Adult Circumcision Surgery - Benefits, Risks & Recovery

Adult Circumcision - Preoperative Tests and Diagnostics

Preoperative diagnosis for circumcision surgery in adults is a relatively simple procedure that your urologist will likely perform to assess and evaluate your overall health. This procedure usually concludes with a simple physical examination. If you are undergoing surgery due to any foreskin-related issue, the surgeon will simply inspect the penis and check for symptoms.

The urologist will likely ask you some questions regarding your lifestyle and surgical history as well. If you are on any preexisting medications, it is imperative that you let the urologist know about it.

In most cases, no further tests are required, and the urologist can move on to the surgery itself. However, to better understand your condition, your urologist may perform some additional tests as well, such as:

• Skin Test: A skin test is one of the most commonly performed diagnostic tests that your urologist will likely perform to check for signs of bacteria, viruses, or fungi on the penis. In this test, the urologist will rub a small cotton swab over and under your foreskin to gather a small sample of secretions. This swab will then be sent to a laboratory for further analysis.
• Urethral Discharge Swab: Similar to a skin test, urethral discharge swab is another test that your urologist will likely perform to check for signs of bacteria and viruses on the penis. In this test, the urologist will carefully insert a small cotton swab (about 3/4th of an inch) in the ureteral opening. The swab will then be sent to a laboratory for analysis.
• Urinalysis: Urinalysis or urine test is the visual, chemical, and microscopic examination of your urine. In this test, the doctor will ask you to urinate into a small cup provided by them. The urine sample will then be sent to a laboratory for analysis. A urine test will allow your doctor to check for conditions such as diabetes that may have caused your condition.
• Blood Test: Routine blood tests will allow your doctor to assess and evaluate your overall health and check for signs of any infection that may have caused your condition. In this test, the urologist will use a thin needle to draw a small amount of blood from a vein in your arm. The blood sample will then be sent to a laboratory for analysis.

Benefits of Adult Circumcision

Some potential benefits that are commonly associated with an adult circumcised penis are given below:

• Reduced Risk of HIV and Other STIs: Some studies suggest that compared to uncircumcised adults, circumcised adults are at a slightly lower risk of contracting certain types of STIs, such as HIV and HPV. However, this remains to be a debated topic, and safe sex practices, such as the use of a condom, remain essential.
• Reduced Risk of Urinary Tract Infection: According to research, male adults who have been circumcised are at a lower risk of developing UTI as compared to uncircumcised adults.
• Improved Hygiene: Uncircumcised and circumcised adults both require proper cleaning. However, as the foreskin is removed, it becomes much easier to regularly and thoroughly wash the penis. Oil, bacteria, and dead skin cells can accumulate under the foreskin and develop into smegma. If smegma isn’t taken care of, it can lead to infections like balanitis.
• Prevention of Infection and Irritation: An adult circumcision procedure is often performed as preventative healthcare from various foreskin-related issues such as phimosis, paraphimosis, and balanitis. These foreskin conditions can be extremely discomforting to live with and can have a significant impact on your day-to-day life.
• Reduced Risk of Cancer: Cancer of the penis is a very rare condition in itself. However, it is found to be even less common among circumcised adults.

Recovery After Adult Circumcision Surgery

A complete recovery after adult circumcision procedure usually takes anywhere from 7 to 10 days. Most patients are able to return to work and their daily routines in just 2-3 days after surgery. As previously mentioned, however, different patients have different healing capabilities.

Depending on your overall health, quality of postoperative care, and method of your surgery, your adult circumcision recovery time may differ. If your recovery is taking longer, do not panic and consult with your healthcare provider. Let them know if you have noticed any odd signs during recovery, and proceed as instructed by the urologist.

After the surgery, you may have slight swelling, pain, redness, and bruising around the penis. These are expected side effects of circumcision in adults and are not considered to be indicative of any complications. They should subside on their own in a few days after surgery.

