Circumcision Surgery in Pune: For Phimosis and Foreskin Problems

What is circumcision?

Circumcision is the surgical removal of the foreskin (prepuce), the retractable fold of skin that covers the head of the penis (the glans). It is one of the oldest operations, done for medical, religious and cultural reasons.

Who may benefit, and how is it assessed?

In men, common medical reasons include:

• Phimosis: a tight foreskin that cannot be pulled back, causing pain, splitting, difficulty with hygiene or pain during sex, which has not improved with steroid cream.
• Recurrent balanitis or balanoposthitis: repeated infection or inflammation of the head of the penis and foreskin.
• Paraphimosis episodes: a foreskin that gets stuck behind the head of the penis.
• Lichen sclerosus (also called balanitis xerotica obliterans): a scarring skin condition of the foreskin.
• Personal, religious or cultural reasons.

In boys, a non-retractable foreskin is usually normal and loosens with age. Circumcision is considered for scarring, repeated infection or difficulty passing urine.

At consultation the doctor asks about symptoms, previous treatment and conditions such as diabetes, which can cause foreskin problems and affect healing. The penis is examined, with your consent, to check the foreskin, the glans and the urinary opening.

What are the treatment options?

Option	Suits	Points to consider
Steroid cream	Mild to moderate phimosis	Several weeks of use; may recur
Treatment of infection and hygiene advice	Balanitis	Diabetes and skin conditions checked
Preputioplasty	Phimosis in men who wish to keep the foreskin	Foreskin kept; tightness can return
Circumcision	Phimosis not responding, recurrent infection, lichen sclerosus, personal choice	Permanent removal; a few weeks of healing

How is circumcision performed?

1. Anaesthesia: a local anaesthetic block numbs the penis in most adults; general anaesthesia is used for children.
2. Marking: the amount of foreskin to remove is marked so the result is even.
3. Removal: the foreskin is removed, and bleeding vessels are sealed.
4. Closure: the edges are joined with fine dissolvable stitches.
5. Dressing: a light dressing is applied, and you go home the same day once you have passed urine.
6. Laboratory examination of the foreskin if a skin condition is suspected.

How should you prepare, and what should you ask?

• Treat any active infection first.
• Tell the doctor about diabetes, blood thinners and bleeding problems.
• Wear loose cotton underwear and comfortable trousers on the day.
• Arrange about a week off work.

Questions to ask:

• Could steroid cream or a foreskin-preserving operation work for me?
• Which technique will you use?
• How do I look after the wound, and when can I shower?
• When can I return to sport and sex?

What is recovery like?

Time	What to expect for most patients
Days 1-3	Swelling, bruising and sensitivity; painkillers; loose underwear
About 1 week	Return to desk work for many
Weeks 1-3	Stitches dissolve; swelling settles
About 2 weeks	Avoid cycling, swimming, sport and heavy lifting until at least this point
Weeks 4-6	Healing complete; sex and masturbation once fully healed

What are the risks?

• Bleeding, usually minor; occasionally a return to theatre.
• Infection.
• Swelling, which can last a few weeks.
• Changed sensation of the head of the penis.
• Narrowing of the urinary opening (meatal stenosis), more likely with lichen sclerosus.
• Cosmetic concerns, such as uneven skin.
• Anaesthetic risks, low with local anaesthesia.

Contact the doctor for increasing pain, redness, discharge, fever, persistent bleeding or difficulty passing urine.

What results can you expect?

Most men heal well within four to six weeks, with relief from the problems that led to surgery. The scar lies just behind the head of the penis and usually becomes inconspicuous.

Is circumcision necessary, and what are the alternatives?

Circumcision for personal or religious reasons is a choice, and there is no medical urgency. For foreskin problems, it depends on the cause. In boys under about five, a foreskin that will not pull back is normal and usually separates by itself, sometimes not fully until puberty, so waiting is safe unless there is scarring, repeated infection or difficulty passing urine. In adults, a tight foreskin left untreated can keep splitting, make cleaning difficult, cause painful erections or sex, and lead to repeated balanitis. Lichen sclerosus can slowly scar the foreskin and narrow the urinary opening, so it should not be ignored. The non-surgical and foreskin-saving options in the table above are reasonable first steps for many men.

Common myths about circumcision

• “A boy’s foreskin must be pulled back from infancy to keep it clean.” Forcing it back can be painful and cause damage; it separates naturally with time.
• “Circumcision is only a religious practice.” It is also a medical treatment for phimosis, repeated infection and lichen sclerosus.
• “Adults are too old to be circumcised.” Adult circumcision is a routine day-care operation, usually done under local anaesthesia.
• “A tight foreskin always needs an operation.” Many cases of adult phimosis improve with a course of steroid cream, and surgery is considered if they do not.

What affects the cost of circumcision surgery in Pune?

• Age: children usually need general anaesthesia.
• Reason for surgery, such as scarring from lichen sclerosus, which can make the operation more complex.
• Technique and anaesthesia.
• Facility, medicines and follow-up visits.

Circumcision for a medical reason such as phimosis may be covered by health insurance; circumcision for personal reasons usually is not.