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Circumcision is a procedure in which some or the entire foreskin of the penis is being removed. Foreskin represents at least a third of the penile skin and serves to cover the glans or the head of the penis.

Circumcision is usually performed on the first or second day after birth and the whole procedure takes about 10-15 minutes.
This “routine”, non-therapeutic infant circumcision has been extremely controversial in the past couple of years. It is done in local anesthesia with dorsal penile nerve block being the most common form of anestesia used in this procedure.

Functions of the foreskin

Male foreskin has also many important functions such as:

    * Protecting the glans from abrasion and contact with clothes
    * Increasing sexual pleasure by sliding up and down - stimulating the glans by covering and exposing it.
    * Minimizing friction during the sexual intercourse and masturbation so that the supplementary lubrication is not needed
    * Providing natural lubrication to the glans because, with no foreskin, after circumcision, the glans becomes dry, tougher and less sensitive

Indications for the operation

There are many medical and non-medical causes or indications for this kind of operation and they include:

   1. Pathological phimosis – A condition of a very tight foreskin that makes retraction over the glans painful or impossible.
   2. Paraphimosis - A condition where the tight foreskin is stuck behind the glans and cannot be moved back
   3. Chronic inflammations of the penis
   4. Penile cancer - It is the cancer of the penis, and it can be located on the glans or the foreskin.
   5. Religion
   6. Parental request
   7. Torn or tight frenulum - This condition is called Frenulum breve. The frenulum is like the joining ridge under the tongue and when it is too short or tight it causes the foreskin to slide forward, which can be very painful. Most common symptoms are pain and bleeding caused by ripping of the frenulum.
   8. Very loose foreskin
   9. Hygiene
  10. For improving of the stimulation during intercourse

Benefits of the circumcision from the medical point of view

Beside relieving the underlying medical cause of circumcision, studies about the benefits of circumcision have provided conflicting results which means that some studies say there are many benefits and some say that there are none. There were many cost-benefit analyses of the medical aspects of neonatal circumcision.
Among the studies performed in the United States of America, The American Academy of Pediatrics done in 1999. says that the medical benefits of circumcision are simply not sufficient to recommend routine circumcision of newborn kids. However, it is not illegal in any way.
 
There were many questions about possible reduction of HIV transmission in the men who have been circumcised. Several studies have proven that there are clear indications that circumcision can reduce the rate of female-to-male HIV infection significantly. The exact mechanism is still unknown. However, many experts said that it is definitely not reliable enough to replace sex education and safer sex practice.
 
Several studies have also shown that non-circumcised men are at greater risk of developing human papilloma virus infection. Another great benefit from the circumcision operation is hygiene. On the other hand young kids and babies require special hygiene care but non-circumcised infant's penis should be left alone and requires no special care.
 
Non-circumcised children are at greater risk of developing several genital infections because the foreskin may contain bacteria and infect if it is not cleaned often enough. It can become infected even if it is cleaned too often with soap, which destroys the protective layer of the skin.

Complications

This operation has many possible complications. First, it is a highly traumatic experience for both infants and young adults. Because the circumcision is a real surgical operation, bleeding and infection are the most common complications that could occur. Nevertheless, there are also many other possible complications such as urinary fistulas, stenosis, ulceration of the glans, removal of too much tissue and secondary phimosis.
 
Common complications also include:

    * temporary pain after the operation
    * temporary irritation of the glans
    * different or decreased sensation during sex


CountryYearNeonatal circumcisions (%)

United States
2002
60.1%
Canada
2003
11.5%
Australia
2004
12.7%
New Zealand
1995
0.35%
United Kingdom
1972
0.41%


Circumcision- history and religion

The oldest evidence of circumcision claim that circumcision began first as a religious sacrifice or a ritual, which was a kind of a child’s entrance into adulthood.
It was also used to improve the hygiene and to discourage masturbation and other socially forbidden sexual behaviors. It was a symbol of castration, which means that the males shouldn’t think about sexual pleasures.
 
