Adult circumcision: Why is it performed?

Circumcision is the surgical removal of the foreskin, which is the retractable skin tissue that covers the head of the penis (the glans). In health, circumcision may be carried out in adults for various reasons.

Here, Mr Neil Haldar, esteemed consultant urological surgeon provides a comprehensive insight into adult circumcision. He explains when circumcision is medically necessary, how painful circumcision is and if circumcision affects sexual sensation, among other important points.

What conditions might require an adult to be circumcised?

The most common reason for having a circumcision as an adult is due to phimosis, which is a condition that causes tightening of the foreskin of the penis. Phimosis leads to difficulties retracting the foreskin back for hygiene and it can also cause pain during intercourse if the foreskin is very tight.

Other common indications for adult circumcision would be recurrent infections or an inflammation of the foreskin called balanitis.

Less commonly, adult circumcision would be considered for a condition called paraphimosis in which again, due to a tight foreskin, the foreskin retracts but gets stuck behind the head of the penis. The foreskin then swells until it cannot be pushed back over the head of the penis again.

In rare cases, adult circumcision would be performed for cancer of the penis.

Is adult circumcision a painful procedure?

Adult circumcision is performed under general anaesthetic, with local anaesthetic infiltrated at the end of the procedure. Thus, there is no pain or discomfort initially.

After a few hours, there may be some discomfort when the local anaesthetic wears off. This requires tablets or another form of oral pain relief, but only for a couple of days.

Following this, there may be some sensitivity especially when rubbing against underwear, but generally, an adult circumcision is not considered a painful procedure.

Can adult circumcision cause erectile dysfunction?

There is conflicting evidence, but a meta-analysis of various papers in 2013 concluded that adult circumcision is unlikely to affect male sexual function adversely. Indeed, there is some evidence that suggests that the instance of erectile dysfunction is likely to be lower in circumcised adults.

Circumcised adults might, however, experience changes in how they perceive their body image. These psychological effects may then influence their sexual life.

Does circumcision reduce pleasure?

Again, there is conflicting evidence. However, a systematic review done in 2020 showed that adult circumcision did not affect sexual function, sensitivity, or pleasure.

What are the benefits of adult circumcision?

The main benefit of adult circumcision is a reduction in inflammation or infections from the foreskin. Circumcision also improves hygiene, especially in adults who are unable to retract their foreskins to clean.

As well as this, there is also a lower risk of urinary tract infections, sexually transmitted infections, and cancer of the penis in adults who have been circumcised.

If you wish to discuss your circumcision options, do not hesitate to visit Mr Neil Haldar's Top Doctors profile today.