It is important to provide the patient with adequate information about the procedure ahead of time. Specifically, the patient should be told about the risks of bleeding, hematoma formation, infection, inadvertent damage to the glans, removal of too much or too little skin, aesthetically unpleasing results and a change of sensation during intercourse. The patient should also be informed that, during the postoperative period, erections can cause pain and disruption of the suture line that may require replacement of the sutures. Full recovery following circumcision generally requires four to six weeks of abstinence from all genital stimulation and sexual activity.
The patient should also be reminded about the benefits of circumcision. If he has the procedure, hygiene will be simpler and may result in fewer local infections, resolution of phimosis and paraphimosis, and less risk of frenular tears and bleeding during intercourse.
Alternatively, if the patient elects not to have the procedure, he should be treated with conservative measures for these conditions (e.g., either oral or topical antibiotics, training in meticulous hygiene for patients with balanitis). Patients having a circumcision for recurrent balanitis should be free from infection before the procedure.
Preparation of the surgical site includes a thorough surgical scrub of the genital area with a povidone-iodine preparation. Shaving and clipping of the pubic hair should be avoided to minimize the possibility of infection. Sterile draping of the area should be used to identify the surgical field. An electrocautery unit should be available to provide hemostasis.