What is Adult Circumcision?
Adult circumcision involves the removal of the foreskin under local or general anesthesia, depending on the individual’s needs. The procedure is similar to circumcision performed on newborns, but since it is done on fully developed adult tissue, the recovery time can be longer.
Circumcision in adults may be performed for a variety of reasons, ranging from health benefits to personal preference.
Benefits of Adult Circumcision
- Improved Hygiene
A significant benefit of circumcision is better hygiene. The foreskin can trap moisture, bacteria, and dead skin cells, leading to infections or irritation. Circumcision removes the foreskin, making it easier to clean the penis, which helps reduce the risk of infections like balanitis (inflammation of the penis head) and urinary tract infections (UTIs) [1].
- Reduced Risk of Sexually Transmitted Infections (STIs)
Circumcision has been shown to lower the risk of contracting certain sexually transmitted infections, including HIV. The foreskin can harbor bacteria and viruses, which can make it easier for infections to spread. Removing the foreskin decreases this risk, making circumcision a preventive measure for sexually active men, particularly those at high risk [2][3].
- Prevention of Phimosis and Paraphimosis
Phimosis is a condition where the foreskin is too tight and cannot be retracted, causing pain and difficulty with urination. As a result, it can also affect sexual relations as it can cause pain during sexual activity. Paraphimosis, on the other hand, occurs when a retracted foreskin cannot be returned to its normal position, leading to swelling and restricted blood flow. Both conditions can be resolved with circumcision, which removes the risk of these complications .
- Decreased Risk of Penile Cancer
While rare, penile cancer is a serious condition. Studies suggest circumcision can reduce the risk of penile cancer, possibly by preventing chronic infections and inflammation caused by the foreskin. Additionally, circumcision reduces the risk of human papillomavirus (HPV) infection, a leading cause of penile cancer [4][5]. HPV infection risks can also be further reduced with HPV vaccine.
- Improved Sexual Health
Some men choose circumcision for potential improvements in sexual health. Circumcision may reduce discomfort during sex, particularly for those with conditions like phimosis.
- Relief from Chronic Infections
Men who experience recurring infections, such as balanitis or other foreskin-related infections, may benefit from circumcision. Removing the foreskin prevents the buildup of smegma (a combination of oils and dead skin cells), which can cause irritation and infection [6].
Indications for Adult Circumcision
Circumcision in adults may be recommended for medical reasons or personal choice. Some common indications include:
- Chronic Infections
If a man experiences frequent infections of the penis or foreskin, such as balanitis or urinary tract infections, circumcision may be advised to reduce the likelihood of these infections recurring.
- Phimosis or Paraphimosis
For men suffering from phimosis (tight foreskin) or paraphimosis (inability to return retracted foreskin to its normal position), circumcision offers a solution to these painful and sometimes dangerous conditions.
- Sexual Health Concerns
Men who experience discomfort during sexual activity due to a tight foreskin or other issues may opt for circumcision. It can help alleviate pain and improve hygiene.
- Preventive Health Measures
For men at risk of sexually transmitted infections (STIs), including HIV, circumcision can serve as a preventive measure by reducing the chances of infection.
- Cosmetic Reasons
Some men choose circumcision for cosmetic or aesthetic reasons, as they or their partners may prefer the appearance of a circumcised penis.
- Religious or Cultural Beliefs
In some cultures and religions, circumcision is a significant rite of passage or religious practice. For these individuals, circumcision may be performed for cultural or spiritual reasons.
Suture-Less Circumcision: A Modern Approach
While traditional circumcision typically involves suturing the wound to close it, the suture-less method has gained popularity due to its simplicity, faster recovery, and reduced risk of complications. In this approach, no stitches are used to close the incision. Instead, specialized devices or pressure are applied to ensure proper healing without the need for sutures.
Benefits of Suture-Less Circumcision:
- Reduced Risk of Infection
Suture-less circumcision can lower the risk of infection, as there are fewer openings or areas where bacteria can enter. Traditional sutures, if not properly managed, can provide a surface for bacteria to grow, whereas suture-less methods minimize this risk
- Faster Recovery
With no sutures to manage or remove, the healing process is typically quicker. Men who undergo suture-less circumcision generally experience less discomfort and can return to their daily activities sooner.
- Less Post-Operative Pain
Many men report less pain after suture-less circumcision compared to traditional methods, as there are no sutures to irritate the surrounding tissue during healing [7].
- Outpatient Procedure
Suture-less circumcision can usually be performed as an outpatient procedure or in day-surgery centers under local anesthesia, making it more convenient and reducing the need for extended hospital stays. Also there is no need for general anesthesia.
Considerations and Risks
While suture-less circumcision offers several advantages, it is important to be aware of potential risks:
Not Suitable for All Patients: This method may not be suitable for everyone, particularly those with conditions like diabetes or other factors that may affect wound healing. A healthcare provider can help determine if the suture-less method is appropriate.
Post-Operative Care: Despite faster recovery, it’s still important to follow proper post-operative care instructions to avoid infection and promote healing. Men who undergo suture-less circumcision should still avoid vigorous physical activity and maintain proper hygiene.
