What Is Circumcision? Procedure, Benefits, and Risks Explained

What Is Circumcision?

Circumcision is a surgical procedure that removes the foreskin, the retractable fold of skin that covers and protects the rounded tip (glans) of the penis. The foreskin removal procedure is typically performed on newborn boys, often within the first 10 days of life, but can also be done in older children, adolescents, and adults. Circumcision is an elective procedure, meaning it's not considered medically essential for all males. The decision to circumcise is influenced by various factors, such as religious or cultural traditions, hygiene preferences, and potential health benefits.

Why Is Circumcision Performed?

There are several reasons why parents may choose to have their sons circumcised or why adolescents and adults may elect to undergo the procedure:

• Religious traditions: Circumcision is an important ritual in Judaism and Islam, often performed in a religious ceremony shortly after birth.
• Cultural norms: In some communities and countries, circumcision is a common cultural practice and is considered the social norm.
• Family tradition: Some families choose circumcision to continue a family tradition or because the father or other male relatives are circumcised.
• Hygiene: Circumcision can make it easier to clean the penis and may reduce the risk of certain infections, although proper hygiene is effective for all boys regardless of circumcision status.
• Potential health benefits: Some studies suggest circumcision may decrease the risk of urinary tract infections (UTIs), sexually transmitted infections, penile cancer, and other conditions, but the preventive benefits are not universally accepted as a sole reason for routine circumcision.

Ultimately, the decision to circumcise is a personal one that each family must make based on their own circumstances and beliefs and in consultation with their doctors.

How Common Is Circumcision?

Globally, circumcision is practiced by about 38.7% of males, with prevalence varying widely by region, culture, and religion. It's most common in Muslim-majority countries, Israel, parts of Africa, and the United States. In contrast, it's less common in Europe, South America, and parts of Asia, where cultural practices differ.

Circumcision Procedure: What to Expect

If you decide to have your son circumcised or to undergo circumcision surgery as an adult, here's what you can generally expect:

• The procedure is usually performed under local anaesthesia for newborns and under general anaesthesia for older children and adults.
• The foreskin, if still attached, is separated from the glans and then removed using specialized clamps or surgical tools..
• The remaining skin is stitched back together using dissolvable sutures.
• The procedure typically takes about 10 minutes for newborns and up to an hour for adults.
• Recovery time varies, but most infants heal within a week, while adults may need several weeks.

Who Performs a Circumcision?

Circumcision is typically performed by a qualified doctor, such as a paediatrician, obstetrician, urologist, or general surgeon. In some cases, especially for religious or cultural reasons, a specially trained religious practitioner may perform the procedure. However, it is generally safest to have circumcision done by a licensed medical provider in a sterile setting to minimise the risk of complications.

What Happens During a Circumcision?

Understanding the steps of a circumcision procedure can help alleviate concerns about what happens during the surgery. The circumcision surgery follows a relatively standard process:

1. Preparation: The penis is cleaned with antiseptic solution to reduce infection risk.
2. Anaesthesia: Local anaesthetic is applied to numb the area (for infants), or general anaesthesia is administered (for older children and adults).
3. Foreskin separation: The surgeon carefully separates the foreskin from the glans if they are still attached.
4. Clamp application: A specialised clamp or device is placed on the foreskin to control bleeding and mark the cutting line.
5. Foreskin removal: The foreskin removal is performed using surgical scissors or a scalpel.
6. Bleeding control: Any bleeding is controlled using pressure or, occasionally, small stitches.
7. Dressing: The area is covered with petroleum jelly and a loose gauze dressing.

The entire circumcision procedure typically takes 10-20 minutes for infants and up to 45 minutes for adults.

What Are The Different Circumcision Techniques?

There are several methods used for foreskin removal, each with its own advantages and considerations:

• Gomco clamp: This is the most common technique used for newborn circumcision. A metal bell is placed over the glans, and the foreskin is stretched over it and clamped in place. The excess foreskin is then cut away.
• Plastibell device: In the Plastibell method, a plastic ring is placed beneath the foreskin and tied off with string. The foreskin is then trimmed, and the ring typically falls off after 5-7 days as the area heals
• Mogen clamp: This device consists of a metal shield that protects the glans while the foreskin is pulled forward and clamped. The foreskin is then cut away using a scalpel.
• Dorsal slit: This technique is sometimes used for older children or adults. The foreskin is slit lengthwise along the top and then removed in a circular cut around the base of the glans.

The choice of technique depends on factors such as the patient's age, anatomy, and the preferences of the doctor.

What Happens After a Circumcision?

After the circumcision surgery, the penis will be covered with gauze or a protective dressing. You may notice some swelling, redness, or minor bleeding, which is normal. Here are some general guidelines for post-circumcision care:

• Keep the area clean and dry. Gently wash the penis with warm water and pat dry.
• Apply a petroleum jelly or antibiotic ointment to prevent the penis from sticking to the diaper or underwear.
• For newborns, change the diaper frequently to keep the area clean and reduce irritation.
• For older children and adults, wear loose, comfortable clothing and avoid strenuous activity until healed.
• Any pain or discomfort can usually be managed with over-the-counter pain relievers.
• Contact your doctor if you notice signs of infection, such as increased redness, swelling, discharge, or fever.

