All posts by admin

Circumcision Complete Information

Circumcision is an age-old practice that continues across the world even today. While it is done for traditional reasons among children, adult males often go for it as treatment for medical issues. But there is a lot of misinformation scattered around circumcision and the benefits/risks it offers. Let’s try to understand it better.


circumcisionAs a tradition

Historic evidence suggests that the practice of circumcision might be as old as 15,000 years. The practice was also found to exist in different cultures, suggesting a common theme: hygiene and safety. In time, it was incorporated as a religious practice. Both Judaism and Islam promote circumcision of young boys, often at infancy. As such, most Muslim-majority nations and Israel see a significant number of circumcisions as a part of religious practice.


Circumcision in today’s world

The cases of circumcision across the world fluctuate across generations. Most Jews and Muslims consider circumcision a part of their religious duty, though the numbers are decreasing. USA also sees a large number of circumcision cases every year. South Korea saw a surge in circumcision in recent decades. It is observed that circumcision in kids today is mostly carried out either due to religious obligation or community tradition. In adults, however, it is largely due to medical complications.


Benefits of Circumcision

Circumcision of kids has continued over the centuries largely due to the benefits it provides. Research has indicated that circumcision can possibly provide the following benefits to the male children later in life:

  • Better hygiene: Circumcised penis is easier to clean than uncircumcised one. It also seems to be the primary reason why circumcision became part of ancient culture.
  • Lowers UTI risk: Urinary tract infection is primary a risk for women and the risk factor for males is quite low. However, it has been observed that circumcised men stand at an even lower risk of UTI than uncircumcised ones.
  • Lowers Penile Cancer risk: Penile cancer is another condition that is quite rare, but it does occur in men. However, uncircumcised men seem to be at a greater risk than circumcised ones.
  • Lowers risk of STI: Many researches have indicated that circumcised men have a lower risk of catching sexually-transmitted infections than their uncircumcised counterparts. This includes perhaps the most dangerous STI, HIV. The risk is lower because the foreskin has a chance of getting ruptured during intercourse, which might catch infections more easily.
  • Prevents other penile problems: Issue related to foreskin can obviously be avoided by circumcision. For example, circumcised men do not have to worry about phimosis.


Risks of Circumcision

Even though circumcision in infants is quite a safe procedure, some risks do exist. These are:

  • The foreskin might not heal properly and cause constant pain in the area.
  • The foreskin might be cut too short (which defeats the purpose of circumcision) or too long (which can cause prolong discomfort to the kids).
  • During healing, the foreskin might attach itself to the penis tip. This would require a minor surgery to correct.

There are some common side-effects of circumcision too, though they are natural and would soon subside:

  • Infection, if the penis was not kept clean after the surgery
  • Bleeding, if the penis was subjected to harsh treatment after surgery
  • Anesthesia, if given, can also cause some mild side effects.


Circumcision For Adults

As opposed to children, adults go through only as a treatment for a medical condition. Some of the common conditions that require circumcision are:

  • Phimosis is a condition where the foreskin is unable to retract from the tip of the penis. It can result in symptoms, from mild pain to urinary problems.
  • Paraphimosis is a severe version of phimosis where the foreskin gets stuck behind the tip of the penis and restricts the flow of blood to it. If left untreated, it can cause gangrene.
  • In Balanitis, the head of the penis swells and makes it harder to retract the foreskin. Like in phimosis, circumcision can solve the issue.

However, it must be remembered that circumcision in adults is much more complex than in infants. The procedure is longer, so is the recovery time. Since the penis has been habituated to the protection of foreskin for years, getting it removed can cause severe pain for weeks. Sexual activity would also cause great pain.


The Procedure

The procedure for circumcision is straightforward and relatively quick. The patient is restrained to the bed to avoid movement during the procedure (optional for adults). The penis is thoroughly cleaned and disinfected. Local anesthesia is either injected on the tip of the penis or applied as a cream over it. A ring is clamped to the penis and a lubricant is applied on its top. Then, usually with scissors or scalpel, the foreskin surrounding the tip of the penis is cut and removed. The penis is then covered to stop the bleeding. The procedure takes merely 10-20 minutes for infants but may take up to an hour for adults.


