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Adult Circumcision

What is this procedure?Tap to read

The foreskin is the fold of skin covering the head of the penis.

Circumcision removes the foreskin. In adults it is most often done for a tight foreskin that will not pull back (phimosis), repeated infection or inflammation, or patient preference.

How it is done: after the prep, the surgeon numbs the penis with a local anesthetic block. The foreskin is removed, bleeding is controlled with cautery, and the skin edges are closed with dissolvable stitches.

Dressing: a light wrap (Kling and Coban) protects the area for the first day or so.

Key points

Supplies

Open

  • Circumcision set and minor set
  • Clippers
  • Straight mosquitoes ×4, straight Kellys ×2, Carmalts ×2
  • #15 blade
  • 3-0 Monocryl, FS-2
  • Lidocaine 1% plain (30 mL) and bupivacaine 0.25% plain
  • 12 mL Luer-lock syringe
  • Saline 500 mL
  • Bacitracin; 1" Kling; 1" Coban

Available in room, open only if asked

  • Razor
  • Lubricating jelly

Gloves

Anesthesia

  • General anesthesia with local block.
  • Surgeon injects a local block after the prep.
  • Local block: 1% lidocaine plain and 0.25% bupivacaine plain, mixed 1:1. No epinephrine.
  • Perioperative antibiotics: cefazolin (Ancef) 2 g IV, unless contraindicated.

Positioning

  • Supine.
  • SCDs on.

Prep and drape

Cautery

Specimen

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