What is circumcision? Why do we do it?

Circumcision is a surgical procedure that involves the removal of the foreskin, the fold of skin covering the head (glans) of the penis. It is commonly performed for religious, cultural, medical, or personal reasons. The procedure is typically done in newborns but can also be performed later in life.

Medical benefits may include a reduced risk of urinary tract infections, sexually transmitted infections, and certain penile conditions. However, like any surgery, it carries risks such as pain, bleeding, and infection. The decision to circumcise is often based on cultural beliefs, health considerations, or personal preference.

In our clinic we offer two different techniques to circumcision: the Plastibell and the Gomco techniques, respectively.

Plastibell Technique

The Plastibell technique is a common method of circumcision, particularly in newborns and infants. It involves placing a small plastic ring (the Plastibell device) over the head of the penis, underneath the foreskin. A suture is tied around the foreskin over the ring, cutting off blood supply to the foreskin. The excess foreskin is then trimmed, and the plastic ring remains in place until it naturally falls off within 5–10 days.

Benefits of the Plastibell Technique

✅ Minimally invasive: No stitches are required, reducing the need for additional interventions.
✅ Lower risk of bleeding: The tied suture helps prevent excessive bleeding.
✅ Predictable healing: The foreskin naturally separates without the need for additional surgical removal.
✅ Short procedure: The entire process typically takes 10–15 minutes.

Downsides of the Plastibell Technique

❌ Delayed separation: The ring may take longer to fall off in some cases, causing parental concern.
❌ Risk of infection: If the area is not kept clean, an infection may develop.
❌ Retention issues: In rare cases, the ring may not fall off properly, requiring medical intervention.
❌ Swelling or discomfort: Some babies may experience mild pain or swelling during the healing process.

Overall, the Plastibell technique is a widely used for neonatal circumcision, with a good cosmetic outcome and minimal complications when performed correctly.

Gomco Technique

The Gomco technique is a common method of neonatal circumcision that uses a Gomco clamp to remove the foreskin. It involves placing a metal bell-shaped device over the glans (head) of the penis to protect it, pulling the foreskin over the bell, and securing it with a clamp. The clamp crushes the foreskin to stop bleeding before the excess foreskin is surgically removed. The clamp is then removed, and the penis is left to heal naturally.

Benefits of the Gomco Technique

✅ Controlled bleeding: The clamp crushes the foreskin, sealing blood vessels and reducing bleeding.
✅ Clean surgical cut: Provides a neat and uniform circumcision with good cosmetic results.
✅ Immediate completion: Unlike the Plastibell method, no device is left behind; healing begins right away.
✅ Widely used and well-studied: One of the most commonly used techniques with a long track record of safety.

Downsides of the Gomco Technique

❌ Longer procedure time: Typically takes about 5–10 minutes longer than the Plastibell method.
❌ Higher risk of bleeding: Since the foreskin is cut immediately after clamping, there is a slightly higher chance of post-procedure bleeding.
❌ Requires careful technique: If the clamp is not applied correctly, there is a small risk of injury to the glans.
❌ Post-procedure care: The open wound requires gentle care, and there may be mild swelling or discomfort during healing.

Overall, the Gomco technique is a safe and effective circumcision method, commonly used due to its precise cut and good cosmetic results, though it requires careful technique and monitoring for bleeding.