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Circumcision (male)

  

Male circumcision is the surgical removal of the foreskin


Circumcision

This commissioning policy is needed because male circumcision (defined as the surgical removal of all or part of the foreskin of the penis) may be done for certain medical reasons, but is often sought for cultural or religious reasons.

Circumcision is not routinely commissioned by the Clinical Commissioning Groups (CCG) unless medically necessary. NB. Circumcision refers to male circumcision only.

Female circumcision is prohibited in law by the Female Genital Mutilation Act 2003 and is the subject of multi-agency guidelines from the Department of Health .

Male Circumcision for cosmetic, social, cultural and religious reasons

not funded

Male Circumcision under 16 years of age

Male Circumcision for clinical indications funded with following clinical indications:

  • Recurrent episodes (more than three) of severe and pathological phimosis (inability to retract the foreskin due to a narrow prepucial ring)
  • OR Severe and recurrent episodes (more than three) of paraphimosis (inability to pull forward a retracted foreskin) and balanitis (chronic inflammation leading to a rigid fibrous foreskin)
  • OR Severe and recurrent episodes (more than three) of balanoposthitis (recurrent bacterial infection of the glans and foreskin)
Male Circumcision over 16 years of age

Male Circumcision for clinical indications funded with following clinical indications:

  • Pathological phimosis
  • OR Three documented episodes of balanoposthitis
  • OR Relative indications for circumcision or other foreskin surgery include the following:

Prevention of urinary tract infection in patients with an abnormal urinary tract

Recurrent paraphimosis

Trauma (e.g. zipper injury)

Tight foreskin causing pain on arousal/ interfering with sexual function

Congenital abnormalities

Absolute indications for circumcision
  • Penile malignancy
  • Traumatic foreskin injury where it cannot be salvaged

Prior approval from the Clinical Commissioning Group will be required before any treatment proceeds in secondary care

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