CIRCUMCISION AT DIFFERENT AGES

Circumcision can be performed at any age for medical, religious or social reasons but it is only available on the N.H.S. for phimosis, paraphimosis and balanitis.

a. Infant.

If circumcision must be done for any reasons then 7-10 days after birth is the ideal time. At this age there is no anaesthetic risk, no separation from parents, no psychological trauma, no stitches, no memory of the event and the wounds heal in a few days without causing any discomfort. Circumcision with a 'Plastibell' is probably the best method and the baby can be bathed normally.

b. Child.

In the child circumcision may be an unpleasant experience causing psychological trouble which persists for some time afterwards. Separation from parents, the anaesthetic, having his 'tail' made sore etc. may all be upsetting. The anaesthetic agent 'Ketalar' and the 'Plastibell' circumcision device have made the operation simpler and safer in young children. Lads in the 2-6 age group are aware of the differences between boys and girls and being unable to appreciate the nature of the operation may fear that their masculinity has been taken away.

c. Adolescent and adult.

Circumcision at this age can readily be done under local or general anaesthesia without psychological harm because the patient can understand the reason for the operation. It can be done on an out-patient basis because the wound is not particularly painful and the patient remains up and about. The wound heals in about two weeks and sexual intercourse can be resumed in 3-4 weeks. To secure maximum benefit the surgeon should be requested to remove all the foreskin. The main problem is embarrassment in having the genitals handled, explaining absence from school or work, and having to face ribald remarks when news of the operation leaks out. The fear that an erection after the operation will tear the stitches is of course quite unwarranted.