Circumcision in Singapore: How I Perform It, What to Expect, and When to Wait

By Law Zhi Wei, MBBS (Singapore), MRCS (Edinburgh), GDFM, PgDip Derm (Cardiff)

I am a Singapore‑trained doctor with more than five years of surgical posting experience. At The Clifford Clinic, I focus on circumcision for adolescents and adults. My aim in this article is to give men and families a clear, experience‑based walkthrough of modern techniques, realistic recovery timelines, and the judgment calls that keep the procedure safe and outcomes consistent—while also being transparent about costs, insurance, and aftercare in the local context.

Circumcision has deep cultural and religious roots, but it is also a medical procedure with defined indications, known risks, and evidence‑based benefits in specific settings. For example, in countries with generalized heterosexual HIV epidemics, randomized trials showed that voluntary medical male circumcision lowers a man’s risk of acquiring HIV from female partners by about 60%, and the World Health Organization has recommended it as part of combination prevention since 2007. That does not mean every boy or man should undergo circumcision; it means the procedure sits within a broader framework of clinical indications, personal values, and informed consent.

Who this article is for

I am writing primarily for adult men considering circumcision and for parents of adolescents who want an unhurried, practical explanation of what happens before, during, and after the procedure in a Singapore clinic setting. Clinicians who refer to us may also find the technique details and follow‑up protocols useful.

My stance on routine newborn circumcision

In the absence of a clear medical indication or a firmly held cultural or religious requirement, I do not advocate for routine newborn circumcision in Singapore. My practice is to counsel families on the natural history of the foreskin and to reserve circumcision for medical indications such as pathological phimosis, recurrent balanitis, or lichen sclerosus, or when an informed family decision is made for cultural or religious reasons. This balances autonomy, beneficence, and the avoidance of unnecessary intervention.

Indications I most commonly treat

Most of the men I see present with pathological phimosis, recurrent balanitis, scarring consistent with lichen sclerosus, a prior episode of paraphimosis, or a purely elective cosmetic preference. HIV risk reduction is part of the evidence base but rarely the sole reason for circumcision in Singapore; nonetheless, the protective effect in high‑burden settings is well documented and worth understanding in counseling.

The techniques I use and why

In adults and adolescents, I primarily offer two modern, device‑assisted techniques: the Shang Ring and stapler circumcision. Both were designed to standardize tissue removal and hemostasis, shorten operative time, and reduce the need for sutures.

With the Shang Ring circumcision, the foreskin is sandwiched between an inner and outer ring that simultaneously compresses tissue planes and allows for controlled excision. Randomized trials in Africa have shown that the Shang Ring offers safety and acceptability comparable to conventional techniques. One randomized controlled trial demonstrated similar complication rates and high satisfaction, and another showed that leaving the device longer can result in spontaneous detachment in some men, though our routine practice is a planned removal visit.

With stapler circumcision (often using ZSR‑type devices), the device cuts the foreskin and places micro‑staples in a circular line in one activation. A large randomized clinical trial reported substantially shorter operative time and less intraoperative bleeding compared with conventional open techniques, albeit with higher device cost and the need to remove residual staples in many patients. In my experience, the trade‑off is worth it for men who prioritize a fast, suture‑free closure and uniform cosmesis.

Anesthesia and pain control

For kids circumcision, I use local anesthesia with sedation under the care of an anesthetist; for adults, I use a combination of topical anesthetic cream and local anesthesia (typically a ring block and dorsal penile nerve block) with or without light sedation. International guidance recognizes circumcision as a day‑surgery procedure that can be performed comfortably under local anesthesia, and these nerve blocks are well supported in the literature for their efficacy.

My post‑operative pain plan is simple and consistent. I advise regular analgesia for the first few days—paracetamol together with a COX‑2 option such as etoricoxib (Arcoxia), tailored to the patient’s medical profile—and I reinforce dosing schedules so patients don’t “chase” pain later in the day. In men with a very sensitive glans in the early healing period, a thin layer of plain lubricant or prescribed lidocaine gel (adolescents) can be helpful.

Hemostasis, sterility, and the operating environment

All procedures are conducted in our clinic’s operating theatre to maintain a sterile, controlled environment. While device‑assisted circumcision minimizes bleeding through compression or stapling, I set up bipolar diathermy for immediate hemostasis, especially if a dorsal slit is required in severe phimosis to allow device placement. This “belt‑and‑braces” approach keeps blood loss low and shortens the procedure; my typical operative time is ten to fifteen minutes.

