Can be divided into two main categories :
1. traditional and clinical methods.
2. Age related such as infant, teen and adult
Circumcision without removing or excising the foreskin was
found in some parts of Africa. The more common method
traditionally used was complete removing of the foreskin. The
foreskin was gripped by either fingers or specially made
object (eg. wooden pincers).
The circumciser then pulled the gripper together with foreskin
so as to stretched out the skin. By using sharp knife, a cut
was made through the skin between the pincers and head of
penis. When the remain skin retracted, it produced a raw
circumferential cut area around the shaft of penis.
The active bleeding area was then rapidly covered by
powdered or herbs before applying clean cloth wrapping
around the cut area to prevent further bleeding. Almost all of
the traditional method did not use any anaesthetic agents.
These type of circumcision found practiced in Africa and
Traditional method has been practiced world wide before
the introduction of modern style surgery of suturing and
Because there was no application of anesthetics, thus the
preferable age for this type of circumcision would be above 10
years old. The older the better. Older boys can retract their
skin fully, and emotionally they are stronger.
Outcome : pain is certainly present. However due to the
expertised of the circumcisers and some ritual rites presents,
the pain can be very minimum.
Bleeding actively from the raw cut area is common.
Some may bleed continuously even after proper bandage.
Blood loss depend on age and size of penis. The elder boys
with bigger penis will loose blood more compare to younger
Healing period could take about 2 weeks to 1 month. Because
of the nature of the wound, the boy will have to minimize his
movements and activities. He may bedridden for 5 days to 2
Thus, the boy would depend a lot on the parents and
guardians to look after his daily requirement like taking bath,
eating and sleeping.
Limitations and problems from traditional circumcisions:
4. Bleeding, unless rapidly controlled, it may cause a
profound significant blood lost.
5. Healing time prolonged especially those of older children or
6. Immobility, patient was unable to freely moved as
movements or activities may caused bleeding and pain.
7. Cannot taking bath for some time until wound closure or
partial healing occurred
Thus to overcome and eliminate those problems above,
modern technique of circumision arise.
Although there are advantages and disadvantages of the
different modern technique available, they all contribute
much better outcome than traditional method.
The clinical methods
- reduced rate of injury to glans penis
- minimized and controlled bleeding better
- reduced rate of infection
- less pain or no pain at all with introduction of anaesthesia
- shortened the healing period
- patient can move, do his normal activities and even can
start to work as usual after circumcision.
1. Glans penis may accidently cut and injured
2. Pain during the procedure and few days to weeks after
3. Foreskin did not cut optimally. It may be cut too little or
The dorsal nerve of the
penis is the deepest division
of the pudendal nerve
Types of circumcision:
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