Introduction
Male circumcision is a surgical procedure performed on men on the foreskin of the penis. Along with benefits, the procedure holds risks. It is commonly performed on newborns. This procedure involves benefits that help prevent acquiring HIV (human immunodeficiency virus), urinary tract infections, penile cancer, and any STD. Penile sexual function or sexual satisfaction is not affected by this procedure. During this procedure, care must be taken to maintain a sterile field, and effective pain management techniques are used.
What Is Male Circumcision?
Circumcision removes the foreskin, which covers the glans that are the head of the penis. This procedure is usually performed on newborn babies. Circumcision is performed for medical, cultural, and religious purposes. This procedure is less common in adults but can also be performed in adults. The skin that covers the round tip of the penis is called the foreskin. The foreskin is attached to the penis at the time of birth, whereas in adults, it can be separated or retracted from the head of the penis. Phimosis affects the foreskin of the penis, where the foreskin does not retract or pull back and gets attached tightly; this can be evaluated and corrected by circumcision.
Is the Procedure Painful?
Male circumcision is a surgical procedure, and surgical procedures may cause some discomfort. Therefore, the procedure is performed under anesthesia, numbing the pain, and the doctor will prescribe pain medication for postoperative discomfort.
Is the Procedure Commonly Performed?
Circumcision is a common surgical procedure. The United States has a 60% rate of male circumcision and 33 % in the remaining parts of the world. Circumcision is common in the middle east, south Korea, and the US and less common in countries like parts of Asia, South America, and Europe. It is a common religious practice among the Jewish and Muslim populations.
What Are the Medical Reasons for Performing Male Circumcision?
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Phimosis: The foreskin on the head or glans of the penis does not retract or pull back and gets attached tightly. It may cause complications where the individual may find it difficult to pass urine and can also be painful while having an erection.
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Paraphimosis: It is a condition in which the retracted or separated foreskin does not return to its position leading to swollen and painful glands or the head of the penis. It can cause serious complications such as restricted blood flow to the penis, requiring immediate treatment.
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Recurrent Balanitis: Infection and inflammation of the head and foreskin of the penis.
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Balanitis Xerotica Obliterans: Scarred and inflamed head of the penis along with phimosis.
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Cancer of the Penis: There is the appearance of red patches and ulcers or wart-like growth on the head of the penis or under the foreskin.
Circumcision and HIV:
For men who are HIV positive, most of the time, the transmission of the virus is through the penis. Epidemiological studies have concluded that uncircumcised men are at a much greater risk of contracting HIV than circumcised men. This is because Langerhans cells contain HIV receptors on the inner surface of the foreskin. This acts as an active spot for the entry of the virus in an uncircumcised man. There have been developments in the prevention of these risk factors, like the introduction of receptor blockers in the penis or vagina before intercourse.
What Are the Risks of Circumcision?
Usually, the complications experienced are rare and insignificant. However, if at all present, they may involve the following:
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The most common problems involve swelling, bleeding, and infection.
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Decreased or permanent loss of sensation while intercourse at the head of the penis.
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Tenderness surrounding the scar.
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Removal of stitches that have not dissolved.
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At times there may be a requirement for another surgical procedure to remove excessive skin.
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Reaction to anesthesia.
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Removal of the foreskin too short or too long.
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Inflamed opening of the penis (meatitis).
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Penile adhesion.
What Are the Benefits of Performing Circumcision?
Circumcision improves hygiene and lowers the risk of the following:
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Conditions of the Penis: These conditions include balanoposthitis, paraphimosis, and phimosis.
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Cervical Cancer: Reduced incidence of cervical cancers in females who are partners of circumcised men.
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Penile Cancer: Circumcised men are less likely to get penile cancer.
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Sexually Transmitted Diseases (STDs): Men circumscribed are at a lower risk of getting infected by STDs.
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Urinary Tract Infections: Less common in circumcised men.
What Does the Procedure Include?
This procedure does not usually require hospital admission and is done on an outpatient basis. The procedure requires general anesthesia; hence the individual will be advised not to consume any food or drink anything for six hours before surgery. The individual may ask the health care provider any queries or concerns regarding the procedure. There may be an option of performing the procedure under local anesthesia or spinal anesthesia, whichever the health care provider suggests. Local anesthesia only numbs the penis and surrounding tissues, and the individual will remain conscious. Spinal anesthesia involves numbing from below the waist.
It is a simple procedure where the foreskin is removed and excised using a scalpel or surgical scissors. Then, the edges are stitched together using dissolvable stitches, and cauterization controls bleeding.
What Happens After the Procedure?
The health care provider will give postoperative instructions on how long it will take for recovery to be able to drive and have intercourse. It usually takes ten days to recover and maybe advised one week off of work. Refrain from sexual intercourse for at least four weeks after the procedure. Initially, there may be swelling and redness around the head of the penis for a few days, which is quite common. The healthcare provider will prescribe painkiller medications after the procedure and before leaving the hospital and may be advised to take them for a few days. If the individual experiences a temperature rise, increased redness and bleeding, and persistent throbbing pain, contact the doctor immediately, as these include signs of infection. To avoid irritation of the penis with the underwear, the application of petroleum jelly can be suggested, and avoid wearing tight-fitting undergarments for a few days.
Conclusion
Male circumcision is a very common procedure that involves minimal to no risk factors. It has many benefits, like less susceptibility to acquiring HIV and sexually transmitted diseases. It is a simple procedure where an individual need not get hospitalized and may require only 20 minutes. The procedure does not involve any complex postoperative care.
