Circumcision

The surgical removal of the foreskin is known as circumcision.  Circumcision rates vary by country, culture, and religion.  In the United States, Israel, and largely Muslim countries in northern Africa, the Middle-East, and Southeast Asia, circumcision is quite common – in many cases exceeding a rate of 90%.  On the other hand; Europe, Northern Asia, Sub-Saharan Africa, and Latin America have low circumcision rates – some less than 2%, especially in Europe.  Canada, New Zealand, and Australia are about evenly split with about half of men being circumcised.[i]  In fact, overall it is estimated that one-third of men on the earth are circumcised.  One note of interest is that almost every culture, regardless of how old or on which continent, has a history of circumcision.  In fact, in cultures where circumcision is not prevalent, it is more a matter that circumcision was discontinued at some point in that culture rather than never started in the first place.  This gives us a fair amount of confidence that circumcision of the penis has been performed for millennia.

Circumcision can also be performed for health reasons.  There are a number of disorders that involve the foreskin which can be treated by circumcision.  These include phimosis, paraphimosis, balanitis, and penile infection (click HERE to learn more).  In fact, men who are not circumcised don’t have any of these foreskin disorders and actually have a significantly lower risk of having penile cancer. 

Circumcision can be performed right after birth or as an adult.  In many cultures, circumcision is performed for religious reasons shortly after birth.  There are multiple different procedures used to circumcise the penis.  If performed right after birth, healing occurs quite quickly, typically within a week.  Circumcision during adolescence and adulthood can be more painful due to the increased frequency of nocturnal erections during the healing process.  Typically circumcision is performed by cutting a slit down the foreskin, then cutting the excessive skin off.  Although the frenulum is usually removed, in some cases the frenulum may not be fully removed.  Some circumcised men who may not have the frenulum fully removed can develop frenular breve (click HERE).  However, if too much skin is removed from the penis during circumcision, men may develop penoscrotal webbing – a condition where the skin of the scrotum pulls up onto the penis shaft to compensate for lack of skin on the shaft of the penis, creating a web-like appearance to the lower penis (click HERE).

 

Circumcision and Sexual Sensitivity

Many adult men who are considering circumcision for themselves or their sons worry that they will experience decreased sexual sensitivity since they feel so much sexual pleasure from the foreskin area.  However, multiple studies have been performed that consistently show circumcised and uncircumcised men have the same levels of sexual satisfaction.  In fact, one study that followed over 2,000 men who were circumcised found that 72% of them reported more sexual sensitivity two years after being circumcised than they did before circumcision.[ii]  In addition, a study on how long it takes men to ejaculate during intercourse found no significant difference in the times between circumcised and uncircumcised men.[iii] 

 

One explanation for this is that the human body is very effective at compensating for “lost” sensation.  One-third of men who are circumcised can have damage or removal of the frenulum nerve on the underside of the neck of the penis.  For many men, this can be the most sexually sensitive area.  However, lack of sexual sensation in this area is often offset by increased sexual sensitivity elsewhere on the penis.  Whether or not to have your son circumcised is a personal decision that may be different for everyone.  However, as far as the concern of diminished sexual sensitivity, another research team concluded that “circumcision has no adverse effects on sexual function, sensation, sensitivity, satisfaction, or pleasure, especially when performed during infancy.”[iv] 

 

Am I Circumcised?

Most adult men will know whether they are circumcised or not.  However, young men may often hear about circumcision but not know whether or not they are circumcised since every penis they’ve seen (dad, brothers, others in public changing rooms) may look exactly like theirs.[v]  On the other hand, some are confused because they don’t look the same as their father or brothers.

  • Circumcised Penis

    • The bell shaped tip of penis (glans)

      • Is completely visible (no skin covering it)

      • Slightly darker than the shaft  and dry to the touch

    • The neck of the penis

      • Skin at neck of the penis is flat against the shaft

  • Uncircumcised

    • The bell-shaped tip of the penis (glans)

      • Is covered (either completely or partially) by the foreskin coming up from the neck of the penis

      • Often bright pink in light skinned men or light brown in dark skinned men and may be moist to the touch

    • The neck of the penis

      • No band of skin at the neck

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[i] http://www.circinfo.net/rates_of_circumcision.html (12/17/2016)

[ii] Krieger, J.N. et al. “Adult Male Circumcision: Effects on Sexual Function and Satisfaction in Kisumuy, Kenya,” Journal of Sexual Medicine (2008) 5:2610.

[iii] Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M (2005). "A multinational population survey of intravaginal ejaculation latency time". Journal of Sexual Medicine. 2 (4): 492–7

[iv] Kigozi, G. et al. “The Effect of Male Circumcision on Sexual Satisfaction and Function: Results from a Randomized Trial of Male Circumcision for Human Immunodeficiency Virus Prevention in Rakai, Uganda,” BJU [formerly British Journal of Urology] (2008) 101:65.

[v] http://www.circinfo.net/what_is_circumcision.html (12/16/2016)

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