Preputioplasty

Specialty of Paediatric urology

What is preputioplasty?

Preputioplasty is a surgical procedure sometimes performed on a child’s foreskin in order to widen it should it not retract (pull back).  A tight foreskin can be released or treated through either circumcision or preputioplasty. Circumcision removes the foreskin while preputioplasty releases the foreskin.

Why is preputioplasty done?

A foreskin which does not pull back can cause recurring infections, and be painful. Your doctor will best advise on the method of retraction, but a preputioplasty may be indicated as it allows the child to keep an uncircumcised appearance, but frees the area underneath the foreskin, meaning it can be kept clean.

How is preputioplasty performed?

The procedure is generally performed under general anaesthetic, meaning your child will be asleep for the surgery. A longitudinal incision (down the foreskin) is made in the end of the foreskin to release the constricting ring of tissue in it. This is then closed and stitched. In some cases, more than one incision may be made.

Before the procedure

Before the surgery your child will need a pre-assessment appointment and the surgery date will be set. This appointment usually happens about a week before the procedure itself, and it is important to ask any questions you might have about the surgery, or questions your child might want to ask. After you have talked through the procedure, you will have to sign a consent form for your child.

Aftercare

The operation is typically performed as a day case, meaning your child can be at home the same day of the procedure. Loose clothes are a good idea to bring, as they will be more comfortable for your child after the surgery. If your child feels any pain in the days following, they can be given an anaesthetic gel to numb the area where the stitches were made. Follow your doctor’s directions for medication and application.

After the surgery you will need to encourage your child to retract his foreskin every day for a period of about six weeks, so the foreskin does not close again. This can be done during bath time. It is normal for this to be painful for your child for a few days afterwards, so encourage and praise them throughout. Make sure your child keeps as clean as he can, even bathing twice daily if possible. Baths can be given on the second day following the operation.

Stitches will dissolve on their own and you should keep your child off school or nursery for about a week after the operation. He will also not be able to play sports for two to three weeks after surgery.

Finally, a follow-up appointment will be scheduled about six weeks later, in order to check progress and assess the foreskin.

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