This leaflet is intended as a general guide to the preparations you should make for your elective adult circumcision and the after-care of your newly circumcised penis. The guidance also applies to the circumcision of pubescent and post-pubescent teenagers but not to infant or childhood circumcisions for which there are separate leaflets.
Hospitals usually have their own special set of procedures and so this guidance may be inappropriate if the circumcision is to take place in a hospital.
If your doctor has given you specific advice regarding preparation for your circumcision or its after-care then you should follow his instructions rather than this article.
There are no hard and fast rules regarding how to prepare for a circumcision, nor what to do and expect after it so the following information is only a guide. This information has been gathered from a variety of sources including hints given on the Internet by newly circumcised men recounting what worked well for them.
Getting advice from others in the same situation is advisable. The more prepared you are, the easier you will find it to deal with the after-care.
Some doctors' lists fill up months ahead. If timing is important to you, e.g. to fit in with available holiday dates, then be sure to make your initial contact with the doctor well in advance. You can always fix a date for several months ahead, even if earlier dates are available.
Most doctors will require you to have a preliminary consultation. At this they will ensure that you know what is involved and will collect some medical details from you to eliminate obvious contra-indications.
Be sure to tell the doctor if you are allergic to any anaesthetic or antibiotic; if you suffer from diabetes; if you are on any prescribed medication; or if you have recently had any other medical treatment.
This is also the time to discuss with the doctor any particular outcome that you require, e.g. a 'tight' or 'loose' circumcision, 'high' or 'low' placement of the scar line, removal or retention of the frenulum. Remember that the terms 'high' and 'low' may not be familiar to the doctor, or he may consider them the opposite way from you! so be specific and show him where you want the scar line placed.
Ask any other questions you may have about the proposed circumcision. This is your last chance to opt out or for a different doctor if you are not entirely happy to proceed.
There is no need to completely shave your pubic hair but it is desirable to trim it fairly short. This aids asepsis during the operation and prevents hairs becoming painfully trapped in the bandaging afterwards. Trim your pubic hair about a week in advance of the operation to allow time for the cut ends to soften again.
There will be a period of up to six weeks after circumcision when you will not be able to indulge in sex. It is desirable therefore that you reduce your desires beforehand. On the morning of the operation either have sex with your partner or masturbate to climax.
Unless you are to have a general anaesthetic, ensure that you eat a light meal before setting out. Having surgery on an empty stomach can cause fainting. Also take some chocolate and a sweet drink (like Coke) to replenish your sugar levels after the operation.
Do not take any alcohol, whether with or without a meal, for 24 hours prior to the operation as it can dehydrate you and may reduce the effectiveness of the local anaesthetic.
Other than prescribed medication, do not take any other drugs for at least 24 hours prior to the operation.
On the morning of the circumcision ensure that you take a good bath or shower and pay particular attention to your genitals. Retract your foreskin as far as you can and clean well under it.
Immediately before the time of the operation empty your bowels and bladder.
After the operation your whole penis will be swollen and look very bruised. This is a normal effect of both the injected anaesthetic and the handling it necessarily receives during the operation. These will gradually reduce over the next week or two.
If you normally wear boxers you may find that they give insufficient support immediately post-operative. You may wish to consider some form of briefs which will hold your penis in position and thus reduce the frictional stimulation which it would otherwise receive if allowed to swing freely.
Pointing the penis upwards in teh tighter underwear helps drain away lymph and thus reduce the swelling.
Do not be surprised if your urine tends to spray instead of forming a neat stream for the first few days. This is a natural result of the swelling and will correct itself as the swelling subsides.
Some doctors bandage only the immediate area of the cut but most will apply a bandage to the whole shaft. This bandage will normally be of a special compression type or else be wound tightly around the penis. It serves two purposes, to protect the wound and to contain and reduce the swelling.
Removal of the initial bandage is a compromise between maintaining the compression for as long as possible to reduce swelling as fast as possible, and changing the dressing on the wound before it sticks too much to the healing skin.
Two to three days after the operation is generally regarded as the best compromise time. The bandage will, most likely, be well caked in blood (particularly the inner layers) and will need to be soaked off in the bath to avoid tearing the healing wound.
