C ircumcision is one of the oldest operations known.
Performing circumcision purely for social / cultural / religious reasons is controversial. From a medical perspective, however, there are definite indications when circumcision is needed.
Circumcision is recommended when any of the following conditions are present:
- Phimosis (This is the inability to retract the foreskin of the penis in order to expose the glans (head of the penis). Phimosis is normal in babies and boys up to the age of 5 years and in this age group the foreskin should never be forced back.
- Paraphymosis (This is a very painful condition that develops when a tight foreskin is forcefully retracted)
- Recurrent infection of the glans (head) of the penis or the foreskin (called balanitis or balano-posthitis). This is common in men who suffer from Diabetes.
- Cancer of the penis
- Warts on the penis
- Trauma to the foreskin (usually caused by a zipper)
Circumcision should not be performed in small babies who:
- Were born prematurely
- Have severe illness
- Have a bleeding tendency (eg haemophilia)
- Were born with an abnormal looking penis:
- Skew or rotated penis
- Abnormally placed urethra (the urethra is the small opening usually located on the tip of the glans where urine comes out. Some baby boys are born with this opening not at the tip of the penis, but somewhere along the shaft of the penis – this condition is called hypospadias)
- It prevents the development of penis cancer: Men who had circumcision as a baby will almost never develop cancer of the penis
- It protects against HIV: Circumcision reduces the rate of HIV transmission by 50-70%
- It may prevent urinary tract infections in baby boys under the age of 6 months
There are many techniques for performing circumcision.
Excision using a surgical scalpel (also called the “double sleeve” technique) is safe and reliable, with a low complication rate and excellent cosmetic result.
Other techniques for performing circumcision include clamps and shields, which are made of plastic or metal. Although these devices can be applied by nurses, it is preferable that a circumcision always be performed by a qualified doctor.
Circumcision has no effect on a man’s libido (sex drive), his sexual ability, his fertility or the quality of his erection.There is controversy regarding the effect of circumcision on a males sexual enjoyment: some people believe that sexual enjoyment is increased after a circumcision while others are of the opinion that it is decreased.
Circumcision is a minor operation with a low complication rate. Most complications are not serious and can be managed with simple measures.
Possible complications include:
- Ulceration of the urethral opening
- Skin complications (related to the surgeon removing too much skin or not enough skin)
- Damage to the glans of the penis
- Damage to the shaft of the penis
- Inability to pass urine after the operation (this is uncommon and will usually resolve within a few hours)