Phimosis and circumcision

What phimosis is

Phimosis is a narrowing of the foreskin that often makes it impossible to retract it behind the coronal sulcus. It can be congenital or acquired - most often as a result of chronic inflammation.

It makes hygiene and intercourse difficult, promotes recurrent infections and, left untreated, increases the risk of developing penile cancer. It is a problem worth resolving - the procedure is short and effective.

What qualification involves

At the consultation I assess the degree of narrowing and the condition of the foreskin, we discuss the options for the procedure (foreskin-sparing plasty or full circumcision) and your aesthetic and functional expectations. Together we choose the scope of the operation.

How the procedure works

The procedure involves excising the narrowing scar and performing a plasty (widening) of the layers of the foreskin or - depending on the indications and the patient's decision - a full circumcision. It is carried out under local anaesthesia, on an outpatient basis; you go home the same day.

The procedure can also be performed under general anaesthesia - at the patient's request, when it is accompanied by strong anxiety or marked hypersensitivity of the penile area. General anaesthesia is also required in more complex situations: after earlier, unsuccessful procedures, or with adhesions between the foreskin and the glans following past inflammation, which may call for a larger reconstructive procedure. I perform such operations at Szpital na Klinach, a hospital in Kraków; the stay lasts about a day - discharge the day after the procedure - and involves a markedly higher cost.

I perform circumcision using two methods: the conventional one and a stapler - a single-use device that in one movement cuts off a section of the foreskin and closes the edges with metal staples. The stapler gives the surgeon less control over the line of the cut and requires the staples to be removed after about 2 weeks; in more complex cases conventional circumcision is decidedly the better solution. In comparative studies the stapler is associated with a shorter procedure time and less blood loss - which in circumcision is small in any case - and the cosmetic assessment comes out comparable or slightly better; the result, however, depends mainly on individual healing. My preference is conventional circumcision.

With every phimosis operation and circumcision I also perform a plasty of a short frenulum.

Recovery

For about 2 weeks - until the stitches come out - you should limit physical activity and abstain from intercourse. I provide detailed wound-care instructions after the procedure.

The sutures are absorbable - they start to fall out about 2 weeks after the procedure and do not need to be removed. Full healing of the wound takes 4–6 weeks; during that time intercourse is not allowed, and you should avoid swimming pools, saunas and dirty environments. For physical work - especially in a dirty environment - the break from work should be at least 3–4 weeks.

Short frenulum

A short foreskin frenulum is a separate problem - some patients have no phimosis, only a frenulum that is too short, which becomes taut and tears during intercourse. Frenuloplasty is a short, practically painless procedure under local anaesthesia: first I apply an anaesthetic cream, then give an injection that is no longer felt. I divide the frenulum with a laser or surgically; after the laser procedure sutures are usually not needed. You will find the prices of both variants in the pricing section below.

Possible complications

The most common complications are bleeding, a local haematoma, wound infection, wound dehiscence and secondary narrowing. They occur rarely; we discuss how they are managed during qualification.

Price of phimosis surgery and circumcision in Kraków

Phimosis surgery and circumcision cost PLN 3,000. The qualification consultation that precedes the procedure is charged separately (PLN 350).

• Qualification consultation - PLN 350, ultrasound included in the visit when needed
• Phimosis surgery - PLN 3,000, local anaesthesia included
• Conventional circumcision - PLN 3,000
• Stapler circumcision - PLN 3,500, stapler included
• Plasty of a short frenulum - PLN 1,500
• Plasty of a short frenulum with a CO₂ laser - PLN 2,000
• Payment by cash, card, BLIK or bank transfer · invoice on request
• Private visits, not covered by the Polish NFZ

The full list is on the pricing page.

Where I treat phimosis and perform circumcision in Kraków

I perform the procedure at Andromeda Centrum Medyczne on ul. Mogilska 69A in Kraków - the Grzegórzki district, 31-545 Kraków. Procedures under local anaesthesia are done on site, in the treatment room, with no hospital stay. Procedures under general anaesthesia - at the patient's request or in more complex cases - I perform at Szpital na Klinach, a hospital in Kraków.