What to expect on the day

A typical adult or adolescent procedure begins with consent and a pre‑operative check, topical anesthetic application, and then local anesthesia. With the stapler, the activation is quick; with the Shang Ring, device sizing and placement take a few extra minutes. Patients usually walk out after observation. The first evening brings mild discomfort that is well managed with the scheduled pain plan and snug—but not tight—supportive underwear. Most adults can return to desk‑based work the next day if needed, although many prefer to rest at home for several days to reduce rubbing and swelling. For adolescents, I recommend one to two weeks off school to avoid accidental knocks from sports or crowded corridors. Patient‑facing guidance from major urology services aligns with a gradual return to normal activity and a period of sexual abstinence during early healing.

Follow‑up and device removal

Follow‑up is straightforward. After stapler circumcision, I review patients on post‑operative day three to remove the dressing and check the staple line, and again at one month to assess healing. After adult Shang Ring circumcision, I remove the ring at day ten to fourteen and see the patient again at one month. In adolescents, I generally allow the Shang Ring to detach on its own rather than scheduling an early removal, a practice that is consistent with device protocols studied in randomized trials.

Recovery milestones and when to call

Most swelling and bruising peak in the first week and settle by the second or third. The glans is often very sensitive at first and then gradually less so as keratinization stabilizes. I counsel abstinence from sexual intercourse for four to six weeks, erring on the side of patience to protect the suture or staple line from shear forces. Large NHS centers similarly advise no sex for about four weeks after adult circumcision. I ask patients to contact us urgently for persistent bleeding, fever, inability to pass urine, or rapidly increasing discharge, because early review allows us to intervene before a minor issue becomes a major problem.

Complications and how I manage them

When minor bleeding occurs, direct focal pressure is usually sufficient; on the rare occasion that it persists, I use bipolar diathermy in the theatre or place a stitch. Suspected infection is treated promptly with oral antibiotics after examination. A retained device component is uncommon but can be removed in clinic. My strongest prevention message is surprisingly simple: take the painkillers on schedule in the first several days and avoid strenuous physical activity for four weeks. Skipping analgesia leads to tension and guarding, which in turn increases swelling and the risk of wound edge trauma.

Outcomes and my audit data

In the last twelve months I performed approximately fifty circumcisions. In this cohort, bleeding and infection were very rare—well under one percent—and no patient required readmission. For broader context, the British Association of Urological Surgeons’ patient information cites low rates of infection and bleeding for adult circumcision, which is consistent with my results in a smaller, single‑operator series.

Common misconceptions I correct in clinic

A frequent worry is that sexual satisfaction will inevitably decline after circumcision. The best current synthesis of studies does not support that claim: a 2025 meta‑analysis of over 14,000 men found that circumcised men, on average, reported higher sexual satisfaction, with small improvements in erectile function and lower odds of dyspareunia; the authors were appropriately cautious about heterogeneity, but the direction of effect should reassure men who require or elect the procedure.

Another misconception is that general anesthesia is mandatory. In fact, adult circumcision can be performed comfortably with local anesthesia, and this is a standard approach in urology guidance; I offer sedation when appropriate, particularly for adolescents or anxious adults, but I individualize the plan to the patient.

Finally, many men assume sutures are always needed. With current devices, the skin can be cut and closed in one step with staples, or compressed with a ring system that obviates suturing. These approaches have been tested in randomized trials and, when matched to the right patient and anatomy, offer faster, more uniform procedures.

Contraindications and risk stratification

I do not proceed with circumcision in the presence of hypospadias, significant penile chordee, or an active local infection; a bleeding diathesis is a relative contraindication that requires coordination with hematology. A focused physical examination usually suffices for pre‑procedure screening in adults. These decision points mirror the contraindications described in standard references and are in place to avoid downstream reconstructive problems.

Alternatives and shared decision‑making

When appropriate, I discuss topical steroid therapy for mild non‑scarring phimosis and surgical alternatives such as frenuloplasty or preputioplasty, especially in men who wish to preserve the foreskin. Hygiene guidance, management of balanitis, and watchful waiting are often appropriate for adolescents with physiologic non‑retractability. The choice is never “device or nothing”; it is a stepwise plan built around your goals and your anatomy.

A case that shaped my counseling

One recent adult case was planned as a stapler circumcision under local anesthesia with topical pre‑numbing. The device fired, but—rarely—it failed to cut while deploying staples. Because I regularly teach and perform conventional sleeve resections, I converted immediately, completed the circumcision with sharp dissection and suturing, and discharged the patient the same day. He recovered uneventfully and was well at one month. Ever since, I have been explicit in consent about device failure, and I explain that when it happens, the fallback is a standard open technique that I perform frequently.

Practicalities in Singapore: where, when, cost, and coverage

All circumcisions in my practice are performed as day surgery in our clinic operating theatre to maintain sterility and rapid turnaround. Adults can often be scheduled the same day if the appropriate device size is in stock. Adolescents generally require three to five days of lead time to prepare a size range and arrange the anesthetist for sedation. My professional fee for non‑insurance cases is S$1,888 before GST; adding sedation raises the fee by S$1,500 before GST.

