Circumcision is the surgical operation whereby the skin, called the foreskin, occupying the tip of the penis and which is retractable is removed.
Although circumcision is carefully carried out, there are still very safe procedures used in carrying out this minor surgical intervention to ensure safety, accuracy, and healing.
Disregarding the technical differences in various circumcision techniques, the following describes the general process involved in a circumcision procedure:
- Preparation and Anesthesia: Prior to commencing the procedure, the medical staff prepares the surgical area, making sure the environment is clean and sterile. The patient, typically an infant or young child, is positioned comfortably on an examination or surgical bed. After this, local anesthesia is given for numbing the area in order to avoid pain during the procedure. For added comfort a topical numbing cream may be applied before the injection.
- Cleaning and Draping: The genital area is methodically cleaned and sterilized as it reduces the risk of infection. In addition sterile drapes are used that helps in creating a sterile field around the penis and thus keeping the environment of surgery hygienic.
- Foreskin Separation: Once the area is numbed and prepared, the surgeon proceeds by gently separating the foreskin from the glans penis (the head of the penis). This must be done with much care to avoid damage or injury to the surrounding tissues in the process.
- Foreskin Removal: The surgeon removes the foreskin once it has been adequately separated, the instrument used for removing the foreskin depends on what the surgeon is comfortable using and, also, on the method that is used. Instruments commonly used in circumcision are the scalpel-a small, sharp knife; or the circumcision clamp.
- Hemostasis and Wound Closure: following resection of the foreskin, the surgeon makes sure there is hemostasis, cessation of bleeding from the site of surgery. This is done either with the use of cautery or heat or meticulous tying of small vessels. The other skin edges are then very carefully approximated and sutured in place using dissolvable sutures. Sometimes, a medical adhesive tissue glue is used to seal up the skin edges to avoid the use of sutures.
- Dressing the Wound: After the circumcision, the area of the surgical site is dressed with sterile gauze. This is done to serve two-fold purpose: protection and absorption of the initial discharge or bleeding from the operation. The dressing is usually not too tight since it has to allow proper circulation of healing to take place in the wound.
- Post-Procedure Care: Once the circumcision is performed, the patient goes into a recovery room where he is monitored to ensure stabilization and comfortability. Instructions for care of the surgical site are given to parents or caregivers including ensuring the area remains clean, use of prescribed medication should it be required, and monitoring for signs of infection or complication.
Although circumcision is a common and straightforward procedure, nonetheless it should always be performed by trained and experienced healthcare professionals in a medical facility equipped with surgical tools. It is imperative to provide both patients and their families with comprehensive pre-operative and post-operative care instructions. This would ensure the best possible healing and will reduce the risk of any complications. Apprehensions on either side will be allayed only through open communications between the healthcare givers and the patient, accompanied by his relatives, putting to rest any misgiving in the conduct of the procedure on the patient.
Although the decision to circumcise the baby or not is mainly based on cultural, religious, and personal beliefs for most parents, there are a number of medical reasons as to why it would be a good idea for the parents to go for this procedure for their newborn sons.
Listed below are 12 medical reasons as designated points elaborating upon the possible benefits of circumcision for infant boys:
- Prevention of Foreskin Trauma
The foreskin is a very thin, highly sensitive membrane covering the glans penis and thus may sometimes be subjected to trauma or injured in highly active infants or toddlers. Such injuries may vary from simple abrasion to deep tears, an incident that may be painful to the child and may have some complications afterward. Circumcision prevents such injuries of the foreskin and hence promotes genital safety and health in the early stages of childhood.
Infants and young children are naturally curious explorers who carry out active movements and play are more than likely to put the genital area at risk of trauma. The foreskin, being a mobile and retractable tissue, is immune to friction. Various activities such as crawling, playing with toys, or while changing diapers can pull or trap the foreskin resulting in its injuries, such as cuts, bruises, or tears.
