CIRCUMCISION
The amputation of the foreskin is called circumcision, and may be inevitable in cases of untreatable or recurrent pathological phimosis. Learn more about this procedure, get to know its different types, check out some important tips on what to do before and after the intervention, and find out some of the history of this millenary practice.
BASIC TECHNIQUE
There is a plethora of different techniques for the removal of the foreskin. While for infant circumcision specific amputation devices are used, for grown-ups the procedure is normally executed using surgical instruments.
In this technique, after the execution of a dorsal slit, the foreskin is cut around the whole penile circumference, allowing its removal.
There are different techniques than the above illustrated, but the objective of the circumcision is always the same: to amputate the preputial structure (composed by the phimotic ring, external and internal skins) around the whole penile circumference, so that the glans remains always exposed. In many cases the frenulum ends up being removed as well, but normally there is no real reason for this to happen (if you suffer from frenulum breve, check out the page about frenuloplasty).
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Depending on where the main cut is made on how much skin is amputated, the circumcision can be classified in different types or styles. The image above exemplifies the "loose" one: the quantity of remaining skin is such that the sulcus (region between the base of the glans and the penile shaft) doesn't end up exposed when the penis is flaccid.
To learn more about the types of circumcision and how they can affect the final result both aesthetically and functionally, click on the button below:
To learn more about the types of circumcision and how they can affect the final result both aesthetically and functionally, click on the button below:
pre-op appointment and preparation
Preparation for circumcision is pretty much commonsense, all you need to do is follow some basic directives when it comes to pubic hair, sex and hygiene:
LOCAL OR GENERAL ANESTHESIA?
On grown-ups, circumcision is normally performed under local anesthesia. What this means is that you'll be kept fully awake during the procedure, but the only pain you'll feel will come from the shots of anesthesia on the glans. Sometimes just one or two injections are enough, but it's not uncommon that a handful of shots on the "head" of the penis are needed for the attainment of the desired anesthetic result.
If you prefer not to be awake during the procedure and/or don't want to feel the shots on the glans, then general anesthesia may be asked for. But keep in mind that the state of unconsciousness always involves some degree of risk (even if relatively low), and that you will need someone to accompany you back home in case you don't want to be kept at the hospital or clinic afterwards.
If you prefer not to be awake during the procedure and/or don't want to feel the shots on the glans, then general anesthesia may be asked for. But keep in mind that the state of unconsciousness always involves some degree of risk (even if relatively low), and that you will need someone to accompany you back home in case you don't want to be kept at the hospital or clinic afterwards.
POST-OP AND RECOVERY
If circumcision is relatively simple, the same can't be said about the postoperative phase. Aside from the discomfort and the absolute need to abstain from sex, a series of precautions must be taken in order to ensure full healing and a smooth, nice looking scar:
AND HOW MUCH DOES A CIRCUMCISION COST?
It's practically impossible to stipulate an average price for this surgical intervention. The cost may vary all the way from zero when executed via the public health system (if that is actually an option where you live) to more than a thousand dollars when done at a private clinic without any health insurance. Besides, the clinic's quality and the type of surgical instruments utilized (conventional/electrocautery/laser) may imply significant price point differences.
Of course, try not to utilize the price as a criterion for choosing where and by whom to undergo your circumcision. The important thing is that it occurs at a place that offers adequate infrastructure, equipment and prophylaxis, and, above all, be conducted and executed by a professional that inspires confidence. And, to inspire confidence, it's of prime importance that he answers all of your preoperative questions and is able to explain why the circumcision is being indicated, and whether it's really necessary or just "optional".
Of course, try not to utilize the price as a criterion for choosing where and by whom to undergo your circumcision. The important thing is that it occurs at a place that offers adequate infrastructure, equipment and prophylaxis, and, above all, be conducted and executed by a professional that inspires confidence. And, to inspire confidence, it's of prime importance that he answers all of your preoperative questions and is able to explain why the circumcision is being indicated, and whether it's really necessary or just "optional".
FOR WHICH CASES SHOULD IT BE INDICATED?
Circumcision should be indicated for cases of pathological phimosis which do not respond to medical treatment or keep coming back. It is also the recommended line of action for chronic posthitis and balanoposthitis (such as candidiasis and other inflammation due to fungi and bacteria), even if not associated with any phimotic condition.
For the resolution of physiological phimosis, however, frenuloplasty (for the liberation of the frenulum) and preputioplasty (for the enlargement of the phimotic ring) are the recommended surgical procedures.
For the resolution of physiological phimosis, however, frenuloplasty (for the liberation of the frenulum) and preputioplasty (for the enlargement of the phimotic ring) are the recommended surgical procedures.
and why is circumcision so popular in some countries?
In order to answer this important question, we need to go back in time and examine the origins of circumcision:
