Product Summary: AMA rates
Opening of foreskin where a phymosis exists, yet foreskin preservation is a requirement. Also done initially with severe septic para-phymosis as interim procedure until sepsis is cleared and a circumcision is possible
Item Number: 30666, 18262, 105
Why is it done?
- Paraphymosis: Foreskin stuck behind head of penis.
- Foreskin preserving.
- An informed consent is required from the patient.
- Patients may not eat or drink from midnight the previous evening.
- Toddlers may still have feeds up to 6 hours before the procedure.
- Patients are to refrain from smoking before the procedure.
- Patients allergic to IODINE/CHLORHEXIDENE must clearly state this to theatre staff and Dr Schoeman.
- Any anti-coagulants such as Warfarin should be stopped 7 days prior to surgery.
- This is a day surgery procedure and can also be done under a penile Block (Local Anaesthesia).
How is it done?
- This is done under general anaesthesic or a penile block.
- A vertical cut is made through the tightest part of the para-phymosis and the foreskin is than able to be covered over the meatus.
- The incision is then closed by opposing edges in the horizontal plane.
- Disolvable sutures are placed between the 2 remaining edges.
- A local anaesthetic is injected into the base of the penis thus giving post-operative pain relief for the next 4-6 hours.
What to expect after the procedure
- Any anaesthetic has its risks and the anaesthetist will explain such risks.
- Bleeding is a common complication.
- With any subsequent erections post operatively, the sutures may pull out causing an opening of the wound with subsequent bleeding.
- An infection of the wound can occur if the dressings are left on too long.
- If the dressing has been applied too tightly, or if there is any discomfort, please remove the dressing immediately. If some hemorrhaging re-occurs, REDO the dressing!
- In very young patients, the foreskin may still be attached to the head of the penis, thus leaving a raw and red glans penis after surgery. Keep the affected area clean and apply ointment as prescribed.
- NB! Each person is unique and for this reason symptoms may vary!
- The dressing should be removed in a bath 48 hours after the procedure.
- The dressing should be soaked until it comes off with ease.
- The dressing may sometimes adhere to the wound causing slight bleeding on removal. Don’t panic the bleeding will stop.
- As soon as the dressing has been removed, Bactriban (or similar) ointment should be applied on the wound twice a day.
- This may not be required if the foreskin was not adhered to the glans penis.
- On discharge a prescription may be issued for the patient to collect.
- A follow-up appointment should be scheduled to see Dr Schoeman within 2 weeks.
- Please don’t hesitate to direct all pre-operative queries to Dr Schoeman’s rooms.
- PLEASE CONTACT THE HOSPITAL WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS.
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