Unveiling the Journey: The Why, How, and After of Adult Circumcision - Medical Pulse



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Definition of circumcision

Circumcision is a surgical procedure that involves removing the foreskin, that is, the skin that covers and protects the glans of the penis. It can be practiced for medical, religious or cultural reasons. In adults, circumcision is generally performed under local or general anesthesia.

Common medical indications for performing circumcision in adults

The main medical indications for adult circumcision are:

  • Phimosis : shrinkage of the foreskin making it difficult or even impossible to uncapping (release of the glans).
  • Paraphimosis : impossibility of repositioning the foreskin after uncapping, which can lead to strangulation of the glans and require emergency intervention.
  • Balanitis xerotica obliterans (BXO): chronic inflammatory condition affecting the foreskin and/or glans.
  • Recurrences of urinary or sexually transmitted infections: some studies have shown that circumcision can reduce the risk of infection by certain viruses such as HIV.
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Potential Benefits of Circumcision in Preventing Sexually Transmitted Diseases

Several studies have demonstrated that circumcision in adults could reduce the risk of HIV infection, particularly in countries where this infection is very widespread. Indeed, the foreskin contains cells that are more vulnerable to the HIV virus. In addition, certain sexually transmitted infections (STIs) can cause lesions on the glans and thus facilitate the entry of the virus into the body.

Circumcision can also reduce the risk of other STIs such as syphilis or genital herpes. However, it is important to emphasize that circumcision does not completely protect against these infections and that it is essential to continue to use a condom during sexual intercourse.

Course of the surgical procedure

The procedure generally takes place under local or general anesthesia depending on the case and lasts approximately 30 minutes. The surgeon makes a circular incision around the foreskin to separate it from the glans then proceeds to remove it. The techniques used to perform this operation vary depending on the surgeon’s preferences and the anatomical characteristics of the patient:

  • Classic technique: use of a scalpel to make incisions.
  • Laser technique: use of a laser beam to cut the foreskin with more precision and less bleeding.
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After removal of the foreskin, the edges are sutured using absorbable sutures which disappear after a few weeks.

Post-operative care and pain management after surgery

Post-operative care mainly consists of maintaining good local hygiene to avoid infections. It is recommended :

  • Clean the operated area daily with mild soap and lukewarm water then apply an antibiotic ointment prescribed by the doctor.
  • Avoid friction on the operated area by wearing loose cotton underwear for a few days.
  • To take analgesics (paracetamol) to relieve the pain, which can be moderate to intense depending on the patient. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be prescribed if there is significant inflammation.

Expected payback period

The recovery period varies depending on the individual but generally, it takes approximately:

  • 1 week: before the edema and bruising completely disappear.
  • 3 weeks: before the absorbable sutures fall off spontaneously or are removed by the doctor.
  • 4 to 6 weeks: before you can resume sexual activity, making sure to use a condom to protect the scar.
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Possible risks and complications

Like any surgical procedure, circumcision in adults carries risks and possible complications:

  • Infection: rare but possible if post-operative care is not respected.
  • Hemorrhage: may require further intervention to suture the affected blood vessels.
  • Persistent pain or hypersensitivity of the glans: generally temporary, it disappears after a few weeks to a few months.
  • Unsightly scars or scar shrinkage: may require additional surgery to correct these aesthetic or functional problems.

Preparation before the procedure and instructions to follow after it

To prepare for the intervention, it is recommended:

  • To consult a urologist or surgeon specialized in this type of intervention to evaluate the medical indications and discuss the operating procedures (anesthesia, technique used).
  • – To carry out a pre-operative assessment including in particular: blood test, consultation with the anesthesiologist, stopping smoking if possible.

  • To shave the pubic area before the procedure to facilitate post-operative care.

After the procedure, it is important to:

  • Strictly follow the doctor’s advice and prescriptions regarding local care and taking analgesics or anti-inflammatories.
  • Consult quickly if there are signs of infection (redness, heat, intense pain) or significant bleeding that persists after the procedure.

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