Procedure during the operation

The extent of circumcision depends on the degree of phimosis, but also on the will of the parents or the patient. Circumcision can be performed radically, whereby the foreskin is completely removed, similar to religious circumcision rites. During the procedure, the foreskin is first detached from the glans and then tightened with the help of two tweezers.

In the next step, both layers of foreskin are separated with the scalpel. The inner and outer skin layers are then reconnected with absorbable thread. This usually falls off within the first 1-2 weeks.

However, this method is rarely mandatory for medical reasons, but is often chosen if circumcision was planned anyway for religious reasons in a child with phimosis. In this case one should pay attention to get the medical reasons well documented, in order to prevent later trouble with the health insurance company. If it is desired that the child’s foreskin is preserved as much as possible, a so-called extension plastic surgery is also possible.

However, this procedure is only possible if the phimosis is not too pronounced. In this procedure, no part of the foreskin is cut off, but rather an enlargement is created by means of a clever incision. For this purpose, the layers of the foreskin are cut in a V-shape or with several cuts, and then sewn together again in a staggered fashion.

This expands the diameter and the complaints disappear. It is particularly important that the foreskin is then pulled back daily. This works best in a sitz bath, e.g. with chamomile.

Another method is the plastic bark method. This method results in a partial circumcision. The foreskin is first cut and spread. Then a plastic bell can be pulled over the child’s glans and the edge of the foreskin tied to it with a thread.This stops the blood flow to the edge of the foreskin, so that it dies off by itself after about 8-10 days and falls off together with the plastic bell.