Benefits of Circumcision

Here are some of the circumcision benefits:

• Reduced risk of urinary tract infections (UTIs): Studies have shown that circumcised infants have a lower risk of developing UTIs compared to uncircumcised infants.
• Decreased risk of sexually transmitted infections (STIs): Some research suggests that circumcised men may have a lower risk of contracting certain STIs, including HIV and HPV.
• Lower risk of penile cancer: Although rare, penile cancer is less common in circumcised men.
• Prevention of foreskin-related issues: Circumcision eliminates the risk of phimosis (inability to retract the foreskin) and balanitis (inflammation of the glans).
• Easier genital hygiene: Without the foreskin, the penis is generally easier to keep clean.

Risks and Side Effects of Circumcision

As with any surgical procedure, circumcision carries some potential risks and side effects:

• Pain: The procedure can be painful, especially for older children and adults. However, pain can be managed with anaesthesia and pain medication.
• Bleeding: Minor bleeding is common after circumcision, but excessive bleeding can occur in rare cases.
• Infection: There is a small risk of infection at the surgery site, which can usually be treated with antibiotics.
• Scarring: Circumcision may result in visible scarring on the penis.
• Injury to the penis: In rare cases, the penis may be accidentally injured during the procedure.

It's essential to discuss these circumcision risks with your doctor and weigh them against the potential benefits when making a decision about the procedure.

Circumcision in Adults vs. Infants: Key Differences

Here are the key differences between infant and adult circumcision:

For adults, circumcision surgery is often done to treat a medical condition, such as phimosis or recurrent infections. The procedure is more complex and requires more extensive recovery compared to infant circumcision.

Aftercare and Recovery Tips

Proper care after circumcision is essential to promote healing and reduce the risk of complications. Here are some tips:

• Keep the area clean and dry. Gently wash with warm water and pat dry.
• Apply a thin layer of petroleum jelly or antibiotic ointment to prevent sticking and promote healing.
• For infants, change diapers frequently and apply a fresh layer of ointment at each change.
• For adults, wear loose, breathable clothing and avoid sexual activity until healed.
• Take pain medication as directed by your doctor.
• Contact your provider if you notice signs of infection, excessive bleeding, or other concerns.

Following these guidelines and attending follow-up appointments can help ensure a smooth recovery after circumcision.

Alternatives and Ethical Considerations

For those who choose not to circumcise, maintaining good genital hygiene is essential to prevent foreskin-related issues. This includes gently washing the penis daily with warm water and fully retracting the foreskin to clean underneath once it becomes retractable.

There are also ongoing ethical debates around circumcision, particularly when it is performed on infants who cannot consent. Some argue that the procedure violates a child's bodily autonomy and that the decision should be deferred until the individual can make an informed choice. Others believe that the potential benefits justify the practice and that parents should have the right to make this decision for their children. Ultimately, it is a deeply personal matter that each family must consider based on their own values, beliefs, and circumstances.

Conclusion

Circumcision is a common surgical procedure that involves removing the foreskin of the penis. While it is often performed for religious or cultural reasons, it may also offer certain health benefits, such as reduced risk of infections and penile cancer. However, the procedure also carries some risks, and the decision to circumcise should be carefully considered based on individual circumstances and beliefs. If you are contemplating circumcision for yourself or your child, it is essential to discuss the potential benefits and risks with a qualified doctor.

For those seeking circumcision surgery or who have questions about the procedure, Metropolis Healthcare offers expert care and support. With a team of experienced physicians and state-of-the-art facilities, Metropolis is committed to providing safe, patient-centred care for all your healthcare needs.

FAQs

Is it healthier to circumcise or not?

Both circumcised and uncircumcised penises can be healthy. Circumcision provides some preventive health benefits, but good hygiene and safe sex practices are important for all males regardless of circumcision status. The decision depends on individual, familial, and cultural factors in consultation with medical providers.

At what age do guys get circumcised?

Circumcision is most often performed on newborn boys, usually within the first 10 days of life. However, the procedure can be done at any age, from infancy through adulthood, although it is more complex in older individuals.

How long does a circumcision take?

For newborns, the circumcision procedure typically takes less than 20 minutes, including preparation time. In older children and adults, the surgery may take 30 minutes to an hour.

Is circumcision painful?

During the procedure, pain is managed with local anaesthesia, so the baby feels minimal discomfort. Afterwards, some pain and irritation are normal but can be controlled with medications. Most newborns recover comfortably within a few days.

How successful is a circumcision?

When performed by a trained practitioner using sterile techniques, circumcision has a high success rate with a low risk of complications. Most procedures result in complete healing without significant problems.

Does circumcision reduce sensitivity?

Some men report a decrease in penile sensitivity following circumcision, but most studies have found no significant long-term differences in sexual sensation, satisfaction, or function between circumcised and uncircumcised men.

Does circumcision affect fertility?

No, circumcision does not impact male fertility. The procedure removes the foreskin only and does not affect sperm production, erectile function, or ejaculation. Circumcised men are just as likely to father children as uncircumcised men.

Who should not have a circumcision?

Circumcision is not recommended for boys with certain congenital penile abnormalities, such as hypospadias (urethra opening on the underside of the penis), chordee (abnormal curvature), or ambiguous genitalia. The risks may also outweigh the benefits in infants with bleeding disorders or other serious medical conditions.

What is the recovery time after a circumcision?

Newborns usually heal within 7-10 days after circumcision. Older children and adults may take a few weeks to recover fully. Proper wound care, rest, and pain control help ensure a smooth and speedy healing process.

When can I have sex after circumcision?

If you are an adult undergoing circumcision, your doctor will likely advise waiting 4-6 weeks before resuming sexual activity to allow sufficient time for healing. Having sex too soon could cause pain, bleeding, or wound separation. Follow your doctor's specific instructions for a safe recovery.