The dorsal nerve of
the penis is the
deepest division of the
Types of circumcision:
Can be divided into two main categories :
1. traditional and clinical methods.
2. Age related such as infant, teen and adult
Traditional method has been practiced world wide before the introduction of modern
style surgery of suturing and stitch.
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.
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. Most of
the traditional method did not use any anaesthetic agents.
This type of circumcision was practiced in Africa and Asia.
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. The foreskin of the
older boys can be retracted easily to expose the glans penis, and they are also
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
Healing period could take about 2 weeks to a 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 weeks.
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 methods:
1. Glans penis may accidently cut and injured
2. Pain during the procedure and few days to weeks after that.
3. Foreskin did not cut optimally. It may be cut too little or too much.
4. Bleeding, unless rapidly controlled, it may cause a profound significant blood lost.
5. Healing time prolonged especially those of older children or adult.
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
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
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