Adult circumcision in the Greater Montreal Area and Quebec City


Adult circumcision in the Greater Montreal Area and Quebec City

Approximate time60 min

Circumcision is the surgical removal of the skin covering the tip of the penis. This procedure can be performed on males of all ages. In male adults, circumcision is typically used to treat medical issues such as phimosis, a condition in which the foreskin is too tight to retract past the head of the penis. Phimosis is generally caused by chronic inflammation of the foreskin or an infection in the foreskin. This occurs frequently among diabetic men.

Circumcision may also be used to treat penile lichen sclerosus, a disorder in which the foreskin becomes thick and hard and develops a whitish colour.

Circumcision is also used to treat certain sexual problems, such as a hypersensitive glans or chronic pain from untreated skin problems. Lastly, men may get circumcised for personal, religious or cosmetic reasons.

uncircumcised penis
 penis circumcised

Why should you choose Cliniques Marois for your circumcision?

Cliniques Marois in the Greater Montreal Area and Quebec City has operating rooms specifically designed for minor surgeries. Every room is equipped with all the necessary technologies and instruments. These operating rooms conform to the Collège des Médecins du Québec standards.

Our urologists are experienced surgeons and are qualified to perform distinct types of circumcision techniques based on your anatomy and the complexity of any underlying conditions. Moreover, they place particular importance on the cosmetic outcome of the surgery. They use circumcision techniques that deliver a more esthetically pleasing result than the standard method (closure with interrupted sutures). Most patients also desire a satisfying esthetic result.

After the circumcision, patients are given detailed post-operative instructions and are provided with follow-up care from a nurse.

What are the 2 types of circumcisions?

An adult male circumcision can be complete or partial.

Complete circumcision
A complete circumcision is when the glans is left exposed, and no foreskin remains.

Partial circumcision
A partial circumcision is when some foreskin and preputial mucosa remains on the penis to protect the glans. While partial circumcision is always an option, it should be noted that, compared to a complete circumcision, it doesn’t provide the same level of protection against sexually transmitted diseases such as HIV and balanitis. Both types of adult circumcision are beneficial for hygiene.

What are the different circumcision styles?

The esthetic outcome is determined by which wound closure technique is used: sutures or glue.

The patient can choose between these options:

Tight or loose
A circumcision can be tight or loose. The amount of foreskin removed during the procedure determines how tight the skin covering the penis will be when flaccid and erect.

In a loose circumcision, less foreskin is removed. As a result, the skin on the penis remains somewhat loose when flaccid and erect.

In a tight circumcision, more foreskin is removed. Therefore, the skin on the penis is tight when flaccid and erect.

High or low
Whether a circumcision is high or low depends on how much of the preputial mucosa is removed and, therefore, how close the circumcision line is to the glans. In a high circumcision, the circumcision line is closer to the glans. In a low circumcision, it’s further from the glans.

These different techniques can be combined.

For example, in a high and tight circumcision, the skin on the penis will be tighter when flaccid, and the circumcision line will be near the glans. With this method, the patient may feel a small amount of discomfort when their penis is erect.

In a low and tight circumcision, the skin on the penis is tight when flaccid and the circumcision line is much further from the glans.

In a high and loose circumcision, the foreskin is completely pulled back past the glans, and a smaller part of the mucous membrane remains. There isn’t any tension when the penis is flaccid or erect.

In a low and loose circumcision, the circumcision line is further down the shaft, and the mucous membrane is intact. There isn’t any tension when the penis is flaccid or erect. This is a partial circumcision.

Which type of circumcision is best?

Based on more than twenty years of experience, our urologists recommend that younger patients get a complete circumcision.

It’s up to the patient to carefully reflect on their decision and discuss the available options at their initial appointment. If the patient doesn’t have a preference or is unsure, our urologists recommend a circumcision that’s midway between high and low and loose and tight.

If the foreskin is affected by a severe medical condition, circumcision options may be limited. Our urologists can provide their expert medical opinion during the first appointment.

What can a patient expect during a circumcision?

