The surgical procedure, when the penis foreskin is removed is called a circumcision. Certain option of this procedure is so-called Burian plastic surgery, when the foreskin is removed only partially.
Men undergo the mentioned procedure because of several reasons. One of them can be a religious or ritual reason, when the foreskin is removed totally and the glans penis stays completely bared after the surgery. The surgical procedure is very simple.
Another reason could be medical problems, so it means a functional defect. In this case we talk about a surgery of phimosis, when it is impossible to retract the foreskin over the glans to the root of the penis; or about the surgery of paraphimosis, when the foreskin cannot be pulled back over the glans penis. It could be caused by narrowing of the foreskin flap from different reasons (inflammation, trauma). In these cases we usually perform so-called Burian plastic surgery. The principle of this surgery is to remove only the narrow part of the foreskin and to turn the skin wedge of outer foreskin side to the dent of the inner foreskin side. This procedure has bigger requests on the experience and accuracy of the surgeon.
The motives for the above mentioned surgery are represented only very rarely by esthetic reasons.
We perform these procedures in any age group; the most frequent reasons in children are medical problems. The surgeries can be performed either under local or general anesthesia, it depends only on the patient’s decision. In children the general anesthesia is more suitable.
In case of local anesthesia, if the client is healthy, it is not necessary to have a pre-operational internal examination neither the laboratory examination. The surgeries under local anesthesia can be performed as out-patient procedures, without the need of hospitalization.
It is necessary to have pre-operational internal examination in case of the procedure under general anesthesia and also at least several hours’ hospitalization.
Getting ready for the surgery, as before any other surgery, involves taking a shower of the whole body and especially the hygiene of the operated area. The actual surgical procedure lasts between 45 to 75 minutes. The wounds are sutured with the absorbable material. After the surgery it is necessary to follow several principles for faster healing and for reduction of the extent of swellings and hematomas. To such principles belong cooling of the operated area with gel packs and a calm mode for at least 2, better 4 weeks. It is also possible to take enzymatic medicine, although it is always necessary to talk to the surgeon about their applicability already before the surgery, during the consultation. We recommend not to take a bath during wound healing, only to take a shower. The wounds are healed within 2-3 weeks, it is necessary to keep a total sexual abstinence.
As in any other procedure, even after this procedure complications may occur. The most frequent are bleeding, eventually creation of hematomas of different size. Another possible complication may be an eruption of sutures to partial rupture of the wound. These complications are usually a consequence to bad keeping of the calm mode after the surgery. An immediate check-up is always necessary, treating these complications is usually not difficult and it prolongs the healing process only for a few days.
An author: Josef Hrbaty, M.D.