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CONDITIONS

Circumcision in Adult Men

What is Circumcision?

Circumcision is the surgical removal of foreskin. Foreskin covers the head of a flaccid penis. When the penis is erect, the foreskin pulls back to reveal the penis.

During a circumcision, a doctor cuts away a portion of the foreskin and reattaches the section that remains to create a shorter section of skin.

Circumcision in infancy is performed for several reasons, including religious, social, medical, and cultural purposes. For example, in Jewish and Islamic communities, this procedure is common as part of religious standards.

Newborn circumcision is more common than circumcision as an adolescent or adult. In the United States, more than 58 percent of newborns are circumcised. However, total circumcision rates in the United States may be as high as 71 percent.

Some people with an uncircumcised penis have the procedure later in life. Adult circumcision is often a simple procedure, though it’s a larger surgery than it is in infants.

People who choose to have it done may do so for many of the same reasons parents choose it for their newborns — medical, religious, or social.

Note that circumcision is an ongoing source of discussion and debate in many societies. We will present some of the current findings and research, but many claims are being challenged.

Common Beliefs Regarding the Benefits of Adult Circumcision

In the United States, the American Academy of Pediatrics currently supports the infant procedure for its health benefits. However, the group stresses that the final choice belongs to the child’s parents, and neither choice is incorrect.

On the other hand, in adults, the benefits of circumcision depend largely on the reason for the procedure in the first place. It’s your own choice.

If it’s done as an established treatment for a medical condition, the health benefits are better known. Conditions that can be treated with circumcision include:

  • phimosis
  • paraphimosis
  • balanitis

Other claimed health benefits should be approached with caution. Commonly cited benefits include the following:

Reduced risk of HIV and other sexually transmitted infections

The U.S. Centers for Disease Control and Prevention (CDC) reports that individuals with a penis have a lower risk of contracting HIV during vaginal sex if they’re circumcised. The World Health Organization reports that risk is 60 percent lower in people who are circumcised.

According to the CDC, circumcision also lowers the risk of a person with a penis getting herpes and human papillomavirus (HPV) from vaginal intercourse.

Other research involving heterosexual couples suggests circumcision may protect people with a penis as well as their sexual partners from syphilis.

However, this remains a hotly debated topic among researchers. Most importantly, you shouldn’t assume that circumcision provides protection against HIV or other sexually transmitted infections.

Reduced risk of urinary tract infections

According to research, people with a penis who have been circumcised may have a lower risk of developing a UTI compared to people who have intact foreskin.

It’s worth noting that this study was done in people who were circumcised as babies.

Prevention of infection and irritation

Phimosis is a condition that develops when the foreskin doesn’t pull back over the penis. This can cause uncomfortable tightness, scarring, inflammation, and even infection. Circumcision can prevent this condition.

Likewise, balanitis occurs when the head of the penis becomes inflamed and swollen. It may be the result of an infection or irritation, but circumcision helps prevent it from occurring again.

Circumcision is a proven treatment for both conditions.

Improved hygiene

This is largely a misconception. Uncircumcised and circumcised penises both require proper cleaning.

While some people believe that an uncircumcised penis requires extra attention when it comes to hygiene, it just requires different steps.

Oil, bacteria, and dead skin cells can accumulate under the foreskin and develop into a buildup called smegma. If smegma isn’t taken care of, it can lead to painful side effects including infections like balanitis.

Religious adherence

Individuals who are devout to a particular religion or wish to comply with cultural traditions may find that completing the procedure has an emotional or spiritual benefit.

This is a personal choice, and if circumcision is important to your spiritual life, you may find a benefit in this area.

Reduced risk of cancer

Penile cancer is very rare, but research suggests it’s even more rare in individuals who have been circumcised.

Risks of Adult Circumcision

Adult circumcision is a relatively simple procedure, but that doesn’t mean it is without risks.

