Circumcision is the removal of the foreskin of the penis. The foreskin is the retractable fold of skin that covers the end of the penis. It’s a continuation of the skin that covers the whole penis.
This surgery is routine in case of babies. But some babies in some countries do not undergo circumcision hence in adulthood they may need it.
The circumcision ratio varies countries to country. It is more common in America. It is up to 80 % in adults. Many of them are circumscribed in childhood or in neonatal days only.
It is more than 90% in Muslim countries.
In India, it is less than 20 % and many of them are Muslims.
The reason for circumcision.
It could be a medical condition or premature ejaculation.
Medical reasons
In men, a circumcision is a treatment option for the following conditions.
Tight foreskin (phimosis)
Phimosis is where the foreskin is too tight to be pulled back over the head of the penis (glans).
This causes pain when the penis get erected. The opening of skin fit back to the glance of the penis and constrict there, cause severe pain while ejaculation. This may result in fear of sexual activity.
Recurrent balanitis
Balanitis is where the foreskin and head of the penis become inflamed and infected.
Paraphimosis is where the foreskin can’t be returned to its original position after the erection of the penis. causing the foreskin swelling and difficulty in repositioning.
Immediate treatment is needed to avoid serious complications, such as restricted blood flow to the penis.
Balanitis xerotica obliterans
These are fibrotic changes of the foreskin more often present in diabetic patients. Such patients have a difficult retraction of their skin. They have a very narrow opening left for micturition.
Cancer of the penis
Although Cancer of the penis is a very rare type of cancer, but it occurs in Indian patients of 50- 70 yrs. age group. Hence every adult should keep in mind this possibility. Many patients would not like to be consult before it is difficult for them to urinate. But by that time the cancer spread to other body part.
Every body should observe a red patch, wart-like growth or ulcer appears on the end of the penis or under the foreskin. If any such symptoms occurs , he must consult specialist doctor.
Premature Ejaculation
While in sexual activity without any fear, if ejaculation ( coming out of sperm as last step) happen without penetration or partial penetration, that can be labelled as premature ejaculation.
Although causes behind premature ejaculations are many and the treatment part also different for each case. But circumsion is also one of the major type of treatment part of this disease.
After circumsion your skin of head of penis get desensitised and hence could not erosed easily by merely touching any body part. And this play major role in prevention of premature ejaculation, especially in new wedding cases (Applicable to India), where they have to face first attempt of sexual activity. This is common picture in India.
Many my patient comes to me on 2nd or 3rd day with either paraphimosis (swelling of irreducible foreskin) or with history of incomplete penetration due to severe pain or premature ejaculation.
When should I undergo surgery
You must undergo circumcision surgery as early as possible.
If you any one of above mentioned problem.
If you are going to marry and not experienced any sexual activity.
If you have repeated urinary infection problem.
If you are not sure but willing to be operated.
In all such cases you must consult a proper general surgeon who can suggest you surgical management and will explain in detail.
About circumcision surgery
Circumcision surgery in adult is totally different than surgery in adult.
Many times it done by conventional method. But now some new methods have also developed. For this procedure some types of stapler have developed. All these surgeries are blood less surgeries.
Anaesthesia requirement for this is spinal anaesthesia. But if patient is comfortable and cooperative then one can do it under local anaesthesia also. Hospital stay in most of time could be for 24 hour. But if you are undergoing the procedure under local anaesthesia then you can get discharge in evening if you are get operated in morning, same day.
24 hour hospitalisation required for your mediclaim insurance also. On next day doctor will remove your dressing. There is no need for dressing or application of any type of ointment. You have to keep the area clean and can wash the wound every time after urination under running water.
If some sensation of burning, doctor may advice you to apply some petroleum jelly over suture line and head.
You can bath freely without any fear. Wash wound with running water and can wear underwear. Many times glans becomes sensitive to contact with undergarments also hence you can wear sterile surgical disposable pad under your underwear. Pads are freely available in all surgical stores.
Sensitivity fade away within one week and you will feel better.
You can resume back to your duty on 3rd or 4th day. But you have to wait for 2 weeks to resume your sexual activity.
Overall post op days are not painful. You can enjoy your all routine activity.
Regarding medication, you may have to take it for 7 to 10 days only.
Doctor can call you on 7th nd 14th day for post op examination.
Conclusion : Anything regarding penile conditions and urinary or sexual difficulties should not overlooked. You must consult your family physician or your general surgeon for better management. Please remember because of this problem you can loose your concentration from your work. Your family relation can be disturbed. Hence please discuss this problem with your spouse and consult doctor in time.