Most adult men contemplating circumcision suffer from one of a number of conditions that are best treated by circumcision. But some men also opt for circumcision to improve their sex lives, please their partners, or boost their self–esteem
The controversy over infant circumcision
One need not only turn to the internet to sample the controversy. Anti–circumcision advocates focus on the potential psychological trauma, as in “How could a being who has been aggressed in this way, while totally helpless, develop into a relaxed, loving, trusting person?” And pro–circumcision advocates cite the health benefits ascribed to circumcised males.
Cultural, religious and ethnic preferences are legitimate factors to consider when deciding whether to circumcise your baby boy. In fact, there are some health benefits to being circumcised, but they aren’t “Essential to health” or significant enough to warrant routine infant circumcision.
Medical reasons for one to be circumcised as an adult
The difference between routine infant circumcision and circumcisions performed on older children and adults is that medical need usually influences the patient’s decision to undergo the knife.
Phimosis: The number one reason for circumcision after infancy is phimosis, a tightness of the foreskin that prevents it from being retracted. Phimosis can be normal in boys less than six months old. In males older than that, however, it can make urination and hygiene difficult and erection painful.
Paraphimosis: In paraphimosis, the second most common reason for post–infancy circumcision is that the foreskin is permanently retracted, constricting the shaft of the penis and causing swelling and pain.
Balanitis (infection of the head of the penis, often caused by accumulation of secretions) and posthitis (infection of the foreskin) can be treated without surgery. As a first measure, a urologist will likely prescribe an anti–fungal and anti–inflammatory ointment, which may help clear up the problem, there is often an associated yeast infection, which thrives in the warm, moist environment created beneath the foreskin. Unfortunately, these conditions often recur, and when they do, a circumcision is advisable.
Other foreskin problems
Tumors of the foreskin, loose foreskin, and tears in the fold of skin of the penis that attaches to the foreskin are all conditions that can be treated non, surgically.
There is a growing body of research that shows a relationship between AIDS and uncircumcised men. It seems that men who have been circumcised have a much lower chance of contracting AIDS, even with a high–risk partner. It is not clear however, whether circumcision as an adult would show this same effect.
Circumcision for sexual reasons
Less than 5% of men who undergo circumcision do so for reasons other than medical ones. Still, some men whose parents opted against circumcision 20, 30, 40 and even 50 years ago are indeed contemplating the procedure, for reasons other than medical ones. Some are prompted by wishes dating from childhood, or by the request of their sexual partners.
The women speak
It’s interesting to note that women seem to play a large role in the circumcision decision. Studies have found that mothers often have the final say over whether their sons are to be circumcised or not. Many men who have opted for the procedure for non–medical reasons say they were pressured by girlfriends or wives. Women who claim a preference for the circumcised penis usually say they are turned off by hygienic problems in uncircumcised men or turned on by the look of the circumcised penis.
In newborns, circumcision takes only a few minutes. But the procedure in older children and adults is a more intricate operation. General anesthesia for adult circumcision was once routine, but now local pain blocks are usually used, and the procedure itself is usually done on an outpatient basis, even in older men.
If phimosis or paraphimosis has caused a lot of swelling, the circumcision may require two procedures: one to make a slit in the foreskin that relieves the pressure and the pain, and another at a later date to finish the circumcision after the swelling has gone down.
In most cases, men should refrain from sexual intercourse or masturbation for about six weeks after circumcision – until the incisions are healed and the sutures are removed. Some men experience frequent and prolonged erections in the first days after the surgery. After the first 48 hours or so, ointments or bandages aren't usually needed, but wearing loose clothing for a few days is recommended.
As with any surgical procedure, bleeding and infection are risks. Other more rare complications include blood clots, tearing of the sutures (usually due to erections) and complications from the anesthesia.
Making the decision
If your medical condition warrants a circumcision, then by all means, have the surgery. But if you’re considering the procedure sheerly for aesthetic reasons, think again.
Dr. Al Cooper of the San Jose Marital and Sexuality Center in San Jose, California, explains, “Remember that there is no turning back. If you are doing it because you think that is what women want, consider this. All women are not alike… If you want to impress a woman, change your pants, your hairstyle or even your personality. Hold off on changing your penis. Remember, she’ll be evaluating the first few before she decides if she wants to see the last one”.