The foreskin (also known as the prepuce) is a retractable tissue that masks the foreskin of the penis. It has minor sensory nerves in the glans, but does not feature any blood or nerve supply of its own. Sunthi operation, also known as Circumcision, is the surgical procedure to remove the foreskin in the male child. The term Sunthi is a Telugu word for circumcision. In medical terminology, it is known as perpetual excision.

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The practice has been prevalent from time immemorial. It is a cultural and religious practice observed in Jewish and Islamic communities. Also, it is a common practice in certain Aboriginal tribes in Australia and Africa. However, this practice is now adopted by people irrespective of religion owing to hygiene and preventive healthcare. Although it is commonly performed in children, it is performed on a significant scale in adults owing to the incidence of penile cancer.

Reasons for opting for Sunthi 

Conditions prompting circumcision

• Stuck penis
• Foul smell 
• White ring around the penis head
• Delay in urination and retraction

Contraindications

Refers to situations where a procedure or surgery should not be used because it may cause potential harm to the patient. Before undergoing surgery, ensure to consult the specialist if you have experienced any of the following conditions:

• Known allergy to anesthesia
• Blood clotting disorders
• Acute infections

Types of Sunthi operation

Pediatric circumcision

Typically, an obstetrician-gynecologist, urologist, or pediatrician carries out circumcision on newborns. The procedure consists of minimally invasive steps and is generally conducted in hospitals using local anesthesia to numb the penis. Most importantly, the child will be awake during the procedure. Pediatric circumcision will be completed in very short time in about 10 minutes. 

 The step-by-step procedure is as follows:.

• The child will be placed on their back. 
• Restraints ensure that the arms and legs are still.
• The doctor then applies an antiseptic to the penis area and a numbing shot, which is usually given at the base of the penis.
• To excise the foreskin, a clamp or ring is placed on the penis 
• Then apply a petroleum jelly or topical antibiotic ointment and wrap it with a gauze.

The baby will be discharged, and you can take your baby home in a few hours.

Adult circumcision

Circumcision in adults is also performed in hospitals and closely resembles the procedure for newborns. An incision is made to remove the foreskin, and the doctor will apply the stitches along the incision. These stitches would dissolve within 10 days. The process takes much longer and lasts about an hour. The penis is wrapped in protective clothing, and you will be shifted to a recovery room. However, complications are more common with adult circumcision, and recovery can take a significantly longer time, potentially lasting up to 3 weeks. 

Sunthi operation procedure

Besides personal hygiene, the Sunthi operation procedure addresses certain health conditions such as Balanitis, Phimosis, tight or painful foreskin, and recurrent infections.

Open circumcision surgery

Another name for open surgery is the dorsal slit technique, and it carries a higher risk of complications in comparison to newer techniques. The process includes the following steps:

• The doctor administers local anesthesia to numb the area
• A cut is made along the outer edge of the foreskin and carefully separates it from the glans penis.
• After removing the foreskin, the incision is closed with the help of sutures.

Laser/Stapler method

Stapler circumcision, also known as the Disposable Circumcision Anastomosis Device (DCAD) technique. Involves the use of a specialized stapling device to remove the foreskin effectively and efficiently. This procedure is known to be quick, efficient, and with minimal risk of complications. In this procedure, surgeons employ a disposable device that cuts and seals the foreskin simultaneously with titanium staples. So, the process ensures minimal loss of blood and swift recovery time.

Sunthi operation Complications

Although the operation has many advantages, it does carry risks and complications as well. They include:

• Infection (children)
• Haemorrhage
• Abrasion of the glans against clothing
• Painful erections due to tightened skin
• Irritation at the tip of the penis
• Improperly cutting the foreskin (whether too long or too short) can lead to issues
• Risk of injury to the penis
• May require recorrection surgery

Lowered Sexual pleasure: Adults who underwent circumcision experience less sexual pleasure as compared to their prior experience before circumcision. No issues in intercourse post circumcision treatment.

Health benefits of the Sunthi operation

Besides genital hygiene, the surgical procedure offers a reduced risk of the following:

• Urinary tract infections
• Sexually transmitted infections
• Penile diseases and penile cancer
• Phimosis, balanitis, and paraphimosis
• Cervical cancer and infections in female partners
• Reduced risk of prostate cancer

Sunthi operation recovery time

The recovery duration after the surgery is contingent upon the type of procedure performed. 

Open circumcision surgery is fairly long and takes about 4-5 weeks to recover completely. Laser circumcision has the shortest recovery time compared to other surgeries, owing to fewer incisions.

Sunthi operation success rate

The success rate of Sunthi operations is notably high, notably higher than 95% with low risk of complications. 

Post-surgery care

As the procedure is performed under extreme sterile conditions, the risk of infection is quite low. You are advised to adhere to the following precautions:

• Regular cleaning of the area to stay away from infections
• Avoid active sports and any strenuous activities
• Regular use of medications to mitigate pain
• Use an icepack covered with a cloth and apply it to the groin area at 10-20 minute intervals for every 2 hours. 
• If needed, gently apply pressure with gauze.  

Pain medications: For the first few days, you may experience mild to moderate pain. Pain relievers such as Ibuprofen and paracetamol would help relieve pain. However, antibiotics may be preferred for adults.

Bleeding: Minor bleeding may occur, which is manageable by following simple measures. If there is significant bleeding, contact your Sunthi specialist immediately.

Dressing: Penis will be covered with a sterile dressing with petroleum jelly. 

Personal hygiene: The area must be kept clean and dry. It must be cleaned with warm water, and mild soap can be applied during cleaning.

Conclusion

Before consulting a doctor for the Sunthi operation, it is important to have a clear understanding of the procedure. Ensure to discuss the potential risks and complications with the specialist, and also let him know your expectations. When choosing a surgeon, consider the experience, qualifications, and reputation of the hospital or clinic. Post surgery, follow the doctor’s instructions with due diligence to ensure proper healing and lower the risk of complications.