Adult circumcision is the surgical removal of the foreskin from the penis. It is most commonly performed for medical reasons, such as to treat conditions like phimosis or balanitis. However, some adult men also choose to be circumcised for religious, cultural, or personal reasons. Unlike infant circumcision, adult circumcision is an outpatient procedure that requires local or general anesthesia. This is because the foreskin is fully developed in adult males and more sensitive compared to infants. Adult circumcision also has a longer recovery time.
Types of Doctors Who Perform Adult Circumcisions
There are several types of doctors who can perform circumcisions on adult males:
Urologists
Urologists are medical doctors who specialize in treating conditions related to the male reproductive system. This includes the penis, testicles, prostate gland, and urinary tract. Urologists receive extensive training in performing circumcisions on both infants and adults. Most urologists regularly perform adult circumcisions as part of their medical practice.
General Surgeons
General surgeons are trained to operate throughout the body. Some general surgeons gain additional expertise in circumcision procedures and offer them routinely. In smaller communities without a urologist, general surgeons may be the main provider available to perform adult circumcisions.
Family Medicine Physicians
Family medicine doctors provide primary care and a range of general surgical procedures. Some family medicine physicians include adult circumcisions among the set of procedures they feel comfortable performing. This is especially common in rural areas or smaller towns where there are fewer specialists.
Plastic Surgeons
Plastic surgeons perform many elective and reconstructive procedures. Some men choose to have their circumcision done by a plastic surgeon, especially if they want a very precise, cosmetic result. The plastic surgeon may use their advanced techniques to minimize scarring as much as possible.
How to Choose the Right Doctor for Adult Circumcision
When selecting a doctor to perform your adult circumcision, there are several factors to take into consideration:
Training and Experience with Adult Circumcisions
Look for a doctor who has significant experience performing adult circumcisions. They should be able to walk you through the procedure and understand the nuances specific to operating on the fully-developed adult penis. Ask how frequently they perform adult circumcisions.
Comfort Level of the Doctor
Make sure the doctor seems knowledgeable, confident, and at ease when discussing adult circumcision. You want a doctor who routinely performs these procedures with excellent results. Avoid any doctor who seems uncomfortable or unfamiliar with the specifics of adult circumcisions.
Skill with Local Anesthesia
Circumcisions on adult males are done under local anesthesia. The doctor should have training in anesthesia application and make you feel at ease with their protocol for pain management during and after the procedure.
Bedside Manner
Look for a doctor who listens to your concerns, answers all your questions thoroughly, and explains things in an understandable way. Make sure you feel comfortable communicating with them.
Aesthetic Skill
If cosmetic appearance is important to you, look at examples of the doctor’s work and choose someone known for excellent cosmetic results. Plastic surgeons often have superior aesthetic skills.
Cost
If paying out-of-pocket, compare fees among different doctors to look for one who provides good value without compromising quality. Be wary of prices that seem too low.
What to Expect During an Adult Circumcision
Here is an overview of what to expect when undergoing an adult circumcision:
Pre-Procedure
– You will have a consultation visit first to discuss the procedure with your doctor. You will be asked about your medical history.
– Your doctor may recommend stopping blood thinning medications temporarily before surgery.
– Arrange for transportation, as you cannot drive yourself home after the procedure.
– Follow any specific preparation instructions from your doctor. This may involve cleaning the genital area.
Anesthesia
– The procedure will be performed under local anesthesia. This involves an injection to numb the penis so you will not feel pain.
– You will remain awake during the procedure. A mild sedative may be used to help you relax.
– General anesthesia is usually not required but can be used if extensive reconstructive work needs to be done.
The Procedure
– You will lie down on your back with your genitals exposed.
– Your penis will be cleaned and sterile drapes applied.
– The doctor will inject local anesthetic into the base of the penis.
– Once numb, the doctor will precisely cut away the foreskin from the head of the penis. This takes 10-30 minutes.
– The remaining skin will be sutured together with dissolvable stitches.
– A bandage and wrap will be applied.
Post-Procedure
– You will need to rest at the doctor’s office for 30-60 minutes before going home.
– Arrange for someone to drive you home.
– Take it very easy for the first 48 hours. Keep the penis wrapped and elevated.
– Use prescribed pain relievers as directed by your doctor. Ice packs can also help reduce swelling.
– Refrain from sexual activity, heavy lifting, or strenuous activity for 4-6 weeks.
– Expect complete healing in around 4-8 weeks.
Recovery After Adult Circumcision
Recovering from an adult circumcision takes consistent care and patience. Here’s what to expect:
Pain
Mild to moderate pain is common after circumcision. Your doctor will prescribe effective pain medication. Take it as directed. Many men report the pain is most bothersome when getting erections. The pain lessens significantly after the first week.
Bandages
Expect to wear gauze wrapped around the penis for 1-2 days. Follow your doctor’s instructions on caring for the bandages. Remove them carefully to avoid disturbing the stitches. Replace with clean bandages.
Bleeding
Spotting and mild bleeding is normal. Apply pressure if you notice significant bleeding. Call your doctor if it does not subside quickly.
