Circumcision is a surgical procedure involving removing the foreskin from the penis. It is a common procedure that is performed for cultural, religious, medical, or personal reasons. Here is what you need to know about the circumcision procedure:
Before the Procedure:
Before the circumcision procedure, it is important to discuss the decision with your doctor to ensure it is the right choice. The doctor will likely ask about your medical history and perform a physical exam to ensure you are a suitable candidate.
In preparation for the procedure, wearing comfortable, loose-fitting clothing is recommended and arranging for someone to drive you home afterwards. You may also be advised to avoid taking blood-thinning medications for a few days before the procedure.
During the Procedure:
Circumcision is typically performed on an outpatient basis, meaning you can go home the same day as the procedure. The procedure usually takes about 30 minutes and is performed under general or local anaesthesia. There are different techniques used for circumcision, but the most common one involves the following steps:
- The foreskin is pulled away from the head of the penis and clamped in place.
- A scalpel or special device is used to remove the foreskin.
- The area is then cleaned, and the edges of the skin are stitched together with dissolvable stitches.
After the Procedure:
After the circumcision procedure, it is normal to experience some pain, swelling, and bruising in the penis. Applying ice packs and taking pain medication can help alleviate these symptoms.
It is important to avoid strenuous activities and sexual intercourse for a few weeks following the procedure to allow the body time to heal. Keeping the area clean and dry is also important to prevent infection.
What are the benefits of circumcision?
1. Reduced Risk of Urinary Tract Infections (UTIs) – Urinary tract infections are a common problem among men, especially in infants and young boys. Studies have shown that circumcised males are less likely to develop UTIs than uncircumcised males. This is because the foreskin can trap bacteria and other germs, increasing the risk of infection. By removing the foreskin, the risk of UTIs is significantly reduced.
2. Lower Risk of Sexually Transmitted Infections (STIs) – Several studies have shown that circumcision can reduce the risk of contracting sexually transmitted infections, including HIV. This is because the foreskin is more susceptible to tears and abrasions during sexual intercourse, providing an entry point for pathogens. By removing the foreskin, the risk of contracting STIs is significantly reduced.
3. Easier Hygiene – One of the most common reasons men choose to undergo circumcision is for hygiene reasons. The foreskin can trap bacteria and other germs, leading to unpleasant odours and infections. By removing the foreskin, it becomes much easier to clean the penis, reducing the risk of infection and improving overall hygiene.
4. Reduced Risk of Penile Cancer – Penile cancer is a rare but serious condition that can be life-threatening. Studies have shown that circumcision can significantly reduce the risk of penile cancer, especially in older men. This is because the foreskin is more susceptible to developing cancerous cells, and removing it significantly reduces the risk.
5. Improved Sexual Functioning – Several studies have shown that circumcision can improve sexual functioning in men. This is because the foreskin can sometimes cause discomfort or pain during sexual activity, and by removing it, men may experience improved sensitivity and overall sexual satisfaction.
What are the risks of circumcision?
While it is generally considered safe, patients should be aware of some risks and potential complications before undergoing the procedure.
- Bleeding: One of the most common risks of circumcision is bleeding, both during and after the procedure. In some cases, bleeding can be severe and require medical attention.
- Infection: There is a risk of infection with any surgical procedure, including circumcision. Signs of infection may include redness, swelling, discharge, or fever.
- Pain: It is common to experience some pain and discomfort after circumcision, especially during the first few days. Pain can usually be managed with over-the-counter pain relievers and careful post-operative care.
- Swelling: Swelling is a common side effect of circumcision and may last several days after the procedure. Elevating the penis and applying ice can help reduce swelling.
- Complications with anaesthesia: Circumcision is typically performed under local anaesthesia, which numbs the area being operated on. In rare cases, anaesthesia may have complications, such as an allergic reaction.
- Scarring: Circumcision can result in scarring, although this is usually minimal and fades over time.
- Changes in sensitivity: Circumcision can result in changes in sensitivity or sensation in the penis, although this is usually temporary and resolves over time.
- Meatal stenosis: In rare cases, circumcision can lead to meatal stenosis, a narrowing of the urethral opening that can cause difficulty urinating.
What are the alternatives to circumcision?
For those who wish to avoid circumcision, there are several alternatives available.
Observation and Education
One alternative to circumcision is to simply observe and educate on proper hygiene practices. With regular cleaning, the risk of infection and other complications can be reduced. Parents can teach their children how to clean their genitals properly and maintain good hygiene habits.
Topical Steroids
Topical steroids are another alternative to circumcision. They can be used to treat a condition called phimosis, which is the inability to retract the foreskin. By applying a topical steroid cream, the skin can be stretched and made more elastic, making it easier to retract the foreskin.
Preputioplasty
Preputioplasty is a surgical procedure that aims to preserve the foreskin while correcting phimosis. The procedure involves making incisions in the foreskin to release the tightness and allow for easier retraction. This alternative to circumcision has a high success rate and fewer complications than circumcision.
Wait and See
In some cases, it may be best to simply wait and see if the need for circumcision arises. If a medical condition develops that requires circumcision, the procedure can be performed at that time. Waiting can allow the individual to make an informed decision about whether or not circumcision is necessary.
Release of Preputial Adhesions
Preputial adhesions occur when the foreskin of the penis attaches to the glans, making it difficult or impossible to retract. This condition is common in uncircumcised boys but can also occur in men of any age.
Fortunately, preputial adhesions can often be treated through a simple and non-invasive procedure known as preputial adhesion release. Preputial adhesion release involves gently separating the foreskin from the glans with a lubricated swab or finger.
In conclusion, circumcision is a surgical procedure involving removing the foreskin from the penis. It is a common procedure that is performed for cultural, religious, medical, or personal reasons. While it is generally considered safe, discussing the decision with a doctor and being aware of potential complications is important. By following all post-operative instructions, patients can reduce the risk of complications and ensure a successful outcome.
Author: Mr Neil A Haldar MBBS MD FRCS UROL
Consultant Urological Surgeon
The Pelvic Specialists