Adult Circumcision in the Greater Montreal and in Quebec

Dr. Marois’ urology clinics in Greater Montreal and Quebec City include operating rooms designed for minor surgeries and equipped with all the necessary technologies and apparatuses. These operating rooms conform to the standards established by the Collège des Médecins du Québec.

Dr. Marois is an experienced urologist and urological surgeon. He’s qualified to perform various circumcision techniques and can therefore provide you with the most appropriate procedure based on your anatomy and the complexity of any underlying conditions.

Dr. Marois is a careful surgeon and he places great importance on the cosmetic outcome of his surgeries. He therefore favours circumcision techniques that deliver a more esthetically pleasing result than the standard method, which requires closure with interrupted sutures.

The majority of circumcision patients also desire an esthetic result. After the circumcision surgery, patients are given detailed postoperative instructions and are provided with follow-up care from a nurse.

An adult male circumcision can be full or partial.

Full circumcision :
Patients can get a full circumcision, in which the glans is left wholly exposed and no amount of foreskin remains.

Partial circumcision :
Alternatively, patients can get a partial circumcision, in which some foreskin and preputial mucosa remains on the penis, offering protection to the glans. While partial circumcision is always an option, it should be noted that, compared with a full 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 wound closure technology will be favoured: threads or glue?

“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. Subsequently, 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.

The various techniques can be combined:
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. This presents a risk of the patient feeling a small degree of discomfort when his 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 is retained. 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 conserved. There isn’t any tension when the penis is flaccid or erect. This corresponds to a partial circumcision.

Based on his 20 years of experience, Dr. Marois recommends that younger patients get a full circumcision.

It’s up to patients to carefully reflect on their decision and discuss the available options with Dr. Marois at the initial appointment. For those with no preference or who are unsure, Dr. Marois recommends a circumcision that’s midway between high and low and loose and tight.

In a case where the foreskin is affected by a severe medical condition, circumcision options may be limited. Dr. Marois will be able to provide a medical opinion during the first appointment.

As the procedure begins, the patient will be placed on his back, with a screen in front of his head that prevents him from seeing what’s happening. After administering the local anesthetic, the surgeon will disinfect the surgical site and lay down surgical drapes. The anesthetic is always checked before the operation begins. If needed, additional anesthetic is provided.

When the circumcision is meant to treat a medical issue, the circumcision technique may vary, depending on the nature of the problem. Obtaining the best possible result is always a priority. However, only recognized techniques are employed. Various instruments may be used to ensure that the excision is perfectly circular. The bleeding is stopped using electrocauterization. The frenulum of the glans is generally cut.

Closing the skin can be done with a surgical glue and is considered the most esthetically pleasing option. Unlike a skin suture, it produces no secondary scarring. This surgical wound closure technique is only possible when the edges of skin can be perfectly aligned.

Once the circumcision procedure is complete, a circular compression bandage is applied to the area. In addition, Polysporin is liberally applied to ensure that the bandage doesn’t stick to the surgical wound.

Receiving the local anesthetic is the most unpleasant part of an adult circumcision. However, it’s a very short moment of discomfort that only lasts for about 15 seconds. It’s, moreover, a critical step that allows the surgery to proceed smoothly.

First, an anesthetic cream is applied to the penis and, if possible, to the glans as well. Next, a topical anesthetic is administered through an injector that distributes the anesthetic liquid through the skin, under high pressure. The patient feels a pinching sensation, similar to being struck by an elastic band. Several injections of this kind are given around the circumference of the base of the penis. This anesthetic greatly 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 to begin the circumcision. This is the moment when the dorsal penile nerve block is optimally effective.

In response to numerous patient requests, we now offer the possibility of same-day consultation and adult circumcision. This allows patients who’ve travelled from distant locations for the circumcision to save time and money.

Same-day circumcisions are performed under local anesthetic. If you wish to receive a general anaesthetic, same-day consultation and circumcision isn’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 that it’s the best value for a high-quality circumcision performed by an experienced urological surgeon.

Your safety and well-being is our topmost concern. We’re able to perform same-day adult circumcision procedures for patients who are in good health, have no major medical problems and aren’t taking blood thinners.

In addition, the patient can’t have any infection in the groin or penis area. Patients should be aware that a same-day consultation and circumcision will not be performed if Dr. Marois judges that it isn’t wise to do so. However, the majority of patients are able to get the circumcision immediately after the consultation, as scheduled.

In some cases, patients come for a same-day consultation and circumcision and, following the examination, Dr. Marois decides that circumcision isn’t the most appropriate treatment. In such a scenario, patients only have to pay the consultation fee.

The choice of whether or not to get the procedure is your own. 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 consider the decision.

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