Circumcision

Benefits of circumcision at BrandeisMD:

1. Dr. Brandeis voted top urologist in the San Francisco Bay area for the past 9 years
2. Dr. Brandeis was chief of urology for John Muir Hospital and Hills physicians from 2012 until 2019
3. Dr. Brandeis developed a painless and quick in office circumcision technique
4. Circumcision performed with local anesthetic.  No sedation or other medications necessary.
5. Dr. Brandeis has tried all forms of circumcision over his 25-year career including CO2 laser, Shang Ring, skin glue, nonabsorbable suture, PrePex, and has developed his technique using absorbable sutures which gives a consistent and cosmetically acceptable result.
6. Consultation and circumcision are done the same day
7. Total cost of circumcision and follow-up care is $1800
8. Pain medication is rarely required after the procedure
9. All sutures used are absorbable
10. Excellent cosmetic result
11. Minimal effects on sensation
12. Frenulectomy alone is an option

• Low cost, painless circumcision
• Board-certified urologist voted top urologist in Bay area
• Local anesthetic, no sedation required
• Excellent cosmetic result, minimal loss of sensation

Benefits of Circumcision

Cosmetic:	Circumcision is common in American society and some men want the same aesthetic appearance as others.  We also commonly see men who want to improve the appearance of their circumcision.
Hygiene:	A circumcised penis is easier to keep clean for some men.
Phimosis:	A condition that happens when the foreskin cannot be easily pulled back over the head of the penis.  Men with this condition frequently experience pain during sexual intercourse or masturbation.
Paraphimosis:	Somewhat the opposite of phimosis, this is a condition where the foreskin becomes trapped after being pulled back and then swells behind the head of the penis.
Balanitis & Balanoposthitis:	Inflammation of the penis head and foreskin caused by the lack of aeration and the accumulation of smegma under the foreskin.
Cancer	Men with a circumcision have a much lesser risk of penile cancer. Circumcision at infancy completely prevents penile cancer.
HIV and Other STD’s	Circumcised men have 50% lower incidence of HIV than uncircumcised men. Men with a circumcision are 10 times less likely to contract HIV from a female partner. The incidences of most other STDs are lower for men with a circumcised penis.

Recovery

Sedentary activity, including travel, is possible immediately following the procedure.  After one-week, moderate activity is allowed. Sexual activity may resume after approximately four weeks depending on how quickly you heal.

You will be given specific instructions for care and length of time that the bandage must be left in place.  Since your circumcision will be sutured with dissolvable sutures, it will not be necessary to have them removed by a doctor.

When the bandage is first removed, the wound will definitely not look like your final result.  Don’t be discouraged! This is normal and it will have a good, healthy appearance within one to three months.

WILL IT CHANGE THE SIZE OF MY PENIS?

No, there should be no change in the size of the flaccid or erect penis after the procedure. We make sure there is enough skin to stretch to cover the penis when erect.

HOW WILL IT AFFECT MY SENSITIVITY?

None of my patients have reported a change in sexual sensitivity after the procedure.

WILL IT AFFECT MY URINATION?

There should be no changes in your urination after healing.  If the procedure is performed for balanitis or phimosis, your urination will improve a great deal.

CAN GUYS GET CIRCUMCISED AT ANY AGE?

Yes. There is no minimum or maximum age for the procedure.

 

HOW IS THE ADULT CIRCUMCISION DONE?

The penis is numbed with an injection at the base with a mixture of two medications. The first is a quick acting agent called Lidocaine and the second is a long-lasting agent called Marcaine.  Patients usually feel only the first needle prick and no discomfort after that.

Incisions are done with a scalpel to ensure a precise and clean result.

The skin is closed with dissolvable, high-quality sutures, the same as those used in plastic surgery.  Sutures are required because adults get strong erections during the sleep cycle, and the sutures hold the skin in place.

 

IS CIRCUMCISION SURGERY PAINFUL?

The penis is completely numb during the procedure. You will not feel any pain. Most men do not need more than Tylenol or Advil after the procedure, but I can write a prescription of stronger pain medication on request.   It is rare that patients require pain medications after a few days from surgery.

 

HOW LONG DOES THE PROCEDURE TAKE?

Dr. Brandeis has developed techniques to perform a precision circumcision in approximately 30 minutes

WHO WILL BE IN THE PROCEDURE ROOM WHEN I AM GETTING THE PROCEDURE?

Dr. Brandeis and his assistant will be in the room.

HOW LONG IS THE RECOVERY TIME?

You will be able to walk and travel immediately following the procedure with minor discomfort.  For the first week we recommend keeping your activity to moderate levels, including limiting the amount of exercise you do.  Sexual activity can usually resume after approximately four weeks depending on how you heal.

 

WILL I WALK NORMALLY RIGHT AFTER THE PROCEDURE?

Yes. You will walk perfectly normally after the procedure.

 

CAN I GET ON A PLANE RIGHT AFTER THE PROCEDURE?

Yes. Some of our patients are from out of town. They fly in the morning of the procedure and leave the same evening.

 

CAN I DRIVE FOR A FEW HOURS AFTER THE PROCEDURE?

Yes. The numbing medicine keeps the penis numb for about 4 hours after the procedure. You are not allowed to take any pain medicine while you are driving. If you plan on driving more than 4 hours after the procedure, we recommend spending the night in San Ramon or somewhere within the 4 hour driving radius.

 

WHAT HAPPENS IF I GET AN ERECTION WHILE I’M STILL HEALING?

For the first few days after surgery you will likely feel some degree of discomfort or minor pain when you have an erection. This is normal and there should be no bleeding because of it. You will be given pain medications after the procedure to make you more comfortable.

 

IS A PRE-EXAM REQUIRED?

No pre-exam is required, but we do require a discussion with Dr Brandeis prior to the circumcision which is typically on the same day as your procedure.