Swelling
Moderate swelling of the penis, scrotum, and surrounding areas is common after circumcision. It usually resolves during week 2. Use ice packs to help reduce swelling.
Wound Care
Gently clean the incision area daily once bandages are removed. Apply prescribed ointment. Do not scrub or disturb the stitches. Take showers instead of baths. Pat dry gently.
Activity Restrictions
Avoid sex, masturbation, and any friction to the penis for 4-6 weeks. No strenuous exercise or heavy lifting during the first month. Return to non-strenuous work after a few days when up for it.
Follow-up Appointment
You will need a follow-up visit with your doctor around 2 weeks after surgery to check healing. The doctor will remove any remaining stitches at this visit once the circumcision is fully closed.
Risks and Complications of Adult Circumcision
While generally safe when performed by an experienced doctor, any surgery does incur some risks:
Pain
While temporary mild pain is normal during the healing process, some men may experience severe, prolonged pain after the procedure requiring medication adjustment or other interventions.
Bleeding
Bleeding generally stops quickly. But rarely a bleed requires emergency surgical intervention and transfusion if it does not clot.
Infection
Infection of the incision or urinary tract while rare can develop after circumcision. Antibiotics are needed to treat infection.
Loss of sensation
Some loss of sensitivity in the tip of the penis can occur after circumcision. For most men sensation returns to near normal after healing is complete.
Unsatisfactory cosmetic results
Scarring or asymmetry in the appearance of the penis may occasionally happen. Further procedures can be done to improve the cosmetic outcome.
Damage to the urethra
Very rarely, injury to the urinary tube in the penis requires surgical repair. This is more likely if the doctor performing the circumcision is inexperienced.
Cost and Insurance Coverage of Adult Circumcision
The typical cost of adult circumcision ranges from:
– $1500 – $3000 with a urologist or plastic surgeon
– $500 – $1500 with a general practitioner
Many insurance plans cover adult circumcision when medically necessary:
– If the foreskin is tight and non-retractable (phimosis)
– For recurrent infections under the foreskin
– If the foreskin tears during intercourse
– For grows or lesions on the foreskin
Cosmetic circumcisions or those done for religious/cultural reasons are often considered elective and may not be covered. Check with your specific insurance plan. Some cover all or part of the procedure fees.
Comparison of Infant vs. Adult Circumcision
| Factor | Infant Circumcision | Adult Circumcision |
|---|---|---|
| Anesthesia used | Local anesthesia | Local anesthesia or general anesthesia |
| Pain level | Minimal pain felt | Moderate temporary pain |
| Healing time | 7-10 days | 4-8 weeks |
| Risk of complications | Extremely low | Slightly higher than infant |
| Effect on sexual function | No/minimal impact | Temporary loss of sensitivity |
| Reasons for procedure | Parent preference, religion, culture | Phimosis, infection, preference |
| Memory of procedure | None | Vivid memory |
Key differences:
– Adult circumcision takes longer to heal, is more painful, and slightly riskier due to the developed anatomy and nerves in the adult penis.
– Infant circumcision prevents phimosis but this condition can be successfully treated via adult circumcision if it develops.
– The procedure and healing is far less traumatic physically and psychologically when performed during infancy.
Frequently Asked Questions About Adult Circumcision
Why would an adult choose to be circumcised?
The most common reasons are:
– To treat chronic infections or conditions like phimosis
– For improved hygiene
– To reduce risk of STD transmission
– For religious or cultural reasons
– For cosmetic preferences
– Enhanced sexual function/sensation
What is the best age for adult circumcision?
Most are done between ages 18-35. This allows for proper healing. After age 50, the risks increase and benefits decrease. But there is no upper age limit if you are healthy.
How long does pain last after adult circumcision?
Temporary mild pain and tenderness typically lasts 1-2 weeks and subsides by 4 weeks. Use medication as directed by your doctor for pain control.
What is the impact on sexual function and pleasure?
Most men report minimal long term impact. Enhanced sensation is possible for some. There may be a period of 3-6 months after surgery where sensitivity is reduced until the penis fully heals.
How long does it take to return to work after an adult circumcision?
With a desk job, most men can return to work in 3-5 days when they feel ready. Jobs requiring heavy lifting or extensive physical activity may necessitate taking 2-4 weeks off work.
When can sex resume after circumcision?
It is vital to avoid sex or masturbation for 4-6 weeks after adult circumcision. This allows the incision to fully heal to avoid complications like bleeding or infection.
Will health insurance cover adult circumcision?
It depends on your individual health plan. When medically necessary, the procedure is often covered. Elective circumcisions for non-medical reasons may not be covered. Check policies closely.
Conclusion
Adult circumcision is most often performed by urologists, though general surgeons, family doctors, and plastic surgeons may also have expertise. When done for the right reasons by a skilled physician, adult circumcision is an extremely safe procedure with potential health and cosmetic benefits. While the surgery does require 4-6 weeks for recovery, most men report minimal long-term impact on sexual function or pleasure after healing. Being fully informed of the details, aftercare, and risks is imperative before making this personal decision.