What Does Circumcised Mean?
Circumcision is a surgical procedure that removes the skin that covers the tip of the penis — the foreskin. In the United States, about 55 to 80 percent of newborn boys are circumcised before they leave the hospital. This means some men may choose to get circumcised in adulthood or never at all.
Some men are concerned about the cosmetics and sensation of the penis after their circumcision. While it is certainly true that your penis looks and feels differently after a circumcision, your preferences and treating any pain or harmful conditions of the foreskin are the most important.
The reconstructive urologists here at University of Utah Health are experts in both circumcision and frenuloplasty to give you the quality care you need for a successful surgery and speedy recovery.
Why Do People Get Circumcised?
Aside from cosmetic, social, and cultural reasons, uncircumcised men may also need to get their foreskin removed for various health reasons such as:
- Phimosis—This is when the foreskin is too tight and cannot be retracted from the head of the penis.
- Paraphimosis—This is when the foreskin of an uncircumcised penis cannot pull back over the head of the penis. The condition occurs more often in boys and older men.
- Balanitis—This is inflammation of the glans penis (the head of the penis).
- Posthitis—This is inflammation of the prepuce, otherwise known as the foreskin.
- Balanoposthitis—This occurs when both the head and foreskin of the penis are inflamed.
- Cancerous or pre-cancerous lesions on the foreskin.
- Warty lesions of the foreskin—like viral warts.
What Are the Benefits of Circumcision?
The American Academy of Pediatrics (AAP) does not recommend routine circumcisions at birth and leaves that decision up to the baby’s parents. But the organization does list some medical benefits that support performing the procedure. These include:
- a lower risk of HIV;
- a slightly lower risk of sexually transmitted diseases;
- a slightly lower risk of urinary tract infections and penile cancer (even though they’re both rare in all males); and
- help preventing balanitis, balanoposthitis, paraphimosis, and phimosis.
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There are a few different circumcision techniques. For newborns, doctors typically use a clamp. As the foreskin is pushed from the head of the penis, the doctor will clamp it with a metal or plastic ring-like device to protect the head of the penis while they remove the foreskin.
For teenagers and adults, we need to do a much more precise surgical procedure to get a good cosmetic outcome. Your doctor will perform the circumcision under a local anesthetic that is injected near the base of the penis. However, you can request to be put under general anesthesia for the procedure as well.
The doctor will make an incision just below the head of the penis and remove the whole foreskin with a scalpel or surgical scissors. They will then close the incision with dissolvable stitches that attach the skin of your penis to below the head. The stitches usually disappear within two to three weeks.
Dorsal Slit Procedure
Your doctor may use the dorsal slit technique if you are suffering from phimosis or paraphimosis. The dorsal slit procedure removes a specific amount of foreskin with scissors; then the doctor will perform the remainder of the circumcision at a later time.
Next in the procedure, we stitch back together the part of the foreskin that has been cut using 4-0 or 5-0 absorbable sutures. We keep any excessive bleeding under control with direct pressure and electrocautery.
Your doctor may apply petroleum jelly to your incision and wrap the stitched area in sterile gauze to keep it protected for the first 24 hours. After that, you can remove it per your doctor’s instructions.
For patients suffering from acute paraphimosis, your doctor may try to decrease the swelling with their hands before proceeding with surgery. They may apply a gentle, steady pressure on the foreskin to decrease the swelling. The doctor will then use his or her fingers to push on the head of the penis and pull on the foreskin in an effort to further reduce the paraphimosis.
If these steps don’t work, your doctor will perform the dorsal slit procedure to relieve the pain.
What to Expect After Your Circumcision
Most studies do not show that circumcision causes sensation in your penis to worsen or sexual pleasure to decrease after circumcision. Also, circumcision does not shorten the penis. If you have scarring from a previous circumcision, we can also repair it successfully.
However, as with any surgery, you can experience some unwanted side effects and risks after your circumcision. These may include:
- Swelling of the penis, which only lasts a few days.
- Increased sensitivity of the penis head, which can last for up to two weeks.
- Permanent altered or reduced sensation in the head of your penis.
Less common risks include:
- Infection of the incision, which may require antibiotics or surgical drainage.
- Bleeding from the wound, which occasionally requires another procedure.
- Swelling of excess skin, which requires further surgery and skin removal.
- Anesthetic or cardiovascular problems, which could require intensive care.
What Is a Frenuloplasty?
This procedure is a variation of a circumcision that doctors try first on patients with a tight frenulum (the tissue between the head of the penis and the underside of the penis). This can cause pain or bending during an erection. If this is the case, your doctor may perform a frenuloplasty to change length of the frenulum of the penis and ease the restriction.
The procedure can be done under a local anesthetic or general anesthetic, whichever you prefer. It’s a quick surgery that’s only minimally invasive, which means you’re in and out of the hospital within a day much like undergoing a circumcision.
Your doctor will start by dividing the skin with a horizontal incision near the top of the frenulum. The cut will be re-stitched lengthwise to elongate the frenulum and alleviate the pain. We will use dissolvable stitches to close up the incision, which usually disappear within two to three weeks.
Each patient may experience different things after their surgery. The important thing to remember is that the side effects below are either temporary or uncommon:
- Swelling of the penis, which may last a few days.
- Reduced sensation in the head of your penis.
- Bleeding from the incision, which could require a hospital visit or more treatment.
- No improvement in symptoms, which may result in the need for a full circumcision.
- Infection at the incision site, which could require antibiotics or further treatment.
- Scar tenderness at the incision.
- Anesthetic or cardiovascular problems that may require intensive care.
After-Surgery Care for Circumcision & Frenuloplasty
For a safe and quick recovery, make sure you follow the steps below:
- Keep the area dry for 24 to 48 hours after the surgery.
- Wear loose-fitting clothing for a few days.
- Avoid any sexual activity for at least four weeks.
- Do not swim for one to two weeks.
- Avoid strenuous exercise for the first month after surgery.
- Take simple pain medicine as needed for discomfort.
- Keep the wound clean and dry after urinating.
If you would like to consult with one of our men's health specialists, contact us at 801-213-2700 to make an appointment. No referral from a physician is needed.