Q: Could you please let me know whether alternative procedures like prepuceplasty is feasible in the case of partial phimosis or I have to undergo circumcision?

A:Circumcision is removal of the entire prepuce. A prepuceplasty (dorsal slit) is simply a cut by which the foreskin becomes retractable. Circumcision takes 25 minutes to carry out and can be done under local or general anaesthesia. Children do not cooperate and need general anaesthesia. Prepuceplasty takes 15 minutes to carry out and the same anaesthetic rules apply. Excessive removal of the skin is a complication of circumcision, and results in a painful erection later. This should happen in less than 1 in 10,000 circumcisions, and is rare enough not to need discussion with your surgeon. Prepuceplasty has no such complication. On the other hand, prepuceplasty may be insufficient, and may not work. If it doesn’t work, one can always get a circumcision done. Other complications are so rare that they are not worth discussing. Basically, both circumcision and prepuceplasty are equally safe procedures. For the nonretractile prepuce, both procedures work equally well. I recommend circumcision because it is cosmetically superior. For 99% of men, an improved cosmetic result on the penis is important. I have done many, many circumcisions, and a few dorsal slits. I personally feel that while the dorsal slit works very well, it looks so horrible that I have stopped recommending it.