CIRCUMCISION

Definition

Removal of the foreskin, a flap of skin that covers the tip of the penis.

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Parts of the Body Involved

• Penis

Reasons for Procedure

In the US, the procedure is mostly done for cultural and/or religious reasons. It is usually performed on babies within the first few days of life. It may be done on older boys or men if there is a medical reason.

Certain health benefits are thought to be associated with circumcision. Many health professionals believe these benefits are slim. Circumcision may be associated with decreased risks of:

Urinary tract infection

• Foreskin infection
• Phimosis (tightening of the foreskin, which can be severe enough to close off the opening to the penis)
• Penile cancer
• Certain sexually transmitted diseases 
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Risk Factors for Complications During the Procedure

• Infants with bleeding disorders
• Infants with a family history of bleeding disorders
• Infants whose mothers were taking blood thinners during pregnancy
• Infants with penile deformities whose foreskin may be needed to repair the deformity
• Premature infants
• Infants with infections or serious jaundice at the time of the circumcision

What to Expect

Prior to Procedure

• The doctor will carefully examine the baby to make sure he is in good health and that the penis appears normal
• Blood and/or urine tests may be performed
• An anesthetic cream may be applied to the penis 60 to 90 minutes before the procedure to begin numbing the area

• During the Procedure

·         An injected anesthetic is also sometimes used    

·         No medications or IV fluids are necessary during circumcision

·         A pacifier that has been dipped in a sugar solution may help keep the baby calm during the procedure Anesthesia

Research shows that the best method is a penile ring block.

Description of the Procedure

The baby is carefully restrained on an infant board or by a chosen individual. The anesthesia is injected. The penis is cleaned with an antiseptic solution.

The doctor pulls the foreskin away from the body of the penis while sweeping away any areas where tissue still adheres to the penis. Pressure is applied on blood vessels. The excess, unwanted foreskin is cut away. Rarely, stitches may be used to sew the remaining bit of foreskin into place on the skin of the penis.

The foreskin can be removed by a number of ways. Some use a simple scalpel to remove the foreskin. Others may use one of several devices to ensure an even circumcision and clamp blood vessels. These devices include the Gomco clamp, Plastibell device, or Mogen clamp. The Plastibell device is left in place instead of a bandage. It falls off on its own within 5 to 8 days. Petroleum jelly or antibiotic ointment is smeared generously on the penis and a bandage is sometimes applied.

After Procedure

No special medications are necessary after circumcision.

How Long Will It Take?

The procedure lasts 15 to 30 minutes.                                                                                

Causes for circumcision

Will It Hurt?

With appropriate anesthesia, the baby should feel only minimal pain.

Possible Complications

·         Infection

·         Bleeding

·         Anesthetic reactions

·         Unsatisfactory cosmetic outcome, due to removal of too little or too much foreskin, or uneven appearance

·         Meatitis and meatal stenosis (irritation or narrowing of the opening of the urethra)

·         Penile skin bridges

·         Decreased penile sensation

·         Loss of excessive penile skin

·         Buried penis

·         Need for further surgery

• Scarring

• Loss of sensation on the glans-penis

• Loss of the sensitive terminal nerves in the foreskin

• Causes early Impotence

Average Hospital Stay

There is no hospital stay associated with circumcision.

Postoperative Care

·         Change the bandage and clean the circumcised area at every diaper change

·         Apply petroleum jelly or an antibiotic ointment to prevent the diaper or the bandage from sticking to the penis

Outcome

There may be significant swelling of the penis and/or a clear scab over the area of circumcision. The penis should be healing well within 7-10 days of the circumcision. If a Plastibell device was left in place, it should fall off on its own within 10 days.

Call Your Doctor If Any of the Following Occurs

·         A bloodstain larger than the area of a quarter on the baby's diaper

·         The Plastibell device has not fallen off within 10 days

·         The penis or the area of the incision appears red, swollen, hot to the touch, or is oozing a yellowish discharge

·         The baby develops a fever or appears to be in pain

·         The baby does not have a wet diaper within about 6 to 8 hours of the procedure

·      The head of the penis appears blue or black                                                                                              

Advantages of a fully Functional Foreskin.

At birth, every boy has the skin of his penis extending to cover the end of it, protecting his penis from abrasion and chemical attack. As the boy grows; this skin, although originally attached all the way 'round to the glans of his penis, comes free, so that by the time he is five or six years old, he is able to roll the skin back to expose the whole of his glans.  Never force this to happen!  The glans and neck area of his penis is very sensitive, as is the interior surface of his prepuce, (foreskin), with millions of touch sensitive nerves distributed throughout the whole foreskin.