To help manage the swelling and discomfort, your urologist may advise you to place an ice pack on the groin every 2 hours for at least 10-20 minutes as well. To help recovery even further and minimize the chances of any postoperative complications as much as possible, the urologist may also instruct you to follow some simple tips and guidelines as well:

• Drink plenty of water and stay hydrated. Generally, it is advised by healthcare providers to drink at least 2-3 liters of water every day. It is also advised to avoid any carbonated beverages. Instead, include healthy fluids such as coconut water and fresh fruit juice in your daily diet.
• Avoid eating outside or any junk food for at least a few weeks after surgery. Prioritize nutritious food that fulfills your body’s requirements. 
• Avoid strenuous activities and exercises that exert too much pressure on the groin area. However, low-impact exercises such as walking are recommended and can help with recovery.
• Avoid going to swimming pools or using public lavatories for at least a few weeks after surgery. 
• Refrain from sexual intercourse or any sexual activities for at least 4 to 5 weeks after surgery. After the circumcision surgery, it is imperative that you give your penis ample time to recover. Engaging in intercourse before that can lead to serious consequences and may even hinder your recovery.
• Avoid wearing baggy boxer shorts. Instead, opt for comfortable, snug underwear that can hold the penis and dressing around it in place
• After the surgery, your urologist will likely schedule some postoperative follow-ups. Make sure to attend these consultations and let your doctor know if you have faced any difficulties during recovery.

Reasons for Adult Circumcision

Circumcision procedure in adults can be performed for both medical and non-medical reasons. In some cases, people decide to undergo the procedure due to religious or cultural reasons. Whereas in some other cases, it can be performed as an effective treatment for various foreskin-related issues. Some of the most common medical and non-medical reasons why circumcision surgery for adults is typically performed are given below:

Medical Reasons

An adult circumcision surgery is commonly performed as a safe and effective treatment for a multitude of foreskin-related conditions. Some of the most common medical reasons for adult circumcision procedure are given below:

• Phimosis: Phimosis is a fairly common urological condition that is characterized by the inability of the foreskin to be retracted over the penis glans. Mild cases of phimosis can usually be treated with non-surgical alternatives such as antibiotics and phimosis creams. Severe cases of the condition, however, require surgical intervention.
• Paraphimosis: This is another foreskin-related condition where the foreskin, once retracted, becomes trapped behind the head of the penis. As a result, paraphimosis can cause immense pain and is typically considered to be a medical emergency. The condition will not go away on its own and, in most cases, requires circumcision for treatment.
• Recurrent Balanitis: Balanitis is a urological condition that is characterized by inflammation of the penis glans. Typically, balanitis can be treated through non-surgical alternatives such as antibiotics, antifungal creams, and simple changes in lifestyle. However, recurrent cases of the condition may require surgery.
• Preventative Healthcare: A circumcision surgery is often performed as part of preventative healthcare. Some studies suggest that compared to uncircumcised adults, circumcised men are at a slightly reduced risk of contracting certain STIs, urinary tract infections, and developing penile cancer.
• Easier Hygiene: As the foreskin is removed, it becomes much easier for a person to regularly wash away any excess microbes, bacteria, or smegma that may have accumulated on the penis over long duration of time. A good penile hygiene helps prevent various penis-related conditions and diseases.

Non-medical Reasons

Circumcision surgery is commonly performed due to religious and cultural significance. A person may also undergo the procedure to better align with their partner’s preference or for cosmetic reasons. Some of the most common reasons for circumcision procedure in adults are given below:

• Religious Significance: Often referred to as a sunnath operation, circumcision surgery is commonly performed as part of religious rites.
• Personal Preference: Some adults often undergo circumcision procedures to better adhere to their partner’s preference or cosmetic reasons

Does Adult Circumcision Improve Sex Life?

As the foreskin is removed during an adult circumcision procedure, the penis becomes slightly less sensitive. As a result, men can last longer without ejaculating. In fact, reports suggest that 64% of adults who underwent circumcision noticed an improvement in their sex life and an increase in sexual pleasure. It is also to be noted that many patients who undergo the procedure due to conditions such as phimosis no longer worry about injuries or pain during sex. 

Alongside, some other potential sex-related benefits that are associated with adult circumcision procedure are given below:

