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What does this procedure entail?
This involves releasing the foreskin from the glans of the penis – folding the foreskin to the root of the penis and releasing it with a fine mallet probe.
The procedure is usually performed on an outpatient basis under general anaesthesia.
What are the alternatives to this procedure?
- Drugs and ointments to suppress inflammation
What should I expect before this procedure?
At the request of the referring physician, you will have to schedule preoperative examinations to assess your overall condition, including laboratory and instrumental tests. If the report does not preclude the indicated procedure, you will be admitted to the hospital. If you don’t undergo a preoperative examination or it is incomplete, you will not be able to have the surgery as scheduled. You will be asked not to eat or drink for at least 6 hours before the surgery!
Remember to inform your physician about the following possible facts before the surgery:
- artificial heart valve
- coronary artery stent pacemaker
- artificial joint
- artificial vascular graft
- neurosurgical bypass
- other implanted foreign body
- use of the following prescription drugs: Acylpyrin, Anopyrin, Aspirin, Godasal, Clopidogrel, Plavix, Kardegic, Aspegic, Micristin, Ibustrin,Ticlid, Tagren, Ipaton Apo-Tic, Plavix, Persantin, Curantyl, Anturan, Aggrenox, Vessel due F.
- drug and other allergies
- any abnormalities or eventualities.
It is NECESSARY to inform the physician about your use of drugs affecting blood clotting before your admission for the procedure.
What will happen during the surgery?
The procedure is performed under general anaesthesia. The foreskin is pulled toward the root of the penis while separating it from the glans with a probe. After the glans of the penis is completely released, the glans and the inner layer of the foreskin are treated with antibiotic ointment to prevent inflammation and repeated adhesion.
The surgery takes about 5-10 minutes.
What will happen immediately after the procedure?
You may feel discomfort or even mild pain for several days after the procedure – you can use common painkillers. An ointment is applied to the wound to prevent tissue ingrowth – sutures are not used here. Starting day 2 after the surgery, baths in a lukewarm chamomile or rapeseed extract solution are recommended, with ointment application after drying (you will receive the prescription upon hospital discharge). It is recommended to pull the foreskin daily towards the root of the penis until it is healed, to prevent it from sticking back to the glans of the penis. Urination itself should not be affected by the surgery.
After the procedure is completed or when you are fully conscious, you should:
- ask if the planned outcome was achieved
- inform the medical staff about any problems
- ask what you can and cannot do
- ask all the questions you have for the healthcare professionals and members of the medical team.
- remember (and understand) why the surgery was performed, how it turned out, and what will follow
What are the postoperative risks or complications?
Common (10% of procedures of this type)
- Rarely, inflammation at the site of the procedure requiring further treatment
- Transient bleeding from places where adhesions were already very strong
- Transiently increased sensitivity
Occasional (2-10% of procedures of this type)
- Possible later need for circumcision if the problem is not solved
- Repeated development of adhesions requiring repeat treatment
Rare (may occur in 2% of procedures of this type)
- Incomplete satisfaction with the cosmetic effect
- MRSA colonisation (0.9% – 1 of 110)
- Intestinal infection by clostridium difficile (0.01% – 1 of 10,000)
- MRSA blood infection (0.02% – 1 of 5,000)
Hospital infection rates may be higher in high-risk patients, such as in cases requiring long-term drainage, after a previous infection, after prolonged hospitalisation or after multiple hospitalisations.
What should I expect when I return home?
When you are discharged from the hospital, you should:
- Get recommendations on recovery at home
- Ask when you can return to normal activities such as work, exercise, driving, housework and sexual activities
- Get a contact number for further questions after returning home or in case of trouble
- Ask about the date and place of subsequent check-ups (hospital or your doctor)
- Make sure you are aware of the reason, course and outcome of the surgery, the results of examinations or the removal of tissues or organs.
Upon discharge from the hospital, you will receive the procedure report. The document contains important information about your hospital stay, your surgery and recommended follow-up. If you need to call your attending physician or visit the hospital for any reason, take this document with you so that the physician knows the details of your treatment. This is especially important if you need to consult another doctor or longer after discharge.
You can return to work / normal activities if you feel well. Adults should avoid sexual contact for at least 2 weeks.
What else should I watch out for?
If you are unable to pull the foreskin or there are signs of repeated adhesions, contact your doctor/urologist.
Pull the foreskin over the glans, not towards the root of the penis. It could cause strangulation, swelling of the foreskin and glans, and then limit the ability of putting it back. In this case, consult a doctor/urologist as soon as possible.