Male circumcision is the surgical removal of the foreskin from the penis. It is performed for several medical reasons including recurring infections, phimosis, and reducing the risk of sexually transmitted diseases. Pre-operative care involves informing and counseling the patient or parent, obtaining consent, and instructing them to empty their bladder. Post-operative care consists of administering analgesics and antibiotics to prevent infection, keeping the wound clean and dry, and avoiding strenuous activities. Complications can include excessive bleeding, infection, surgical mistakes resulting in loss of the penis or glans, and even death.

1. MBALIZI HEALTH SCIENCE
INSTITUTE
CODE : NMT 06210:
COURSE: Care of Patients with Reproductive Surgical
Conditions
TOPIC: Nursing care of undergoing male circumcision
MR MICHAEL NDABILA

2. NURSING CARE
OF UNDERGOING
MALE
CIRCUMCISION

3. Objectives
• At the end of this session each student will be
able to;
• Define circumcision
• Identify the indication for male circumcision
• Give pre and post circumcision care
• Explain complications of male circumcision

4. • Circumcise means cut around. Male
circumcision is the surgical removal of the
foreskin-which is the retractable fold of tissues
over the head of penis (glans penis). This is
surgical procedure that ideally should be done
by qualified urologists but in most of
circumstances it can be done in most settings
by other well trained health professionals i.e.,
medical doctors or Ngariba, in Swahili.

5. Indications of Male Circumcision
• Scarring of the foreskin that stops it from
retracting (phimosis)
• Recurring inflammation or infections of the
penis (balanitis or lichen sclerosis)
• Recurrent urinary tract infections.
• To reduce the risk of sexually transmitted
diseases

6. Pre and Post Circumcision
Preoperative care
• For adult circumcision
– Inform the patient about the procedure and reassure to
allay anxiety
– Educate the patient about the benefits of the procedure
– Give the patient sexual reproductive services including:
• Screening and treatment for sexual transmitted
diseases
• Counseling and testing for HIV
• Family planning education
• Counseling on gender issues like promotion of respect
for woman and young girls
• Education about cancers of the male reproductive
organs like penile and prostate cancers

7. • Obtain consent
• Instruct the patient to empty bladder before
the operation
For infant circumcision
– Obtain consent from the parent or guardian
• Explain to the parent or guardian about the
procedure

8. • Post operative care
• For adult circumcision
– Give analgesics as prescribed
– Give antibiotics to prevent infection
– Instruct the patient on the following
• They should keep the wound clean and dry
• They should wear loose closes
• They should avoid strenuous activities at home

9. • Instruct the patient to return back to the
hospital in case of the following
• Continous bleeding from the wound
• Swelling of the penis
• Formation of large blood clots under the skin
near the wound

10. • For infant circumcision
– Give analgesics as prescribed
– Give antibiotics to prevent infection
– Instruct the mother on how to care for the baby
– Instruct the mother to bring the baby back to the
hospital in case of the following
• Continous bleeding from the wound

11. Cont.….
• Swelling of the penis
• Formation of large blood clots under the skin near the
wound
• Puss coming out of the penis

12. Complications of Male circumcision
Immediate complication
• Excessive bleeding especially in hemophiliacs
etc.
• Infection
• Complications from anesthetics administered
• Surgical mistakes, including loss of glans and
loss of entire penis
• Death

13. Note:
Late complication
• Extensive scarring
• Skin tags and skin bridges
• Tearing and bleeding at the scar
• Curvature of the penis
• Tight, painful erections
• Difficulty ejaculating
•

14. Evalution
• : Key Points
• Male circumcisions the surgical removal of some
or all of the foreskin (or prepuce) from the penis
(Bare Penis)
• Complications includes :
– Excessive bleeding especially in hemophiliacs etc.
– Infection
– Complications from anesthetics administered
– Surgical mistakes, including loss of glans and loss of
entire penis
– Death

15. • What are the indications of male
circumcision?
• What are the preparations before male
circumcision?
•

16. References
• Auvert, B., Taljaard, D., Lagarde, E., Sobngwi-
Tambekou, J., Sitta, R., & Puren, A. (2005).
Randomized, controlled intervention trial of male
circumcision for reduction of HIV infection risk:
the ANRS 1265 Trial. PLoS medicine, 2(11), e298.
• Gray, R. H., Kigozi, G., Serwadda, D., Makumbi, F.,
Watya, S., Nalugoda, F., ... & Sewankambo, N. K.
(2007). Male circumcision for HIV prevention in
men in Rakai, Uganda: a randomised trial. The
Lancet, 369(9562), 657-666.