Adult circumcision is a common and straightforward surgical procedure. It involves the removal of the foreskin, the retractable skin covering the head of the penis, and is performed for various personal and medical reasons. While the procedure is quick, the process requires a thorough pre-operative assessment and adherence to a specific recovery plan, differing significantly from that performed on infants.
Initiating the Process
The first step is to schedule an initial consultation with a qualified specialist, typically a urologist or an experienced general surgeon. During this appointment, the physician reviews the patient’s medical history, performs a physical examination, and discusses the goals for the surgery.
The consultation determines the pre-operative workup, which may include blood tests to ensure the patient is a suitable candidate. The discussion covers the risks, benefits, and expectations of the surgery, ensuring informed consent. Physicians also discuss the type of anesthesia and whether the procedure will be performed in an outpatient clinic or a hospital setting.
Common Motivations for Adult Circumcision
Adult males seek this surgery for medical necessity, hygiene, or personal preference. The most common medical indication is phimosis, a condition where the foreskin is too tight to be retracted properly over the glans, causing pain and difficulty with hygiene. Other medical issues include recurrent inflammation of the glans (balanitis) or paraphimosis, where the retracted foreskin gets trapped behind the glans.
Many individuals pursue the procedure for perceived improvements in hygiene, especially where persistent moisture under the foreskin is an issue. It is also associated with preventative health benefits, such as a reduced risk of certain sexually transmitted infections and penile cancer. Non-medical reasons include personal aesthetic preference, cultural alignment, religious conversion, or the preference of a sexual partner.
Surgical Techniques and Anesthesia
Adult circumcision is most frequently performed under local anesthesia, often combined with a mild oral sedative. The local anesthetic is administered via a penile nerve block, sometimes with a ring block, which completely numbs the area while the patient remains conscious. General anesthesia is less common, typically reserved for patients with high anxiety or complex medical cases.
The two most common surgical approaches are the sleeve resection and the dorsal slit technique. The sleeve resection involves making two circumferential incisions and removing the tissue between them, often resulting in a clean cosmetic outcome. The dorsal slit technique involves a single cut along the top of the foreskin, frequently preferred when treating severe phimosis or paraphimosis. The procedure is brief, lasting 30 minutes to an hour, and is generally performed in an outpatient setting.
Managing Recovery and Expectations
Recovery is a gradual process requiring strict adherence to post-operative instructions, with full healing typically taking four to six weeks. Swelling and bruising around the incision site are normal, usually peaking in the first two to three days. Pain is generally mild and manageable with over-the-counter pain relievers, though a prescription may be provided.
Wearing supportive, snug-fitting underwear is recommended to keep the penis elevated against the abdomen, which helps reduce swelling. Strenuous activities, heavy lifting, and intense exercise must be avoided for at least two weeks to prevent strain on the incision. Most patients can return to light work and normal daily activities within two to five days.
The dissolvable sutures may take two to three weeks to fall out completely. Patients must avoid all sexual activity, including intercourse and masturbation, for a minimum of four to six weeks to allow the incision to heal fully. Minor complications like light bleeding or discharge are common, but increasing pain, persistent bleeding, or a fever should prompt immediate contact with the surgeon.