It is well known that, in some parts of the world, it is almost obligatory for children to be circumcised for religious reasons. This relates mostly to the Islamic countries.
 
Several religions that promote circumcision are not doing it because of the religion but strictly for the aesthetic reasons. In these countries, body modification of the genitals is needed to change the “bad” appearance of the genitals. Countries that have a big percentage of such aesthetical circumcisions are The United States, the Philippines and South Korea.
 
Islam is one of the world religions that promote circumcision out of the religious reasons although it isn’t mentioned in Quran. Timing of the operation can vary from country to country.
 
Some Muslim countries perform circumcision on the eighth day after the birth, while others perform the ritual later in life. Circumcision is a religious practice traditionally required by Judaism also. The ritual is called Brit Milah.

Psychological effects of circumcision

The dissatisfaction of circumcised men is a very common psychological symptom. Some of them complain about feeling like their penis is incomplete, deformed or maimed.
Some of them even felt violated and abused. Most of the men, who are not satisfied with the fact that they are circumcised, tend to include at least one of the following feelings: anger, resentment, revenge, rage, hate, sense of loss, deficiency, diminished body image, disbelief, lack of understanding, confusion, embarrassment or shame.
 
However, the fact is also that many circumcised man are extremely satisfied with the fact that they had this operation. They are very happy with their appearance and sex life and definitely do not feel any kind of shame because of it. The experts have different explanation for this phenomena, but most of them claim that this is because circumcised men simply do not know what they are missing. Most of them are circumcised as infants and think that sexual sensitivity they have without a foreskin is normal. Many of them also accept the fact that they are circumcised because of the cultural assumptions and religious beliefs!

Erection and sexual pleasure

After the circumcision the erection is usually not a major problem for man. The patient shouldn’t have sexual intercourse or masturbate at least five weeks after the operation until the wound heals properly. There were some theories about the fact that circumcision can cause premature ejaculation problems because of increased sensitivity on the glans of the penis but none of this has been proven yet. Some experts also say that circumcision can promote kids' over-masturbation and in that way produce a layer of scar tissues on the glans, which could be a barrier for sexual orgasm.
 
Several studies have also proven that during the circumcision, about one-half of the erogenous tissue on the penile shaft is being removed.
According to some psychological tests made in the past, the circumcised men are significantly more likely to masturbate and to participate in oral sex activities, as well as engage in various sexual practices.

Circumcision - a women’s perspective

Maternal instinct is definitely in conflict with this operation because of the mother’s responsibility to protect the child from any harm or pain. Contrary to this, mothers still sign the majority of the hospital circumcision forms!
As for the effects of circumcision on sexual pleasures we must say that it can affect female sexual enjoyment adversely. This means that in most of the cases women do enjoy more when the foreskin is present. Many women reported that they were much more likely to experience vaginal dryness during intercourse with a circumcised man than with an uncircumcised one.

Read More: Circumcision Could Lead To Better HIV Protection. Or Maybe Not.

Advice for the circumcised men

After the operation, you should wash the area with clean and hot water everyday. You may experience some swelling since it is a normal part of the rehabilitating process. It takes 7 to 10 days for the penis to heal after the circumcision and almost a month until you may start participating in sexual activities.
Water and soap should prevent bacterial super infections, which are very common after this kind of operation. If you notice any signs of infection, you should report it to your doctor immediately. The most common signs of infection are temperature of 100.4°F or higher, redness, swelling or a yellowish discharge.
The following important symptoms should be always reported to your physician:

   1. Constant bleeding from the wound
   2. In cases of infant circumcision, within 6-8 hours after circumcision a diaper should be wet. If this is not the case, there is a risk of urethra blockage
   3. If the redness and swelling around the tip of the penis does not relieve after 3 to 5 days, this could be a sign of bacterial super infection.