Put only enough lukewarm water in a bath as needed to just cover your groin completely. Throw in a couple of handfuls of salt or Epsom Salts to promote healing. DO NOT add any form of antiseptic solution. Sterilize a pair of small scissors by dipping in an antiseptic solution followed by a quick rinse in clear water (they will not actually touch your wound, so need not be absolutely aseptic). Use these to cut the bandage into manageable lengths as you unwind it. (Having a small plastic bag available to throw the used bandage into is a good idea.) Slowly unwind the bandage, stopping whenever you start to need to use any force to release it - let the water soak the clotted blood off and then continue. Be sure to remove ALL of the bandage, including any odd strands of gauze which might otherwise become embedded in the wound.
Once the bandage is off, swill away the bloody water and replace with more lukewarm water and salt. Allow the exposed penis to soak for a few minutes (not too long, but enough to remove caked blood) and then pat dry with a gauze pad followed by applying a fresh bandage to protect the wound as it continues to heal. A thin coating of a bland ointment, e.g. Vaseline or Sudocrem, before applying the bandage will reduce the possibility of blood making it stick to the skin.
Repeat the process every 48 hours or so until the middle of the second week, after which the light bandage can be left on or off as you wish. If you choose not to use a bandage then a gauze pad or even paper tissue may be useful to prevent the stitches catching in your underwear.
Do not apply any antiseptic cream to your penis, nor add any antiseptic to bath water. Whilst they do help to kill germs, most are corrosive to new skin and actually slow down healing. In the rare cases where an infection develops, see a doctor as soon as possible.
It can be beneficial and very soothing to soak the wound for 10 to 15 minutes a couple of times a day in a cupful of cooled, boiled water to which has been added a teaspoon of salt or Epsom Salts.
Everyone reacts differently in respect of pain. For most people circumcision will not be truly painful, but a degree of discomfort is to be expected during the first few days.
If you choose to take pain killing tablets then follow the instructions precisely. Do not take more than the recommended maximum dose.
If you have a favourite brand of pain killer and the doctor has prescribed something else, be sure to ask about the effects of 'mixing and matching'.
Do not take Aspirin or any Aspirin based product since these thin the blood and have an anti-clotting action which can increase bleeding from a wound. Paracetamol or Ibuprofen based products are to be preferred.
Stitches (sutures in medical parlance) need to remain in place long enough for the cut edges to knit together but not so long as to allow the skin around them to fully heal. In practice this usually means they should remain for between 1 and 2 weeks. Leaving them longer increases the risk of small holes ('stitch tunnels') remaining in the skin.
Although the doctor will normally use soluble (or self-dissolving) stitches they should still be removed after 2 weeks if not already dissolved by then. You can go to your own doctor to have the stitches removed or can do it yourself (even easier, get your partner or a friend to do it for you).
Sterilize a pair of fine-pointed scissors and a pair of flat-bladed tweezers. Wash your hands and penis thoroughly. Carefully cut through a stitch near the knot and pull it out by grasping the knot in the tweezers. Do not be surprised if the location bleeds a bit; in fact this is good as it indicates that a 'stitch tunnel' has not yet formed.
Remove alternate stitches, stopping if the two edges of the circumcision line separate - this indicates that healing is not far enough advanced. If all is well then you can remove the remaining stitches, or you may choose to leave them a couple of days more if you wish.
To reduce the effect of nocturnal erections pulling on the stitches during the first few days, empty your bladder before retiring and any time you wake 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.
Do not be over eager to have sex until your circumcision has healed, which will normally take up to six weeks. If you need relief during the healing process then try techniques which stimulate places other than the glans and scar line. These can include squeezing the shaft alone, massaging the nipples or prostate massage.
To avoid excessive friction on the healing scar line you may wish to consider the use of a condom. A condom should always be used for penetrative sex (even with a regular partner) until the scar line is completely healed and settled down, which may take two to three months to achieve.
There is no absolute need to take time off school or work after circumcision, but you may find it very hard to concentrate on work for the first few days and it may be useful to take a week off.
A week (or even two) off work is very desirable if you do heavy lifting or if your job keeps you seated and unable to move around freely for long periods.
Do not schedule a circumcision immediately before major examinations if you wish to pass them, as you cannot get up and walk around to relieve any pressure on your penis.
You should naturally avoid fast-moving or contact sports, cycling and swimming until your circumcision has fully healed.