The patient will be placed on their back, and a screen will be pulled in front of their head to prevent them from seeing what’s happening during the procedure. The patient will then be administered a local anesthetic. The medical staff will disinfect the surgical site and apply surgical drapes. The team will ensure the anesthetic is effective before the procedure begins. If needed, additional anesthetic will be administered.

Various instruments may be used to ensure the excision is perfectly circular. Bleeding is stopped using electrocauterization, and the frenulum of the glans is generally cut.

The incision can be closed with surgical glue. This is considered the most esthetically pleasing option. Unlike skin sutures, it produces no secondary scarring. However, this surgical wound closure technique is only possible when the edges of the skin can be perfectly aligned.

Once the circumcision is complete, a circular compression bandage will be applied to the area. Polysporin is generously applied to the area to ensure the bandage doesn’t stick to the surgical wound.

How is the anesthetic administered?

Receiving the local anesthetic is the most unpleasant part of an adult circumcision. However, the discomfort only lasts for about 15 seconds. This is a critical step that allows the procedure to go smoothly.

First, an anesthetic cream is applied to the penis and, if possible, the glans as well. Next, an anesthetic is administered through an injector that distributes the anesthetic liquid through the skin under high pressure. The patient will feel a pinching sensation, like being snapped by an elastic band. Several injections of this kind are given around the base of the penis. This anesthetic dramatically reduces the discomfort of receiving the local anesthetic.

Next, the local anesthetic is administered using a technique called a dorsal penile nerve block. This involves injecting a combination of anesthetics under the skin around the base of the penis. The surgeon will then wait about 12 minutes before proceeding with the circumcision. After this time, the dorsal penile nerve block will be optimally effective.

In response to numerous patient requests, we now offer the possibility of same-day consultation and adult circumcision. This allows patients who have travelled for the circumcision to save time and money. Same-day circumcisions are performed under local anesthesia. If you want to receive general anesthetic, same-day consultation and circumcision aren’t possible. Over 90% of our patients opt for a circumcision under local anesthesia. If you’re concerned about the cost of the procedure, you can rest assured it’s the best value for a high-quality circumcision performed by an experienced urological surgeon.

What if I choose not to go ahead with the circumcision?

The choice of whether to get the procedure is yours. If you change your mind following the consultation, this isn’t a problem. Alternatively, you can choose to undergo the circumcision on another day or take more time to think about the decision.

Contact us for more information or to schedule an adult circumcision at a private clinic in Laval, on the South Shore or in Quebec City.

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Prepare for the procedure.How to prepare for an adult circumcision

The day before the procedure
The area around the penis must be shaved.
The day of the procedure
We recommend that the patient be accompanied and avoid drinking coffee or taking other stimulants the morning of the circumcision.

Patients who are particularly nervous or who have experienced vagal shock before should advise our nursing staff beforehand. They’ll be given medication before the procedure.

We also recommend bringing headphones and a music player, such as an iPhone or iPod, to help you relax during the procedure.

RecommendationsPost-operative recommendations for adult circumcision

The day of the procedure
Take 650 to 1,000 milligrams of Tylenol for the pain every 4 hours. You can also take a prescription painkiller if you’re still in pain.
The week following the procedure
Change the Kling bandage (rolled bandage) and apply Polysporin (not cream) to the area once a day for 7 days after showering and as needed during the second week. If the Kling bandage falls off on its own after the procedure, don’t worry. It can be replaced. If the bandage is too tight and prevents you from urinating, you must undo it and wrap it less tightly. Avoid physical activity for one week.
1 month following the procedure
We highly recommend continuing to apply a rolled bandage to the area at night during the second and third weeks to avoid traction on the wound by nocturnal penile tumescence.

Take 10-minute baths starting in the second week to help dissolve the sutures.

If surgical glue was used to close the wound, the glue crust will fall off on its own after about 10 days. It often falls off completely without issue. Take short showers to avoid excess moisture. Baths are only allowed when there’s no more glue crust.

Avoid sexual activity for at least 1 month.
2 months after the procedure
We will schedule a follow-up appointment 2 months after the procedure.

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Would you like to make an appointment, or do you have any questions? Write to us and we will get back to you as soon as possible!

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