In opting to circumcise, parents also eliminate the possibility of foreskin trauma occurring in their infants or toddlers. Circumcision eliminates the foreskin completely so that no trauma or injury pertaining to this specific tissue can occur. There is, for one thing, no retractable tissue that will catch or get pulled in any given accidental way during the daily course of activities.
Moreover, circumcision is especially advantageous for infants or toddlers who are susceptible to skin conditions such as balanitis or infections under the foreskin. These conditions can therefore be avoided by circumcision where the foreskin is not a source of pain or discomfort, and is not prone to any trauma.
- Decreased Risk of Phimosis
Phimosis is actually a current condition in which the foreskin of the penis is too tight and cannot be comfortably pulled back or retracted over the glans, explained as that very sensitive head of the penis[1]. The stiffness can be painful during urination, sexual activities, or even during simple cleaning methods of the genital area. In certain cases, phimosis causes a number of complications like recurring infections or difficulty in maintaining the necessary hygiene of the genitalia.
For individuals who are suffering from recurring phimosis, circumcision is the only way out as it offers a long-term solution by permanently removing the foreskin. The removed foreskin allows the glans to be sufficiently exposed hence it is easily accessible, allowing for its proper cleaning, and eliminating the risk of any trapped bacteria or infections under the foreskin[2].
In terms of better hygiene when there is phimosis due to a too-tight foreskin, circumcision offers one of the greatest advantages. Smegma is a combination of dead skin cells and natural oils that can get trapped when the foreskin cannot be pulled properly over the head of the penis. This can cause bacteria to accumulate, give off an offensive odor, cause irritation and, in some cases, further infection. Being circumcised allows this area to be cleaned much more easily so that these types of problems are reduced and hygiene in the genital area is improved.
- Reduced Risk Phimosis-related Infections
One of the big issues with phimosis is increased risk of infections. Trapped bacteria cause inflammation, redness and soreness, commonly, showing itself as balanitis – the inflammation of the glans[3] and foreskin – Itching, soreness and discharge may accompany balanitis, thus making it a real source of discomfort and distress for those affected.
In addition, the recurrence of infections in cases of phimosis is always frustrating and not easy to cope with. That is, if a person has a certain level of personal hygiene, it may be difficult for him to get rid of the offending bacteria that hide under the foreskin, hence leading to a cycle of infections that perpetually impacts the quality of his life. Indeed, such phimosis-related infections can be very severe and frequent to the extent of justifying permanent forms of treatment, including circumcision. In circumcision, the foreskin is surgically removed, hence offering a life long solution to the tightness that often causes the infections. Any trapped bacteria in the Phimosis area can no longer cause any deadly infections as the foreskin has been removed therefore resulting in better genital health.
- Prevention of Paraphimosis
Paraphimosis is a medical condition marked by the inability to retract the foreskin back over the head of the penis once it has been pulled back[4]. Paraphimosis, in simple terms, is usually caused by aggressive retraction of the foreskin and may get stuck in such a position that its return to the glans as a covering is not possible. The foreskin becomes entrapped behind the glans. It results in constriction, or blockage of blood flow into the tip of the penis-a painful process that can cause swelling and possible tissue damage unless treated. The paraphimosis can present with discomfort as well as possible complications if left untreated. Fortunately, it has been shown that conducting circumcision is an effective prevention from paraphimosis and its risks.
This defines Circumcision as an intervention that prevents Paraphimosis since it actually makes it impossible to have the foreskin trapped behind the glans given that one removes the foreskin permanently. Thus, the issue of both restriction and constriction is successively resolved [5].
- Reduced Risk of Recurrent Balanitis
Balanitis serves as a medical term that indicates the inflammation of the head of the penis known as the glans[6]. Pathogenic microorganisms like infections, irritants, and also underlying medical disorders can prove to cause Balanitis. One must know about balanitis and its crucial handling for the needed genital health and also to avoid any future incidents.
