Adult circumcision is a surgical procedure that removes the foreskin, the sleeve of skin covering the tip of the penis. While commonly performed during infancy, the procedure is safe and effective for adults who choose or require it later in life. The surgical process is feasible for mature anatomy, though it differs significantly from the quick procedure performed on newborns. Adult circumcision is typically an outpatient procedure, allowing the patient to return home the same day.
Primary Reasons for Seeking the Procedure
The decision to undergo adult circumcision is often driven by medical necessity or personal choice. Medical indications are the most common reason, typically involving issues with foreskin functionality or recurrent infection.
One frequent medical indication is phimosis, the inability to fully retract the foreskin over the head of the penis. This tightness can cause pain during erections or intercourse and may result from chronic inflammation or scarring. A related emergency condition is paraphimosis, where a retracted foreskin becomes trapped, causing painful swelling and potential tissue damage.
Recurrent balanitis (inflammation of the glans) or balanoposthitis (inflammation of both the glans and foreskin) can also necessitate the procedure. These recurring inflammatory issues are sometimes linked to underlying conditions like diabetes or poor hygiene. When conservative treatments, such as topical steroid creams, fail, circumcision is often recommended as a long-term surgical solution.
Beyond medical need, many adults choose the surgery for non-medical reasons, including personal preference, aesthetic appearance, or improved hygiene. The procedure is also sought for religious or cultural reasons, such as during conversion, or to reduce the risk of certain sexually transmitted infections, including HIV.
Understanding the Adult Circumcision Procedure
The adult procedure reflects the mature anatomy and requires precise tissue management. The surgery is usually performed on an outpatient basis and takes approximately an hour to complete. A thorough consultation and physical examination precede the surgery to ensure the patient is a good candidate and understands the expected outcome.
Adults most often receive local anesthesia, typically administered as a dorsal penile nerve block, which numbs the surgical area while the patient remains awake. Patients who are anxious or have complex cases may opt for intravenous sedation or general anesthesia, which requires the presence of an anesthesiologist. The choice of anesthesia can influence the setting; local anesthesia often allows for an in-office procedure.
The surgeon employs specific techniques, such as the sleeve resection or the dorsal slit method, to remove the foreskin. The sleeve resection involves removing a ring of foreskin and joining the edges of the remaining skin with sutures. The dorsal slit is sometimes favored when the foreskin is severely narrowed, such as in acute phimosis, as it relieves constriction before removal. Dissolvable sutures are used to close the incision, eliminating the need for a follow-up appointment to remove stitches.
Recovery and Post-Operative Expectations
The recovery process for adult circumcision is longer than for infants due to the greater amount of tissue and slower healing in mature skin. Initial healing, where swelling and discomfort subside, typically takes about two to three weeks. Full recovery, allowing for the resumption of normal activities, usually requires four to six weeks.
Patients should expect some swelling and bruising (edema) around the surgical site for the first few days. Wearing comfortable, supportive underwear is advised to help manage swelling and keep the penis positioned upward. Pain is generally manageable with over-the-counter pain relievers, though a doctor may prescribe stronger medication for the initial period.
Activity restrictions are important during the post-operative period to ensure proper healing. Strenuous activity, heavy lifting, and intense exercise should be avoided for at least two weeks. Sexual activity and masturbation must be avoided for four to six weeks to prevent the wound from reopening or becoming infected.
Although complications are rare, patients should be aware of potential risks, including bleeding, infection, and poor cosmetic results. A temporary increase in sensitivity of the glans is common as the tissue adjusts to constant exposure. A change in sensation during intercourse has been reported in some cases.