How is Adult Circumcision Done? What are the Risks and Changes to Sensitivity

What is Circumcision?

Circumcision is the surgical removal of the foreskin from the human penis.

Risks of Adult Circumcision

If you’re considering doing an adult circumcision, the risks of surgery are something that you should be aware of. Before every surgery, I tell my patients that this operation is a routine surgery. It’s something we often perform and feel very comfortable doing.  However, we do want you to be aware of the risks. The risks of this surgery include:

• Bleeding: There will be some bleeding. You may also have some bruising afterward.

• Infection: There is a low risk of infection with this procedure.

• Injury: There is a risk of injury to surrounding structures, mostly the tube that drains the bladder, or the urethra. However, this is very low.

• Removal of too much/not enough skin: There is a risk of sometimes taking too much or too little skin. If you take too much, sometimes you can have a cosmetically unappealing result. f you take too little,  you may have a cosmetically unappealing result. If you take too much, it can be uncomfortable when you have erections

• Change in sensation: Sometimes, people will have a change in sensation after surgery. This may include increased sensitivity of the glans. The reason for this is the glans has been covered for your entire life with foreskin, it’s now always uncovered, and so it can be hypersensitive. This usually resolves with time.

How is it done?

Usually, it’s done under local anesthesia, meaning you’re wide awake. We numb the penis. Typically, all you feel is the poke of the numbing medication. It’s typically very comfortable after the block and patients don’t feel anything except for some minor tugging.

Aftercare for Adult Circumcision

• You will have a bandage around the penis, it will usually stay on for a one or two days, and then you’ll take it off or come back to your doctor’s office and remove it.
• You have to avoid any heavy lifting or strenuous activity for about two weeks and no sexual intercourse or putting your penis into anything for about four to six weeks, depending on your doctor’s orders.

Changes in sex life after adult circumcision

Will having a circumcision change my sex life? There are a few studies that have looked at changes in sex life after adult circumcision. I’m going to go through some studies that go over this.

In 2002, an AIST American study looked at patients who had an adult circumcision, and they surveyed 123 men of which 43 responded. Did they have a change in their sexual function? Did they have a difference in their penile sensation or sexual satisfaction or a rate of sexual activity? 

What they found was that there was a decrease in erectile function and penile sensitivity in patients who had an adult circumcision. However, they did have improved satisfaction. That comes from people having less pain during intercourse. Sometimes people get an adult circumcision because they are having pain during intercourse. Some also reported enjoying the appearance of their penis more after circumcision. Looking at the whole cohort, 63% had an improved sex life overall whereas 20% said that they had a worsening. Twenty percent is not a small percentage so I suggest you need to really critically decide if this is something you really want to do.  Of course, you have to take all these studies with a grain of salt because many adult men will develop erectile dysfunction in their lifetime so it’s unclear if that’s exactly related to the Circumcision itself or that’s what they remember before they started developing issues with their erectile function.

Another study of college women evaluated their preference for circumcised or uncircumcised men by looking at pictures and (87%) of college-age women who preferred circumcised penises. Hence, I see a lot of young men come in. They want to have a circumcision because their partner wants them to have one. I suggest you should proceed with a circumcision only if you really want to do it, don’t do it for someone else because you might end up being unhappy with the results.

In 2006 in South Korea, another study was published on sexual function in adult men undergoing circumcision. South Korea is an interesting place because many adult men were undergoing Circumcision in South Korea around this time when the study was published. They looked at (373) men of which (273) were circumcised and (115) were not, and they looked at again how did Circumcision change the quality of their sex life? In this particular study, which I think is a more substantial study because you’re comparing circumcised men to uncircumcised men, they saw no difference in sex drive, ejaculate, or latency, or how long it takes you to reach ejaculation and erectile function, or sensation. They did find that there was some percentage of men who had a decrease in enjoyment with masturbation that was about (48%) whereas (6% ) enjoyed masturbation more. If we look at the whole cohort, the vast majority of them had no significant change in their sex life. (6%) improved their sex life after Circumcision and (20%) felt that their sex life was worse.

Why and How Circumcision Changes Sensitivity?

The theory behind why Circumcision changes the sensitivity of the gland is that, before Circumcision, your glands are covered by foreskin. When you eliminate that foreskin, your gland is now exposed to your clothes and everything else. Initially, it’s hypersensitive. We have observed that over time it becomes desensitized. That can cause some changes in the sensation of the glands. There is also evidence to suggest that there are fine touch receptors in the foreskin which are removed during Circumcision resulting in sensory changes.

Summary

Overall I think adult circumcision is very safe when done in the right hands. At the same time, there is a risk of change to sensation. If you’re considering a Circumcision it’s essential to realize that while it is a safe and effective procedure, there may be potentially changed to your penile sensation which you should consider carefully.

References

https://pubmed.ncbi.nlm.nih.gov/11956453/

https://pubmed.ncbi.nlm.nih.gov/23600924/

https://pubmed.ncbi.nlm.nih.gov/17155977/