Common symptoms due to the inflammation attributed with balantis include swelling, soreness, redness and pain in the affected organ. Depending on various external factors and individual factors the threshold of these symptoms varies from mild to severe. Prevalent causes of balanitis are bacterial or fungal infections, poor hygiene, irritants such as various chemicals or harsh soaps, and certain skin conditions like eczema or psoriasis.
When balanitis is recurrent in that it keeps occurring repeatedly over time, it can impact very seriously on an individual’s quality of life and genotype health. Recurrent balanitis may be indicative of some form of underlying issue for which to be dealt with so as not to have future episodes and complications. Healthcare providers can, in such instances, recommend circumcision as a long-term solution or measure.
Circumcision is the surgical removal of the foreskin exposing the glans penis. For men with recurrent balanitis, the benefits of circumcision are several. The warm and moist situation under the foreskin, which acts to incubate bacterial or fungal growth, is removed. The trapped moisture and bacteria are decreased so that the inflammation and ultimately the infection, giving rise to balanitis, vernacularly, is prevented.
Additionally ,circumcision can be convenient for better and easier genital hygiene. Without a foreskin, the penis is easier to clean; hence, there is less tendency for irritants or infectious agents to accumulate and cause balanitis episodes. Better hygiene practices, coupled with the absence of a foreskin, can promote better genital health and comfort.
- Prevention of Posthitis
The term posthitis is used for inflammation of the foreskin. It produces symptoms of discomfort, swelling, and redness in the affected area. This may be due to an underlying infection or many other causes like irritants, poor hygiene, and any underlying skin conditions. Patients who develop acute recurrent posthitis or wouldn’t settle despite conservative management should know about posthitis to help identify possible avenues of management for their symptoms.
The conditions that cause inflammation of the foreskin – or posthitis – are usually bacterial or fungal infections, for example candidiasis, or bacterial balanitis. The conditions under the warm and moist foreskin are very favorable for multiplication of such microorganisms in case regular hygienic measures are not taken. Except for infections, there can be other irritants that evoke inflammatory reactions of the foreskin, such as soaps, detergents, or chemicals..
In this regard, recurrent posthitis can be very problematic for the patient since it may cause them a lot of discomfort, itching, pain on urination or sexual act, and other forms of genital irritation. Sometimes it could progress to being chronic where constant management may be done to ensure proper care and detail to avoid exacerbation.
The circumcision procedure removes the warm and moist area underneath the foreskin where infectious agents or irritants could accumulate, thereby reducing recurrent inflammation. It also makes hygiene in the genital area much easier to maintain as the disappearance of the foreskin makes it easier to clean the area, hence reducing the possibility of irritants or infectious agents triggering posthitis episodes..
- Prevention of Frenulum Breve
Frenulum breve is a condition where the frenulum or the small band of tissue which connects the foreskin to the underside of the penis is short or tight. Consequently, this leads to discomfort, pain, or difficulty during sexual activity: intercourse or masturbation[7]. It is imperative that one understand frenulum breve and the health risks associated with it such that individuals experiencing symptoms can act preemtively.
The frenulum allows for the mobility and flexibility of the foreskin during sexual activity. A short frenulum, being too tight, will limit the movement of the foreskin causing tension, pulling, or even tearing of the frenulum tissue. This is painful and uncomfortable and might interfere with sexual pleasure or satisfaction in some cases.
One of the more common presentations of frenulum breve includes pain or discomfort associated with sexual intercourse, particularly during entry or those motions that involve stretching of the foreskin. Due to the tightness at the level of the frenulum, a pulling sensation occurs and may even enlist laceration of the frenulum, resulting in bleeding and discomfort. This can dramatically impact sexuality and is often presented as the cause of much distress for both individuals and their partners.
Healthcare recommend circumcision if frenulum breve causes constant pain, discomfort, or even makes sexual activity impossible. Circumcision – removal of the foreskin and thus includes the frenulum – would then eliminate the problem of a short or tight frenulum. Thus relaxing the tension and constriction that lead to pain or discomfort during sexual intercourse. It can also help in avoiding recurrent tearing or injury to the frenulum, which will help in better sexual health and function.
