Circumcision at Meadowbank Medical Centre (MMC) and what you need to know

NP Ariane Araquel-Lacamiento
5 min readJun 29, 2024

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What does this procedure involve?

The procedure involves the removal of the foreskin. It is usually performed for one or more of the following reasons:
- a tight, non-retractile foreskin — known as phimosis
- recurrent infections under the foreskin — known as balanitis
- skin disease on the foreskin and glans (head of penis) — such as chronic inflammation
- large warty lesions of the foreskin
- cancerous or pre-cancerous lesions of the foreskin; or
- for cultural/religious requirements

During the Initial Appointment

— You will complete a health questionnaire and genital assessment (photos taken before, after, and at 3 or 4 weeks).
— Your clinician explains the procedure, preparation, risks, and benefits.
— A short-term topical steroid cream for phimosis will be given if you have not decided to proceed with circumcision just yet.
— You can book a circumcision date after the appointment or call later. (Fees apply for additional consultations.)

Important Notes:
— Smokers, diabetics, or pre-diabetics have a higher risk of infection and slower wound healing.
— Consult your GP about smoking cessation and blood sugar control before the procedure.

Before the procedure

  • You will be advised to wear supportive briefs and comfortable trousers on the day of the procedure. (well-fitted, not too tight or too loose)
Examples of supportive briefs: refer to images with check marks.
  • It is preferable to shave/trim your pubic hair before the circumcision day.
  • Have a shower before your circumcision procedure. Do not apply any lotion, cream or moisturiser to the genital area and between your legs.
  • If you are taking certain blood thinners and herbal supplements, your clinician will advise you to stop taking them before the procedure and when to resume taking them.

On the day of Circumcision

  • Your clinician will briefly review your history and medications and discuss the surgery again to confirm your consent. If you are having a local anaesthetic, this will also be explained to you at this stage.
  • A local anaesthetic agent will be injected at the suprapubic area and around the base of the penis before the procedure to numb the area and provide post-circumcision pain relief.
Injection of local anaesthetic agent. From WHO Manual of Circumcision
  • The penis and surrounding area will be cleaned with a betadine solution. If you are allergic to betadine/iodine, please inform your clinician before the circumcision.
  • Once the area is numb, the clinician will make a circular incision in your foreskin at a level just below the head of the penis and remove the whole foreskin; this leaves the glans (head of the penis) completely exposed.
Circumcision procedure. From baus.org.uk
  • Dissolvable stitches will be used to attach the skin of your penis to below your glans; these stitches usually disappear within two to three weeks.
  • The area will be cleaned to remove the betadine solution, and dressings will be applied to cover the wound and expose the head of the penis.

After the Circumcision

A follow-up will be scheduled 3 weeks after circumcision for wound check.

You are expected to follow these measures to avoid complications and delayed healing of the circumcised penis:

Dressings: Keep on for 48 hours, then remove. Ensure the opening for urination is exposed. Keep dry; if soaked, remove.
Stitches: Will dissolve in 2–3 weeks. You may see bits in your underwear.
Care: Keep the area dry. The exposed glans may scab. Apply Chlorsig ointment twice daily to aid healing and reduce sensitivity. Continue until the tube is finished.
Clothing: Wear loose-fitting clothes for 2–3 days. Continue wearing your supportive underwear.
Restrictions: No sexual activity, spa, or bath for 6 weeks. Keep showers short and dry the area before applying ointment.
Erections: Expect normal erections; initial tightness is normal and will improve over a few months.
Pain Relief: Use paracetamol or ibuprofen as needed. You’ll receive a prescription before leaving.
Antibiotics: Start immediately if prescribed and finish the course (usually 7 days).
Swelling and Bruising: Normal for several days.
Appearance: It may take up to 6 weeks for the final cosmetic appearance. Sensitivity will decrease after the first 2 weeks, but overall sensitivity will be slightly less than before.
Ejaculation and Fertility: Unaffected by the procedure.
Follow-Up: Inform the receptionist if you want your GP to receive the operation notes.

Driving after Circumcision

If your procedure is done under local anaesthetic, you may drive yourself home after the procedure. If you are unsure whether you can drive yourself home, please arrange for a designated driver to bring you home after the procedure.

Risks and Complications

The surgical risks and complications of circumcision, which may happen during or immediately after the include:

Risks and complications of Circumcision. From baus.org.uk

Other complications include:
- irritation of the glans penis (head of the penis)
- meatitis (inflammation of the opening of the urethra)
- injury to the penis
- excess foreskin (this may require re-excision of foreskin after healing)
- adverse reaction to the anaesthetic used during the circumcision.

These complications are rare when circumcision is performed by well-trained, adequately equipped, experienced healthcare personnel and are usually easily and rapidly resolved. Data from controlled trials show that fewer than 1 in 50 procedures result in complications (from WHO Manual for male circumcision, 2018).

Costs

Initial Appointment:
$90 — Adults (16 years old and above)
$45 — Children (10 to 15 years old)

Extra Appointments before Circumcision:
$90 — Adults (16 years old and above)
$45 — Children (10 to 15 years old)

Circumcision/Frenuloplasty Procedure under local anaesthesia:
$900— Adults (16 years old and above)
$500— Children (10 to 15 years old)

3-Week Follow-up Appointment:
$90 — Adults (16 years old and above)
$45 — Children (10 to 15 years old)

Extra Appointments after 3-Week Follow-up:
$90 — Adults (16 years old and above)
$45 — Children (10 to 15 years old)

** Fees as of June 2024. Fees may be subject to changes. Please confirm with MMC reception before booking your initial appointment.

Contact Meadowbank Medical Centre if you would like to inquire about Circumcision/Frenuloplasty and book an appointment. Visit https://www.meadowbankmedical.co.nz/ for contact details.

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NP Ariane Araquel-Lacamiento
NP Ariane Araquel-Lacamiento

Written by NP Ariane Araquel-Lacamiento

Nurse Practitioner in Aotearoa (New Zealand) 🇳🇿 Specialising in Adult Urology and General Practice

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