Cosmetic Circumcision

A new variation of circumcision is gaining popularity among adult males, known as cosmetic circumcision. It when carried out in adults, often caused great deal of pain and leaves the penis looking disfigured. This is because instead of the natural growth span than children get, the foreskin heals like a scar tissue among adults. It can often become a cause of embarrassment among men who go through the procedure.

However, cosmetic circumcision aims to solve the issue. The procedure uses high-precision scalpel instead of scissors and absorbable sutures commonly used in plastic surgery. This ensures that there is minimal pain, minimal scar and a speedy recovery. In major cities of India, cosmetically it is quickly becoming a favorite. For example, professionals like Dr. Gautam Banga in Delhi are seeing an increase in adult men opting for the procedure.


Recovery from circumcision among infants might take up to 10 days. The penis is generally sore during this period, and the pain becomes apparent as soon as the anesthesia wears off. The penis tip would also acquire a red, swollen look due to losing its protective flap. Occasionally, yellow pus might appear on the penis head, which is completely normal.

During recovery of the kid, you must take care of the following:

  • Try to keep the penis lubricated at all times, usually with things like petroleum jelly.
  • It is okay to wash the penis during recovery period, but make sure to use soaps without any harmful chemicals or irritants.
  • Ensure that your kid is wearing loose-fitting clothes that do not stick to the penis.
  • Keep an eye on your kid and stop him from putting any excessive pressure on the penis head.
  • In case the kid does not urinate or bleeds for a long period, contact the doctor immediately.

Among adults, the recovery period is longer and more painful. However, all of the suggestions shared above apply on adults too.


It is not a major or a complex procedure by any means, but it is one of the most common ones. However, the confusion about it often stops men from seeking it even when they need it. However, you can now make a more informed choice about opting for it.

For further information on it do consult:-

Dr Gautam Banga

MBBS,MS,M.Ch (Urology)
Urologist, Andrologist and Genito -Urinary Reconstructive Surgeon
Contact no. : +91-9999062316

Best MicroTese Treatment in Delhi NCR

Best MicroTese Treatment in Delhi NCR is done at Urethra and Penile Surgery. Here we will know all the details on Microtese Treatment and its effects.


MicroTESE Procedure for Male Infertility


Male infertility is one of the major conditions that affect men across the world. Particularly in middle-aged men, who want to have children, this could be a major cause of stress. Male infertility is not a single condition but an end result of multiple conditions. One particular condition is azoospermia, where men are unable to produce sperm. While many procedures exist to treat it, the most effective one by far is microTESE. Let’s take a closer look at microTESE and how it became one of the best diagnostic tools for azoospermia.


Understanding MicroTESE

Microscopic testicular sperm extraction is a surgical procedure involving the extraction of sperm directly from the testicles. The procedure is used for men who are unable to produce healthy sperm for reproduction. MicroTESE extracts sperm by making a small incision in the testes and extracting the testicular tissue. The testes are located within fleshy bags called scrotum and a pair of them exist just below the penis. Both of these testes include testicular tissue.


Male Infertility

Infertility is a condition when the reproductive system of the body becomes dysfunctional. In males, infertility is usually caused due to either of two organs: testicles and penis.

Azoospermia is a case of male infertility where the no sperm is released from the body. It is largely of two types. Non-obstructive azoospermia is when the body produces no sperm at all. Obstructive azoospermia is when sperm is produced, but an obstruction stops it from getting released.

Azoospermia is a very common cause of male infertility. Generally, preliminary tests are carried out to check the sperm count in the semen. This includes blood test and semen analysis. If these tests give no conclusive results, more advanced methods are employed. In case of non-obstructive azoospermia, microTESE treatment is used.


Testicular Biopsy

Testicular biopsy is a very common diagnosis method to find out issues surrounding the male reproductive and sexual health. The biopsy is usually preceded by a semen analysis. In most cases, semen analysis is enough to find basic information like sperm count and azoospermia. However, sometimes the analysis can return inconclusive results. In such cases, a testicular biopsy is suggested.

Testicular biopsy focuses on taking a sperm sample directly from the testicles. This could be done in two ways. Percutaneous biopsy inserts a very thin needle directly inside the testicle and extracts testicular tissue through a syringe. Surgical biopsy involves making a small incision on the testicle and then extracting testicular tissue through the opening.