Should the opening of the foreskin of an older boy be too small for the glans to be pulled back for cleaning, introduce him to our specific exercise for stretching the foreskin.  With the advent of antibiotic medicines, any medical reason for circumcision falls away. This topic is more fully discussed in our Member's Area

Circumcision performed on the newborn baby boy traumatically interrupts the natural separation of the foreskin from the glans that normally occurs anywhere between birth and age 18. The raw, exposed glans penis heals in a process that measurably thickens the surface and results in desensitization of the head (glans) of the penis.

Even though the medical indications for circumcision have fallen away, except in cases where the flow of urine is totally restricted, circumcisions are still being carried out as a matter of course.  We, along with a growing number of concerned parents and others interested,  recommend that circumcision should be avoided except in life threatening situations.

Although there has been a call for further research study into the location and function of sensory receptors in the male genitalia, consultation of any uncircumcised male over the age of two years will confirm that life is a lot more fun with a foreskin than without!  In America, studies are in progress, evaluating the psychological effects of circumcision.

In order to decide whether a child's foreskin should be ablated, the anatomy and function of the structure should be clearly understood.  The supposed danger of conserving the child's  foreskin must be balanced against the hazards of the operation, including the mortality rate and negative after effects, which must be known and considered, and which may include Hemorrhage (bleeding) - Serious hemorrhage occurs in about 2% of infants during the circumcision procedure, resulting in shock and sometimes death. While death is a rare complication of circumcision, it does occur.

Boys with unrecognized bleeding disorders are at risk for serious hemorrhage.  Not the least is the unsightly scar tissue and  mutilated aspect of the circumcised penis resulting from emergency  measures that are needed from time to time. None of the above, can in any way describe the screams of agony and anger of the child!

As the protective, mechanical and sensory roles of the foreskin become recognized and better understood, a growing number of circumcised men are becoming interested in the possibility of restoring their foreskin through a non-surgical process of skin expansion and skin development by means of simple self-applied methods.

Read more about the foreskin.

The foreskin has twelve known functions.

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1. To cover and bond with the synechia so as to permit the development of the mucosal surface of the glanspenis and inner foreskin.
2. To protect the infant's glans from feces and urine ammonia in diapers.
3. To protect the glans from friction and abrasion for a lifetime.
4. To keep the glans moisturized and soft with emollient oils.
5. To lubricate the glans
6. To coat the glans with a waxy protective substance.
7. To provide sufficient skin to cover the erection by unfolding and stretching.
8. To provide an aid to masturbation and foreplay.
9. To serve as an aid to penetration.
10. To reduce friction and chafing during intercourse.
11. To serve as erogenous tissue because of its rich supply of erogenous receptors.

To contact and stimulate the G-spot of the female partner.

Effects of penile reduction surgery (circumcision) on sexual intercourse

Although still pleasurable for the man, intercourse without the participation of the prepuce lacks the gliding mechanism. The only source of stimulation is the glans rubbing against the wall of the vagina. The sensations from the specialised receptors of the frenar band, frenulum and inner foreskin layer are missing.

"With intravaginal containment of the normal penis, the male's mobile sheath is placed within the woman's vaginal sheath. It is impossible to imagine a better mechanical arrangement for non-abrasive stimulation of the male and female genitalia than this slick 'sheath within a sheath.' Circumcision destroys this one sheath within a sheath . . . I would hazard a guess, that dyspareunia [painful intercourse] is more common in the women whose husband is circumcised . . . one would be foolish to discount the circumcised male's immobile penile skin sheath as an ancillary item contributing to vaginal, abrasive discomfort . . . The male with a penis already moderately obtunded by circumcision may be less apt to use a condom, which he feels may further decrease his genital sensitivity . . . because most American males lack a facile prepuce, the period of foreplay and dalliance may be abbreviated in the rush to the intra-vaginal method of penile stimulation. Both these factors conceivably could be of significance in increasing the rate of venereal disease, including AIDS . .

The narrow or right foreskin

Intertrigo is an inflammation of large skin surfaces that are in close contact. A common site is the groin, especially in babies, the elderly and the obese. The condition is also common in hot climates.

Symptoms 

§  An inflamed, unpleasant smelly skin area.

Causes

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§  The skin becomes excessively moist due to sweating or incontinence (involuntary passing of urine)

§  Friction between the damp surfaces leads to infection.

Treatment in the home 

   Bath often, dry yourself carefully and afterwards apply talc powder or our magnificent non-medicinal texture cream.

   In certain cases, Intertrigo is caused by diabetes.

Prevention 

§  In general, bath often and dry yourself carefully.

§  If you are obese, try to reduce your mass.

§  If you suffer from incontinence, try our treatment and the texture cream should cure or prevent incontinence or infection, but good hygiene and regular care or exercise is required to prevent recurrence.

§  As always, further consult your urologist or physician if you have any sexual infections or diseases.

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