Male circumcision is the surgical removal of the foreskin. The foreskin is the roll of skin that covers the end of the penis.
Circumcision in boys
Circumcision in boys may be carried out for medical reasons or religious or cultural reasons.
Circumcision may be a treatment of last resort for conditions such as:
- tight foreskin (phimosis)
- recurrent infection of the foreskin and head of the penis (balanitis)
Religious or cultural reasons
This is a common practice in Jewish and Islamic communities. It's also practised by many African communities. Most cultural circumcisions are carried out in young boys.
How the foreskin develops
It's normal for a baby boy's foreskin not to pull back (retract) for the first few years of life.
Around the age of 3 the foreskin should start to separate naturally from the head of the penis (glans). Full separation occurs in many boys by the age of 5 years.
For some boys, the foreskin can take longer to separate. This does not mean there's a problem, it will usually just detach at a later stage.
As the foreskin starts to separate from the head of the penis, you may see the foreskin ballooning out when your son pees. This can occasionally lead to infection (balanitis). This ballooning usually settles down with time.
Never try to force your son's foreskin back, as it may be painful and damage the foreskin.
Medical reasons for a boy to have a circumcision
It's rare for circumcision to be recommended for medical reasons in boys. This is because other less invasive and less risky treatments are usually available.
The following conditions affect the penis and, in rare cases, may need a circumcision.
Tight foreskin (phimosis)
Where the foreskin is too tight to be pulled back over the head of the penis. This can sometimes cause pain when the penis is erect and, in rare cases, peeing may be difficult.
Recurrent infection (balanitis)
Where the foreskin and head of the penis become inflamed and infected.
Where the foreskin can't be returned to its original position after being pulled back. This can cause the head of the penis to become swollen and painful. Immediate treatment is needed to avoid serious complications, such as restricted blood flow to the penis.
Balanitis xerotica obliterans
This condition causes a tight foreskin. In some cases it also affects the head of the penis, which can become scarred and inflamed.
Circumcision is usually carried out on a day patient basis. This means your child will be admitted to hospital on the same day he has surgery and won't need to stay overnight.
He will not be able to eat or drink before having surgery. You'll receive detailed information about this from the hospital.
After being admitted to hospital, your child will be seen by the surgeon who will carry out the procedure. They'll explain the operation in more detail. They'll discuss any concerns and answer any questions you have.
They'll also ask you to sign a consent form, giving your permission for the operation.
The anaesthetist will also visit your child before the operation. Your son will usually have a general anaesthetic. He'll be asleep throughout the procedure and unable to feel any pain or discomfort.
Circumcision involves removing the foreskin just behind the head of the penis using a scalpel or surgical scissors.
Any bleeding can be stopped using heat (cauterised). The remaining edges of skin are stitched together using dissolvable stitches. It will take up to 6 weeks for your son's penis to fully heal.
Recovering after male circumcision
After the operation, a dressing will be put over the penis to protect the wound. It may be removed before your child goes home, or it may be left. If it is left it should fall off itself within 24 hours.
He will be allowed home after he's peed, which may be slightly uncomfortable at first.
The penis will be sore and inflamed for a few days after the operation. Ointment may be prescribed to use for a few days to help the area heal.
Your child will also need regular pain relief for at least 3 days. They can take paracetamol or ibuprofen following the instructions on the packet.
Your child will be able to have a bath the day after the operation. He should avoid riding a bicycle or other toys you sit on until any swelling has gone down.
It may be more comfortable to wear loose clothing – or no clothing at all – on his bottom half for a few days after the operation. Peeing in the bath or shower may also be more comfortable.
He should be able to return to school or nursery about a week after the operation. Make sure you tell the school or nursery about the operation.
In most cases, a follow-up appointment won't be necessary.
Non-urgent advice: Contact your GP or hospital care team if:
- your child's penis is bleeding
- your child's penis is still swollen 2 weeks after the operation
- peeing is still painful a few days after the operation
Risks of male circumcision
Risks of circumcisions when carried out by qualified and experienced doctors are small.
The main risk is reduced sensation or a permanent change in the sensitivity of the head of your child's penis. This is one of the reasons why circumcision is only recommended for medical reasons.
But it should not affect your child's ability to have a fulfilling sex life in the future.
There is a small risk of bleeding, both during and after the operation. The surgeon will seal off any bleeding during the procedure. The dressing applied afterwards will absorb any further bleeding.
Look for medical advice if your child's penis continues to bleed after they return home.
Content supplied by the NHS and adapted for Ireland by the HSE