- Reduced Risk of Urinary Tract Infections (UTIs)
UTIs are the infections that may occur along the urinary tract, involving parts such as the bladder, urethra, ureters, and kidneys. It is true that though UTI is described mostly among females, males can also get infected, though at a significantly lower rate. There have been some studies vis-à-vis the role of circumcision with regard to UTI-risk and show that there is a fair reduction in the occurrence of UTI cases due to circumcision..
The penis foreskin can be a warm and moist area that will allow bacteria to grow including those that cause UTIs. When the foreskin is kept over the top of the penis, bacteria may accumulate underneath it. More common in uncircumcised men, bacteria that are associated with UTIs may then move up the urethra causing infection during urination or sexual activities[8]. This greater bacterial presence and risk of contamination can contribute to the development of UTIs.
Circumcision has been shown in research studies to be linked to a lower UTI risk in males. This is especially true during infancy and childhood, which the lower risk is thought in part to be the effect of the removal of surface area where bacteria can inhabit and reproduce by removing the foreskin. Thus the circumcised male will have fewer UTIs compared to the uncircumcised male.
- Reduced Risk of Penile Cancer
Penile cancer is a life threatening condition that impacts the tissues of the penis. Even though causes of penile cancer have not been fully understood, there are certain risk factors assessed. These include poor hygiene, human papillomavirus infection, smoking, phimosis, and chronic inflammation or infection of the penis[9]. Circumcision has long been postulated to be one preventive measure that could decrease the risk of having penile cancer. This is very true, particularly in eliminating the possible risk factors involving the foreskin.
The penis foreskin can serve as a warm and moist environment for the development of bacteria and viruses, including HPV. HPV is among the etiological agents responsible for inducing various types of cancers, examples also include penile cancer. In the absence of circumcision, the foreskin can trap bacteria and viruses, increasing infections as well as related complications
It is theorized that one of the mechanisms through which circumcision helps prevent penile cancer is through the removal of the foreskin, decreasing surface area on which infections can occur, thereby decreasing the chance of chronic inflammation or infection that may lead to cancer development. Also, astrology will find genital hygiene easier and more effective after circumcision, thereby decreasing deposits of harmful agents that might cause tissue damage and malignant changes over time.
Research studies have portrayed that circumcised men have reduced cases of penile cancer when compared to the uncircumcised men, particularly in regions where the rate of penile cancer is significantly higher.
- Reduced Risk of Balanoposthitis
Balanoposthitis, in medical terms, is the inflammation of both the glans penis and the foreskin; that is, the head of the penis together with the loose skin covering the head. The inflammation in this area can be due to several reasons including infection, irritants, poor hygiene, and skin conditions like atopic dermatitis[10]. For people experiencing recurrent or even severe symptoms, information on balanoposthitis, as well as its potential management using circumcision methods, is of great importance..
Inflammation of balanoposthitis may take various forms: swelling, redness, soreness, itching, and discomfort of the affected part of the genitals. Symptoms are bothersome and may interfere with a normal life, including sexual functioning. There are a lot of causes of balanoposthitis, and the most typical ones are bacterial or fungal infection, irritants like soap or chemicals, causing irritation of the area around the penis, tight foreskin or phimosis, and certain types of skin disorders, such as eczema or psoriasis.
Removal of the foreskin eliminates the warm, moist environment necessarily required by the bacteria and fungi to flourish in. Circumcision hence lowers the risk of recurrent infection or inflammation. It is also easier to maintain genital hygiene. Easier penetration and hence reduced irritant exposure; helping minimize balanoposthitis episodes.
- Improves Hygiene
Circumcision chiefly enhances genital hygiene by making it easier to keep the genital area clean. The foreskin’s removal via circumcision provides a number of benefits that lead towards better hygiene and less possibility of the development of local infections and inflammation.
