A foreskin-preserving alternative to circumcision

A proportion of men have a foreskin that will not retract due to a single tight band. A Preputioplasty is a surgical option for treating this condition while preserving the foreskin, offering an alternative to circumcision.

What is preputioplasty?

• The tight band of foreskin is widened with one or more longitudinal incisions, which are then closed transversely (horizontally)

• This releases the constriction and allows the foreskin to retract normally, while keeping the foreskin itself intact.

• It is usually performed as a day-case procedure under general or occasionally local anaesthetic. A preputioplasty is more of a minor procedure than a circumcision, with a shorter recovery time and less post-operative risk.

Who is it suitable for?

• Men and boys with a tight, non-retractile foreskin due to a tight band, causing discomfort, ballooning on urination, or pain with erection or intercourse.

• Preputioplasty is not usually suitable where there is significant scarring from a skin condition such as lichen sclerosus (balanitis xerotica obliterans) — in this situation circumcision is usually recommended instead.

The procedure

• Performed as day surgery — you go home the same day.

• Takes approximately 30 minutes.

• Dissolvable sutures are used, so there are no stitches to be removed. Often a dressing is not required. 

Recovery and aftercare

• Some swelling and bruising of the foreskin is normal for the first 1–2 weeks.

• Keep the area clean and dry; showering is fine from the day after surgery.

• Simple pain relief (e.g. paracetamol, ibuprofen) is usually sufficient.

• Avoid sexual activity and masturbation for 4–6 weeks to allow the tissue to heal fully.

• Most men return to desk-based work within a few days, and to full activity within 2 weeks.

Risks and complications

• As with any surgery: bleeding, infection, and swelling.

• A small chance the tightness can recur; most of the time, steroid cream is helpful. Very occasionally, significant tightness persists, requiring a circumcision. 

• Altered sensation is uncommon.

• Your surgeon will discuss the risks relevant to you in more detail before the procedure.

Questions?

If you have any questions about preputioplasty or whether it is the right option for you, please don't hesitate to contact the team at Bay Urology.