• Decreased Risk of Injury During Sex: Due to having a tight foreskin, some adults can find penetration painful as the foreskin is pulled back. This can lead to skin tearing and stinging pain on the foreskin and penis. However, with the foreskin itself removed, penetration becomes much easier for men. An adult circumcision procedure also decreases the risk of injury to the frenulum (the small bridge of tissue that connects the foreskin with the penis glans). As a result, you can be less worried about injury during sex and enjoy better sexual pleasure with your partner.
• Better Orgasms: When the foreskin is removed, the penile glans become less moist and dilated. Additionally, they also rub against the clothes more often compared to uncircumcised adults. Due to these reasons, there is a slight decrease in penile sensitivity. However, some adults report being able to last longer with their partner without ejaculating. In fact, 54.5% of adult men who underwent circumcision report having much easier and more fulfilling orgasms compared to before. This results in not only a better sexual experience for you but your partner as well.
• Lower Risk of STIs: Compared to uncircumcised adults, circumcised men have shown in clinical trials to be less likely to acquire certain Sexually Transmitted Infections (STIs), such as syphilis, herpes, high-risk strains of Human Papillomavirus (HPV) and Human Immunodeficiency Virus (HIV). According to healthcare professionals, this happens because the tissue that is most vulnerable to these viruses is removed. It is to be noted, however, that this is a debated topic and there has been no conclusive evidence that supports a correlation between circumcision and reduced risk of contracting STIs. When engaging in sexual intercourse, it is imperative to maintain safe sex practices and wear a condom.

Risks Associated with Adult Circumcision

Circumcision surgery is widely considered to be a completely safe procedure with minimal chances of any postoperative complications. However, as is the case with any other surgical procedure, they can still happen and should not be taken lightly. Some complications that are associated with adult circumcision surgery are given below:

• Excessive Bleeding: Minor bleeding is one of the most common side effects of circumcision in adults. It is not considered to be indicative of any complications and should subside on its own in a few days after surgery. However, excessive and persistent bleeding may be a sign of complication. In most cases, bleeding can be controlled by applying firm pressure on the incision site for a few minutes.
• Infection: An adult circumcision procedure is performed under completely sterile conditions. The urologist will take various precautionary steps to ensure that the chances of an infection are as minimal as possible. However, in some rare cases, an infection can happen despite the safety measures. Usually, signs of an infection after circumcision include fever, chills, redness, and drainage of yellowish pus from the incision site. If caught early, infections can be treated with antibiotics and topical creams. But, severe cases may require further surgical intervention.
• Sharp Pain: After your circumcision surgery, it is considered normal to have slight pain and discomfort around the penis. This pain should subside on its own in a few days after surgery and typically does not require medical intervention. But if the postoperative pain does not subside and continues to worsen, it could be a sign of complication. In such a case, it is advised to contact your healthcare provider as soon as possible.
• Insufficient Removal of the Foreskin: Normally, a circumcision procedure removes the foreskin only to the level where the penile glans are completely visible. However, in some rare cases, too little of the foreskin may be removed due to improper placement of a stapler device or inaccurate incisions. Insufficient foreskin removal can result in not only unsatisfactory cosmetic outcomes but also functional issues with the penis. In such a case, you may need to undergo a revision circumcision procedure for treatment.
• Meatal Stenosis: Meatal stenosis is an uncommon complication that can occur after an adult circumcision procedure. It is a condition where the meatus (the opening at the end of the penis) becomes narrower than normal. This can lead to functional problems with the penis. In some cases, steroid creams can treat the condition. But, a surgical procedure known as meatotomy is considered to be the best and the most effective treatment for this complication.
• Reaction to Anesthesia: An adult circumcision procedure is usually performed under local anesthesia. Hence, you experience some anesthesia-related complications and side effects such as allergic reactions, nausea, dizziness, blurry vision, vomiting, or difficulty waking up. To avoid any such complications, it is imperative to let your doctor know of your dietary routines and any preexisting prescription you may be on.

Adult Circumcision Side Effects

Besides the initial swelling, infection and bleeding are the two most common concerns associated with adults circumcision. Other possible complications of circumcision in adults can include the following:

• permanent decrease in sensation in the head of the penis, specifically during sex
• tenderness around the scar
• the need to remove stitches that haven’t dissolved
• sometimes, another operation is required to remove some more foreskin 

Does Insurance cover Adult Circumcision?

Yes, an adult circumcision procedure is typically covered by most health insurance plans in India. Circumcision is a commonly performed urological procedure that can be performed as an effective treatment for various foreskin-related conditions such as phimosis, paraphimosis, or balanitis.

If these foreskin issues are left untreated, they could lead to severe consequences that require further, more complex procedures for treatment. Hence, an adult circumcision surgery is considered to be medically necessary and covered by insurance plans. However, if the reason behind your condition is strictly cosmetic or religious in nature, insurance coverage may not be provided. 

Prior to surgery, it is best to have a detailed discussion about your insurance plan and its inclusions and exclusions for your adult circumcision insurance with your insurance provider.