One of the things associated with the hygiene benefits of circumcision is the elimination of the warm, moist environment which might develop under the foreskin. This environment is quite favorable to the growth of bacteria, fungi, and other microorganisms that can easily cause infections and inflammation. Once the surface area where these microorganisms might thrive is reduced by the removal of the foreskin, this ensures easier maintenance of cleanliness and dryness in the genital area.
It further facilitates cleaning of the penis. Daily hygiene practices, such as washing with a mild soap and water, are easier to undertake; one is not required to retract under a tight or adherent foreskin and clean there. Good cleaning removes sweat, smegma, a natural lubricant and exfoliant, accumulated debris as well as reduces the risk of bacterial or fungal overgrowth and related infection.
This advantage of a more easily maintained genital hygiene through circumcision is important in infancy and childhood. A young boy may not be capable enough to keep the space under the foreskin clean, and a parent or caretaker may not maintain the best hygiene in uncircumcised infants. Circumcision at this time facilitates hygiene practices at these earliest stages of development and helps to prevent accumulation of smegma that might cause irritation and infections in this vulnerable group of patients.
- Reduced Risk of Local Irritation and Inflammation
A proper hygiene of the genitalia is very important in ensuring that there is no irritation, inflammation, and infection. Having a foreskin can provide an ecology by which hygiene may not be properly maintained; placing one in a position to accumulate smegma, overgrowth of bacteria and skin irritability among many. Circumcision has, therefore, been proven as a measure to reduce the risk of these problems by making hygiene easy to maintain while providing a cleaner and healthier genital appearance.
One of the major problems linked with poor hygiene of the foreskin is the accumulation of smegma. Smegma is a mixture of exfoliated skin cells, oils, and moisture that can collect underneath the foreskin. Unless cleaned on a regular basis, smegma can turn out to be an optimum breeding ground for bacteria and fungi. This can lead to bad smell, irritation, and even infections. Circumcision gets rid of the foreskin hence eliminating the environment for smegma growth, reducing the risk of smegma-related issues.
Moreover, improper care of the foreskin also results in redness, swelling, pain, and itching of the genital area. Circumcision prevents such infections as it involves the removal of the infected part which serves the breeding ground for the micro-ogranism, thus lowering the opposite surface area.h.
Lastly it must be said that circumcision results in a better airflow and ventilation to glans penis, the moisture becomes less abundant, with a less conducive environment created towards microbial proliferation. Such a type of ventilation is quite friendly for the overall genital health and minimizes localized irritation and inflammatory risk.
Conclusion
In conclusion, the medical benefits of circumcision are immense and broad. Besides preventing foreskin traumas and related injuries, and prevention of diseases such as phimosis, paraphimosis, recurrent balanitis, posthitis, and frenulum breve, it also reduces UTIs, penile cancer, balanoposthitis, and local irritation/inflammation as well.
The importance of circumcision can’t be emphasized enough. The benefits mentioned are only few of many and together they can foster overall quality of life, well-being, and genital health in circumcised individuals. Parents must properly investigate circumcision centers and consult with healthcare providers pertaining to the potential benefits and risks involved. Circumcision constitutes a very important preventive measure with long-term positive consequences on the outcomes of infant boys’ health
[1] https://www.webmd.com/men/phimosis; https://www.rch.org.au/clinicalguide/guideline_index/the_penis_and_foreskin/
[2] https://www.webmd.com/men/phimosis; https://www.rch.org.au/clinicalguide/guideline_index/the_penis_and_foreskin/
[3] Head of the penis
[4] https://my.clevelandclinic.org/health/diseases/22244-paraphimosis
[5] https://my.clevelandclinic.org/health/diseases/22244-paraphimosis
[6] https://my.clevelandclinic.org/health/diseases/21186-balanitis
[7] https://my.clevelandclinic.org/health/diseases/23361-frenulum-breve-short-frenulum
[8] https://my.clevelandclinic.org/health/diseases/9135-urinary-tract-infections
[9] https://my.clevelandclinic.org/health/diseases/6181-penile-cancer
[10] https://my.clevelandclinic.org/health/diseases/24117-balanoposthitis
