Male circumcision is an operation to remove the foreskin that covers the tip of the penis. The functions of the foreskin include protecting the head of the penis and contributing to sexual sensations. While recent research suggests that circumcision may bring some medical benefits, some doctors believe these are too small to justify surgery.

A medical circumcision is a circumcision performed to treat a disease, such as pathological phimosis (lichen sclerosis), recurrent balanitis or recurrent urinary tract infections.

A request circumcision is a circumcision performed for non-medical reasons, such as parental preference, religious reasons or to potentially prevent disease at some future time.

Circumcision is mostly performed on babies for family, religious or cultural reasons.

Recent research suggests that circumcision may bring medical benefits such as:

• a 10 times lower risk of a baby getting a urinary tract infection (UTI) in his first year of life (remembering that only one per cent of babies are at risk of a UTI, so 1,000 circumcisions are needed to prevent one UTI)

• no risk of infants and children getting infections under the foreskin

• easier genital hygiene

• much lower risk of getting cancer of the penis (although this is a very rare condition and good genital hygiene also seems to reduce the risk. More than 10,000 circumcisions are needed to prevent one case of penile cancer)

• a possibly lower risk of men getting sexually transmissible infections (STIs) than men who are not circumcised (although these studies have not been scientifically confirmed and safe sex practices are far more effective in preventing these infections).

Reasons not to choose circumcision

There are also good reasons why parents choose not to have their sons circumcised, such as:

• wanting to avoid surgery that is not essential and that carries some risk of complications, even though these are small

• concern that removing the foreskin may reduce the sensitivity of the tip of the penis and reduce sexual pleasure for both partners later in life

• wanting to avoid the pain of circumcision, which can occur at the time of the operation and for some time after.

Circumcision of older boys and men

Some older boys and men need to have a circumcision due to medical problems such as:

• scarring of the foreskin that stops it from retracting (phimosis)

• recurring inflammation or infections of the penis (balanitis or lichen sclerosis)

• a foreskin that is too tight and causes pain or spraying when urinating

• recurrent urinary tract infections.

No.

We spend a lot of time education the patient about the procedure to make sure they understand everything about the procedure.

There are different methods of circumcision. Either local or general anaesthesia should always be used.

It really depends on the patients, age, genital anatomy and other patient needs. There are several different methods.

If you are considering circumcision for yourself or your son, you need to discuss a range of issues with your doctor or surgeon including:

• medical history

• any possible bad reactions or side effects from the anesthetic.

Circumcision may be performed in the first few days after birth under local anesthetic or after six months of age under general anesthetic. Parents and their doctor should make sure that the person performing the circumcision is experienced and competent, uses appropriate anesthetic and has the skills to deal with any potential complications.

After the operation you can expect:

• discomfort and swelling

• a small patch of blood in the baby’s nappy (smaller than a 10-cent piece – if it is any larger, contact your doctor immediately)

• the wound area looking unsightly for about 10 days.

Be guided by your doctor, but general suggestions include:

• giving your child lots of cuddles and comfort

• applying a little petroleum jelly or ointment on a light gauze dressing to the wound

• applying fresh petroleum jelly and a new gauze dressing at each diaper change. This reduces the risk of urine irritating the wound

• a daily bath to keep the area as clean as possible.

Complications following circumcision are rare, but can include:

• pain

• excessive bleeding

• infection

• cutting the foreskin too short or too long

• irritation to the head of the penis, since the foreskin seems to protect the head of the penis

• narrowing of the meatus (the tube that allows urine to exit from the body)

• reduced sensitivity, which may cause a decrease in sexual pleasure later in life or painful intercourse for the man’s sexual partner.

See your doctor immediately if your child experiences:

• continuous bleeding from the wound

• blue or black discoloration of the penis

• failure to produce a wet nappy within six to eight hours of the circumcision

• fever

• ongoing pain

• redness or swelling of the penis that doesn’t resolve after three to five days

• a yellowish discharge from the penis