The most common risks associated with adult circumcision include:

  • Bleeding. You may experience bleeding for a few hours or days after the procedure around the incision.
  • Infection. Infection at the incision is possible. It may prolong recovery.
  • Reactions to anesthesia. Most people will receive some type of anesthesia before the procedure. Reactions to the medications are possible. They include nausea, vomiting, and headache.
  • Foreskin issues. During the procedure, it’s possible the skin may be trimmed too short. Likewise, the skin could be left too long. Both can cause additional issues and complications.
  • Wound complications. The incision and stitches may not heal properly. This can lead to skin issues or problematic circumcision scars.
  • Reattachment. The foreskin could reattach to the penis improperly. This condition can be very uncomfortable and may require more surgery.

How It's Done

Newborn circumcision is a very brief procedure. For an adult, however, the surgery is slightly more involved. It can take between 30 minutes and an hour.

An anesthesiologist will administer medication to help sedate you. Depending on your preferences, you may receive general anesthesia or more localized anesthesia.

During the procedure, the doctor will move the foreskin away from the head of the penis and then back onto the shaft. They’ll take measurements of exactly how much skin they need to remove.

Then, the doctor will use a scalpel to cut the skin. (For infant circumcision, a doctor snips the skin away from the penis with scissors or a special appliance.)

For adults, the skin will then be cauterized or stitched back to the shaft with sutures that will dissolve. When the stitches are in place and the penis is wrapped in a protective dressing, you’ll be wheeled into a recovery room.

As long as there are no immediate complications, most people can go home the day of the surgery.

Recovery Timeline

In the immediate hours and days after the surgery, you’ll likely experience swelling and bruising on and around the penis. This is to be expected. Apply an ice pack to your groin for 10- to 20-minute windows of time every two hours. Be sure to put a thin piece of fabric between the ice and your skin.

In the first few days of recovery, it’s important the dressings around your penis stay clean so you can reduce the risk of infection. On day two or three, your doctor may ask you to return to their office to have the dressings replaced.

Recovery from adult circumcision typically takes two to three weeks. You may need to request a week off from work. Some people will not be able to return to normal activities for longer.

With your doctor’s permission, you may be able to return to normal physical activity, including exercise, four weeks after the procedure. Sexual intercourse and masturbation may need a bit longer — up to six weeks.

Your doctor can guide you on an appropriate timeline based on your healing and health.

Postsurgical Care Instructions

Pain from adult circumcision is typically mild. Your doctor may prescribe a mild pain reliever, but over-the-counter options may be sufficient to ease any discomfort. Your doctor may also prescribe an antibiotic in order to prevent a possible infection.

Wear comfortable but supportive underwear that can hold the head of the penis toward the belly button lying flat. Loose-fitting underwear allows for too much movement. This can increase swelling and pain.

Within a day or two of the surgery, you should begin trying to walk. Keep the movement low-impact and slow at first. Don’t jump to normal physical activity without permission from your doctor.

As soon as your bandage is removed, you can take a shower. Be careful not to swipe the incision with a washcloth or towel, and don’t use any scented soaps or gels for several weeks. The fragrance and chemicals may irritate the sensitive skin as it heals. Pat dry the area to reduce sensitivity.

What Will Your Results Be?

The results you experience from adult circumcision will largely depend on the reason you had the procedure in the first place.

If you chose to have it to stop or prevent infections or physical issues like phimosis, the procedure is typically very successful. You may not experience these again in the future.

If your circumcision was for religious reasons, you may feel more deeply personal about your beliefs after completing the procedure.

Each person’s results are different, and you may discover you were affected in other ways. For most individuals, the surgery will have no lasting impact on sexual function, urinating, or sensitivity.

The Takeaway

Most individuals in the United States who are circumcised undergo the procedure as a newborn. Choosing to have it as an adult requires some initiative and planning. It’s important you make sure you understand your reasons as well as the risks associated with the procedure.

However, keep in mind that adult circumcision is a simple procedure with very few risks or complications.

Talk to your doctor about your expectations for circumcision. Together, you can make a plan that is comfortable and suitable for your objectives.

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