Adult Circumcision in London, UK

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 will 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 a circumferential block by injection will give virtual pain free men circumcision at the 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. Please visit our London Circumcision Centre website

INDICATIONS

The men Circumcision in London Clinic is most often performed due to medical reasons in men. Circumcision may be performed for the following reasons:

  • Phimosis (tight foreskin)
  • Tight foreskin due to Balanitis Xerotica Obliterans (BXO),
  • Paraphimosis
  • Balanitis or balanoposthitis (infection of foreskin or glans)
  • Frenulum breve, tear or scarring at frenulum cause pain during sexual activity
  • Tight or short frenulum causes the head of the penis tilt, bleeding during sex or tilt down during erections
  • Hygiene, cultural or religious

CIRCUMCISION CONS AND PROS

 Circumcision is recommended in view of medical reasons in men and adolescents, especially BXO or phimosis affecting the sexual life. The consequences of circumcision still debate in the existing literature, and conflicting conclusions have been reported. There is evidence reported that men circumcision has health benefits. The less risk of urinary tract infections and a reduced risk of sexually transmitted infections (STIs) has been reported in men.

The trials conducted in Africa provide enough evidence of the outcome of circumcision for the prevention of several STIs and HIV among men. Protection against penile cancer and less chances of cervical cancer in female sex partners is also reported in the medical literature. Circumcision is not unethical for parents or carers who choose to be circumcised or have their children circumcised for religious, social, or cultural grounds.

Circumcision rarely causes serious complications if performed by trained surgeon, in a dedicated clinic with a proper follow-up. Advantages and disadvantages of circumcision with risks and benefits must be discussed when circumcision is recommended for the adult and adolescents.  Possible risks of men circumcision are bleeding, infection, poor cosmetic result and change in sensation during sexual activities.(Friedman, CMI 2016;22:768).

ANAESTHESIA

A local anaesthetic is injected into the base of the penis and all around the shaft of the penis. This provides safe and effective pain-relief during the operation. Pain relief is recommended after the operation and the patient is not put to sleep during the procedure. This also minimises post-operative pain for a few hours.

MEN CIRCUMCISION COST IN THE UK (16-YEAR-OLD AND ABOVE)

 What is the cost of circumcision in the UK at London Circumcision Clinic or alternative to circumcision?

We provide frenuloplasty without additional cost when you have a circumcision at the same time.

  • Consultation only £150

  • Full circumcision with frenuloplasty (stitches) £550

  • Full circumcision and frenuloplasty (Glue) £625

  • Frenuloplasty of prepuce of penis £475

  • Preputioplasty: an alternative to circumcision £475

  • Revision or Redo circumcision £800

  • Biopsy if required £130 in case of BXO

  • One free follow-up visit, otherwise follow up fee £50

Circumcision is legal in the UK. NHS provides free circumcision in the UK due to medical reasons, however waiting list is very long for the most hospitals.  In England and Wales non-medical circumcision operation is no longer funded on the NHS (Atkin et al 2009, Wheeler and Malone 2013).

INFORMED CONSENT

We provide the patient with adequate information about the procedure ahead of time. Circumcision is an irreversible procedure and makes the head of the penis exposed permanently. Informed consent is taken before the procedure.

FULL OR PARTIAL CIRCUMCISION

Full circumcision means moderate cutting inner and outer foreskin to expose the head of the penis. Partial circumcision leaves some loose skin, which might partially cover the head of the penis and is very similar to lose circumcision. Full circumcision might give a false impression of loose/partial circumcision when the penis is in a flaccid state especially patient with buried penis. Partial circumcision is possible, but it has a few complications in the long term. These can be discussed with our specialist at Adult circumcision in London.

PROCEDURE TECHNIQUES

Following are methods of adult and boys over 16-year-old for circumcision

1.     Dorsal slit method: Dorsal slit method for the circumcision is mainly used for phimosis (tight foreskin) and paraphimosis. After partial dorsal slit, the surgeon needs to identify the corona of glans to cut the correct amount of foreskin.

2.     Sleeve method: Free hand cutting the foreskin

3.     Forceps guided method: Use of forceps to cut the foreskin

4.     Free hand method: cutting the foreskin with a scissor

5.     Shang ring: disposable clamp to use

6.     Glue and stitches circumcision: Glue or stitches are applied to skin edges.

Our preferred method at Adult Circumcision in London is Glue circumcision. Men circumcision with Shang ring is a quick procedure, however, wound healing takes longer than conventional circumcision in adults (J Urology 2012). Circumcision may be done at any age. You can get circumcised at age of 16, 20 or later. Gown up men can get circumcised at the London Circumcision Clinic. 

CIRCUMCISION RECOVERY FOR ADULT CIRCUMCISION

Circumcision with glue heals quicker than one with stitches. Swimming and weight lifting should be avoided for 2-3 weeks. Full recovery following circumcision generally requires 4-6 weeks.  Oversensitivity of the glans may take a few months to resolve.

ADULT CIRCUMCISION HEALING TIPS

To reduce the effect of night erections pulling on the stitches or glue during the first few days after the adult circumcision, empty your bladder before retiring and a few times during the night. Do not lie on your back, but on your side. It may be helpful to draw your knees up a bit into a more foetal position. Wear tight underwear after the procedure to prevent the excessive movement. Follow the aftercare advice and keep the wound dry for 48 hours.

Please take vitamin C regularly for 10 days to promote healing. Apply vitamin E or bio oil to the scar after 15 days if the wound is completely healed to improve the scar.  Please contact to Dr. Khan at London Circumcision Clinic for further advice.

RISKS OF MEN CIRCUMCISION

Risks of the circumcisions explain to the patients. Risks are bleeding, bruises, haematoma formation, infection, inadvertent damage to the glans, removal of too much or too little skin, lymphoedema, aesthetically unpleasing results and a change of sensation during intercourse and masturbation. The patient should also be informed that, during the postoperative period, erections can cause pain and discomfort.  Very small chances of disruption or scarring of wounds which might require a redo operation.

POST-OPERATIVE CARE

You might experience discomfort for a few days after the circumcision, but painkillers help to decrease the discomfort. Passing urine is painless and is not affected by the operation. There will be swelling and bruising of the penis for a few days after the procedure. This will last 7-15 days and will then subside gradually and should not be a cause for alarm. Bleeding after circumcision can be stopped in adults by applying pressure or a bandage.

A dressing (bandage) is applied around the wound line to prevent the wound from sticking to your underclothes. A bandage will stay for 2 days with self-adhesive stretch gauze (Cobain). It is advisable to wear light clothing for 2-3 days. The wound will be at least 7- 15 days before healing occurs and you may return to work when you are comfortable enough. Most people require at least a week off work. You should gently wash the wound daily for the next a few days and shower regularly.  You should  avoid gym or heavy weight lifting for 2 weeks. You should refrain from any sexual activity for a minimum of 4-6 weeks after the procedure to avoid breakdown of the wound.

PS: This information is for guidance only. This is not a replacement for professional medical advice. Please call to Dr. Khan for free telephone advice +447527314081 without any obligation at Adult Circumcision in London.