to all normal activities.