When circumcision is medically indicated—phimosis, recurrent balanitis, recurrent urinary tract infection—it is commonly claimable under MediSave and, where applicable, Integrated Shield Plans. MediSave has transparent day‑surgery and surgical withdrawal limits, and the exact reimbursable amount depends on the operation and the bill. Patients can review current day‑surgery coverage (for example, the daily limit for hospital charges) on the CPF Board website and can estimate claims using CPF’s calculators; our administrative team assists with pre‑authorization and documentation.

Safety and regulation of devices

All medical devices supplied in Singapore must comply with the Health Sciences Authority’s requirements and, where applicable, be listed on the Singapore Medical Device Register. Patients who wish to verify product registration can search the HSA Infosearch portal; we are happy to provide product details on request.

The bottom line

Modern circumcision—done for the right reason, with the right technique, and with methodical aftercare—is a short day‑surgery procedure with a high satisfaction rate and a low complication rate in my practice. My role is to help you decide whether you need it now, later, or not at all, and if you do proceed, to use a technique that fits your anatomy, lifestyle, and recovery goals.

References

• World Health Organization. Voluntary medical male circumcision for HIV prevention. Geneva: WHO; updated 2023. Available at: https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/hiv/prevention/voluntary-medical-male-circumcision. Accessed November 5, 2025.
• British Association of Urological Surgeons. Complete Removal of the Foreskin (Circumcision): Patient Information Leaflet A24/077. London: BAUS; June 2024. Available at: https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Circumcision.pdf. Accessed November 5, 2025.
• University College London Hospitals NHS Foundation Trust. Circumcision: Post‑operative information for adults. Updated July 4, 2025. Available at: https://www.uclh.nhs.uk/patients-and-visitors/patient-information-pages/circumcision-post-operative-information-adults. Accessed November 5, 2025.
• Sokal DC, Li PS, Zulu R, Awori Q, Combes SL, Simba RO, et al. Randomized controlled trial of the Shang Ring versus conventional surgical techniques for adult male circumcision: safety and acceptability. JAIDS—Journal of Acquired Immune Deficiency Syndromes. 2014;65(4):447‑455. doi:10.1097/QAI.0000000000000061.
• Barone MA, Awori QD, Li PS, Simba RO, Weaver MA, Okech J, et al. Randomized trial of the Shang Ring for adult male circumcision with removal at one to three weeks: delayed removal leads to detachment. JAIDS—Journal of Acquired Immune Deficiency Syndromes. 2012;60(3):e82‑e89. doi:10.1097/QAI.0b013e31824ea1f2.
• Jin XD, Lu JJ, Liu WH, Zhou J, Yu RK, Yu B, et al. Adult male circumcision with a circular stapler versus conventional circumcision: a prospective randomized clinical trial. Brazilian Journal of Medical and Biological Research. 2015;48(6):577‑582. doi:10.1590/1414‑431X20154530.
• Karaahmet AY, Laleh SS. The influence of circumcision on male sexual function: a meta‑analysis of satisfaction, erectile function, and dyspareunia. Journal of Sex & Marital Therapy. 2025;51(6):551‑573. doi:10.1080/0092623X.2025.2499141.
• Warees WM, Anand S, Leslie SW, et al. Circumcision. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; updated May 2, 2024. Available at: https://www.ncbi.nlm.nih.gov/books/NBK535436/. Accessed November 5, 2025.
• CPF Board. Using MediSave for hospitalisation and day surgery. Singapore: Central Provident Fund Board; updated 2025. Available at: https://www.cpf.gov.sg/member/healthcare-financing/using-your-medisave-savings/using-medisave-for-hospitalisation. Accessed November 5, 2025.
• CPF Board. MediSave withdrawal limits (effective 1 April 2025). Singapore: Central Provident Fund Board; 2025. Available at: https://www.cpf.gov.sg/content/dam/web/member/healthcare/documents/MediSave%20Withdrawal%20Limits_1%20April%202025.pdf. Accessed November 5, 2025.
• Health Sciences Authority (Singapore). Infosearch for health products and services (Singapore Medical Device Register). Singapore: HSA; 2025. Available at: https://www.hsa.gov.sg/e-services/infosearch. Accessed November 5, 2025.

Law Zhi Wei, MBBS (Singapore), MRCS (Edinburgh), GDFM, PgDip Derm (Cardiff), is a clinician at The Clifford Clinic with more than five years of surgical posting experience. He performs adolescent and adult circumcisions using device‑assisted and conventional techniques with an emphasis on comfort, sterility, and consistent outcomes.