Testicular biopsy is used to diagnose a wide variety of conditions. It could find cause of lumps or blockages in the testicles. It can extract sperms to be later used for In-Vitro Fertilization (IVF). In some cases, it can be used to confirm testicular cancer. Also, the biopsy is used when semen analysis is not enough to confirm conditions like azoospermia and male infertility.


Choosing MicroTESE

It is important to understand the scenarios in which microTESE could be used. Despite being safe and effective, it cannot work in all condition. Like in case of obstructive azoospermia, the blockage cannot be removed by microTESE treatment.

MicroTESE is preferred in cases of males who have sufficiently high level of testosterone in their body but are still unable to produce sperm due to some reason. Alternatively, males who have undergone prior treatment of azoospermia and have normal level of testosterone can also opt for this.


MicroTESE instead of Biopsy

While biopsy is a common procedure, it is not without its complications. Particularly in cases of non-obstructive azoospermia, biopsy is not very effective at sperm extraction. In fact, an open biopsy might even further complicate things.

MicroTESE is a more effective procedure to extract sperms, especially in the aforementioned scenario. It must be remembered that prior biopsies can reduce the chances of sperm extraction by a significant margin. While there is a 56 percent chance of finding sperm in patients with no prior biopsies, this drops to 26 percent in patients with 3 or more prior biopsies.


MicroTESE Procedure

The procedure of microTESE is as complicated and elaborate as any other major surgery. The patient is first given general anesthesia because the procedure requires complete stillness. The surgeon then makes a small incision, usually 3-4 cm in size, in the middle of the scrotum. Through this incision, the surgeon looks inside using a microscope. The aim is to find seminiferous tubules which have the highest probability of containing sperm.

If such tubule is found, the surgeon extracts a tissue sample from it. After this the incision is stitched shut and any bleeding is stopped. The body contains seminiferous tubules in both sides, so the procedure has also to be carried on both sides. This is done to determine if the cause is localized to one testis or is affecting both testes equally.

At the end of the surgery, all incisions made on the testicles are stitched layer-by-layer. The stitches dissolve on their own and in a few weeks no sign of the surgery would remain on the testicles.



MicroTESE is a very low-risk surgical procedure. The chances of the testicle getting damaged during the surgery are insignificant. The incision is made carefully and by layers, so no damage occurs. However, there are chances of side-effects arising due to the procedure. Patients undergoing microTESE have a risk of bleeding, infection and acute pain. Even these side-effects are extremely rare among patients.



The recovery from microTESE is really easy and quick. Testicles have an inherent fast healing factor due to their vital importance to the body. The carefully layered approach during surgery further minimizes any damage.

Immediately after the surgery, patients might feel discomfort but any pain is rare. It is recommended to use an ice pack on the testicles for the first 24 hours to avoid inflammation. Pain killers are optional and should be taken only if the ice pack is ineffective. For 10-14 days after the surgery, any vigorous activity involving the testicles is to be avoided. This includes sex, exercise and masturbation.

In a matter of weeks, the stitches dissolve and no scar is left behind. There is no long-term impact of microTESE. It is also safe to undergo multiple rounds of microTESE treatments, if there is sufficient recovery gap between them.


Alternative Method: TESE

Testicular Sperm Extraction (TESE) is similar to microTESE for the most part but with some crucial differences. While microTESE treatmentis applicable for men having non-obstructive azoospermia, TESE is used for men having obstructive azoospermia. Unlike microTESE treatment, which needs a full surgery, microTESE treatment requires a minor surgery that could be done in a clinic under local anesthesia. TESE also require a lot less tissue compared to microTESE.

In the microtese treatment procedure, first the testicle and surrounding skin is numbed using local anesthesia supplied via small needle. Then a minute cut is made on the testicle and sperm is extracted from it.


Final Thoughts

Male infertility is a serious condition that can cause great physical and emotional discomfort to those affected by it. However, the right procedures can go a long way in dealing and surviving it. Microtese  treatment is one such procedure. With microtese treatment, infertility in men could be accurately diagnosed and treated, and allow them to lead a happy life again.

For further information on Microtese treatment do consult:-

Dr Gautam Banga

MBBS,MS,M.Ch (Urology)
Urologist, Andrologist and Genito -Urinary Reconstructive Surgeon
Contact no. : +91-9999062316