Circumcision: An Overview of the Procedure

Circumcision meaning: What is it?

Circumcision is the surgical removal of the foreskin, which is the layer of skin that covers the head of the penis. The foreskin is completely attached to the penis when a baby is born. The length of the foreskin varies in different people, but it should be loose enough to be retracted (pulled back) easily to expose the glans. Normally, the foreskin becomes retractable around the age of 5. It is common for baby boys to undergo circumcision shortly after birth. Although it is less common, adults can also undergo circumcision. 

Circumcision: Why is it done?

Circumcision can be a religious or cultural ritual in different ethnicity, it can also be a matter of family tradition, personal hygiene or preventive health care. 

Sometimes, there is a medical need for circumcision including:

• If the foreskin is trapping the urine, causing a bulge under the foreskin during urination 
• If the foreskin is very long and the penis cannot be cleaned thoroughly, which can lead to a higher risk of infection
• If the foreskin is tight, causing pain and swelling upon accidental foreskin retraction 
• If the foreskin is tight, causing discomfort or pain during sexual intercourse

Circumcision: Benefits

Circumcision has several benefits, not only in the aspects of penile health, but it can also improve hygiene, as a circumcised penis is simpler to clean and wash, especially for children.

Other health benefits of circumcision also include:

• Protection against penile cancer, and a lower risk of cervical cancer in female sexual partners
• Prevention of inflammation of the glans (balanitis) and inflammation of the glans and foreskin (balanoposthitis) 
• Prevention of the inability to retract the foreskin (phimosis) and inability to return the retracted foreskin to its original location (paraphimosis) 
• Reduce the risk of urinary tract infection
• Reduce the risk of sexually transmitted infection, such as HIV, however safe sexual practices remain essential in such aspect 

Circumcision: Risks

Circumcision surgery is associated with the risk of bleeding and infection, just like most other surgeries. Rarely, circumcision may result in foreskin problems, such as:

• Cutting the foreskin too long or too short
• Irritation on the top of the penis 
• Inflamed opening of the penis (meatitis)
• The remaining foreskin doesn’t heal properly and reattach to the end of the penis (penile adhesion), which will require another minor surgical repair

Who should not have a circumcision?

Circumcision is not recommended if your baby:

• Has certain medical problems or bleeding disorders
• Has a problem with the opening of the urethra, where it does not form correctly at the tip of the penis (hypospadias), as the surgeons will need the foreskin to correct the problem 

Circumcision: Procedure

1. Circumcision can be done as day surgery under local or general anaesthesia, the penis and the surrounding area will be numbed
2. The foreskin is removed behind the head of the penis
3. A dressing will be applied to the end of the penis to reduce the stinging sensation during urination 
4. The procedure is short and takes around 30 minutes. Patients can go home after the surgery if they are stable

Circumcision: Recovery

Recovery from circumcision commonly takes around 8-10 days for babies. During the healing process, the penis may look swollen and red. Recovery from an adult circumcision may take longer, up to 6 weeks. The exposed tip of penis may feel very sensitive. It is advisable to keep the area dry for 2 days and avoid swimming for around 2 weeks. 

Should I have my baby circumcised?

Circumcision has benefits but also carries risks, ultimately the decision is personal. Seek medical advice about the pros and cons so that you can make the decision that is right for you and your baby. 

Sources

https://www.acog.org/womens-health

https://www.nhs.uk/