Overview
Circumcision is a surgical procedure to remove the foreskin, the sleeve of skin that covers the head of the penis. Infant circumcision is one of the ancient practices and is common in many countries and religious communities.
Circumcision is a minor surgery that is mostly done during infancy. Adult circumcision is mainly done for aesthetic reasons, clinical conditions, and hygiene.
Circumcision is a simple procedure and has its possible risks and benefits.
Some parents go for circumcision procedures for their babies for religious traditions, hygiene, and preventive care. For others, the procedure may seem unnecessary.
Is circumcision necessary?
Generally, circumcision is an optional procedure. Many parents decide to circumcise their newborn boys for cultural and social reasons. Some adult males decide to undergo circumcision for hygienic benefits and aesthetic causes.
Circumcision may be necessary to treat certain medical conditions like phimosis or penile cancer.
Medical reasons for circumcision:
Phimosis
Phimosis is the inability to retract or prepuce the foreskin behind the penis head or glans penis.
Congenital or physiologic phimosis is a common condition in newborn males. Natural separation and retraction of the foreskin occurs normally when the baby reaches the age of three.
Persisting phimosis in adolescents and adult males is an abnormality and requires medical intervention and probably a corrective procedure like circumcision.
Paraphimosis
Paraphimosis occurs in uncircumcised or partially circumcised males. The condition needs emergency medical care.
The condition is extremely painful as the foreskin gets trapped behind the glans penis and cannot be pulled down.
It can also restrict the blood circulation at the penis head and cause swelling or discolouration of the skin.
The condition is common in children between the ages of 4 months to 12 years.
Recurrent balanitis
Balanitis is a painful inflammation of the glans penis. The condition is detected by redness and discoloured patches at the penis tip.
There can be swelling and itching in the foreskin. Some of the skin in the penis are shiny and white.
You may have some smegma or discharge from the foreskin.
A foul smell in the penis or difficulty in urination.
In some rare conditions, older men above the age of 60 can have lesions or sores at the penis tip.
Balanitis is mainly caused by:
- Yeast infections
- Sexually transmitted infections (STIs)
- Scabies
- Diabetes
- Skin infections like eczema or psoriasis
- Chemical irritants
Balanitis can occur if the foreskin is unclean and also due to old age, or obesity.
Balanitis xerotica obliterans (BXO)
BXO is long-term inflammation of the glans penis. The affected area may have flaky and dry patches of skin (xerotica).
Lesions occur on the foreskin and extend and attach to the skin preventing the foreskin from retracting or pulling back. The condition can be very painful.
There can be pain during urination.
BXO is more common in adult men.
Sexually transmitted infections (STIs)
Reports and studies show that circumcision provides partial protection from sexually transmitted diseases and may also reduce the risks of HIV transmission in the community.
Urinary tract infections (UTIs)
Neonatal circumcision reduces the risks of the occurrence of UTIs and their recurrence by 10-30% in babies and children. Recurrent UTIs can lead to other major health conditions in the future.
Penile cancer
Penile cancer is not a preventable disease but circumcision can help in reducing the risks of developing the disease.
Signs of penile cancer:
- Bleeding from the foreskin
- Smelly discharge
- Sores
- Discolouration of the foreskin
- Thickening of the foreskin
Should a baby boy be circumcised?
The decision to circumcise your baby is entirely yours.
Neonatal circumcision is a fairly common tradition in certain religious communities and parts of the world like the United States.
Newborn circumcision is still a debated topic but according to the American Academy of Pediatrics (AAP), the benefits of circumcision are much greater than the risks.
Certain medical conditions like hypospadias which is a birth defect require circumcision at the neonatal stage.
Generally, the urethral opening is located at the top of the penis. Hypospadias is an abnormal condition where the opening is not located in its usual position. Rather it is located somewhere at the shaft of the penis. This may require a circumcision.
Parents also believe that circumcision can reduce the risks of developing UTIs, HIV, STIs, foreskin infections, and phimosis in children.
It also simplifies hygiene. Uncircumcised boys simply have to follow a different routine to maintain hygiene and prevent infections.
Are there any complications for circumcision?
Though circumcision is a safe procedure, the surgery is not devoid of risks.
Parents should talk to the doctor and learn about the advantages and benefits before the procedure.
Complications include:
Bleeding
Bleeding is the most common complication, however, the risk of bleeding in neonatal circumcision is very mild.
Insufficient removal of the foreskin
Sometimes the foreskin removed is insufficient and uneven and may require a repeat visit to the operating room.
The redundant foreskin may be too long and slide back over the glans penis causing a phimosis. It can also cause smegma buildup and other complications.
Reduced sensitivity
Sometimes the removal of the foreskin may reduce the sensitivity at the top of the penis head and reduce sexual pleasure.
Epidermal inclusion cyst
This is a rare complication and can occur due to accumulation of smegma at the incision site.
Meatitis
Inflammation or redness of the urethral opening is known as meatitis.
Stop your suffering NOW
Don't just jump into a surgery because your doctor is advising you to go for it. Consult our doctors to know if you need a surgery at all. Rest assured, we WON'T recommend you surgery unless it's the last resort.
What to expect after a circumcision procedure?
Recovery from adult circumcision may take six weeks.
After circumcision, it is normal to have the penis slightly swollen and bruised. The swelling slowly resolves over the next one to two weeks.
There will be a tight bandage on the wound site which may cause urinary retention. This is temporary and will resolve after the bandage is removed.
You should wear loose-fitting clothes and underwear and abstain from sexual activities for a few weeks as recommended by your doctor.
Take your painkillers as instructed by your doctor.
Recovery in children and infants after circumcision
After the circumcision procedure:
- It is normal to develop some fever after surgery
- The circumcision site will be slightly pink and swollen. This will normalize after some time
- A yellowish or whitish tinge may appear on the penis head which will go away after some days post-surgery
- After the dressing is removed, antibiotic ointment should be applied several times as recommended by the doctor
- There will be no problem with urination
- It is normal to have some blood at the incision site for the first two days
- On the third day of the surgery, your baby may soak in a tub of clear, warm water for 5-10 minutes. This prevents crusting on the penis tip and keeps it clean
When to call a doctor for your baby?
- Your baby has developed a high fever
- The swelling is not improving
- There is some yellowish discharge from the penis
- Difficulty in urination
- Increased pain
- Continuous bleeding from the circumcision site
