Adult Circumcision

It's Your Choice.

Adult CircumcisionThere comes a time in some men’s lives that an adult circumcision is a must. Perhaps due to vanity, or medical due to the foreskin being too tight during an erection. Whatever the reason your urologist can perform the procedure you need. Urologists are well versed with this procedure and usually have performed this procedure many times over the course of their career. Their intent is to achieve a cosmetic quality of a neonatal circumcision for adult patients. Your urologist also respects and seeks out specific individual cosmetic outcomes which patients may be seeking. Patients are encouraged to make suggestions and guide the surgeon to promote their greatest degree of satisfaction.

What is an adult circumcision?

A circumcision is a surgical procedure that removes the foreskin (the loose tissue) covering the glans (rounded tip) of the penis. Circumcision may be performed for religious or cultural reasons, or for health reasons. Newborn circumcision is thought to diminish the risk of cancer of the penis and lower the risk for cancer of the cervix in sexual partners. It is also believed to decrease the risk of urinary tract infections in infants and reduce the risk of certain sexually transmitted diseases, especially HIV.

Adult circumcision reduces the risk of HIV transmission without reducing sexual pleasure.

ScienceDaily (Apr. 26, 2009) — Two studies have been presented that show that adult circumcision reduces the risk of contracting the human immunodeficiency virus (HIV) and the risk of coital injury — without reducing pleasure or causing sexual dysfunction.

Common Reasons Circumcisions Are Performed

  • Cosmetic appearance
  • Phimosis (tight foreskin)
  • Paraphimosis (inability to pull the retracted foreskin back over the glans)
  • Balanitis and balanoposthitis (inflammation of glans and glans and foreskin)
  • Frenulum breve (short frenulum which tears with intercourse)
  • Diseases of the foreskin, including cancer

What is the cost of the procedure?

The fee for first-time circumcision or revision is approximate $2500. If the foreskin is non-retractable, the fee is estimated $3000. 

What technique is used for adult circumcision?

 Most urologists utilize a free hand or sleeve resection technique most commonly. The incision lines are marked on the inner (mucosal) and outer layers of the foreskin where the patient wishes. Incisions are utilized with a scalpel rather than scissors as it gives a more precise incision. Skin closure is with absorbable sutures of the quality used for plastic surgical procedures.

Will circumcision change the size of my penis?

No, the structures of the penis that give it length and girth are deeper in the anatomy than the skin. The skin is the only component that is altered with a circumcision; therefore, there is no possibility of altering penile size with a circumcision.

Can revisions be performed to improve the cosmetic appearance or tightness of an earlier circumcision?

Yes, this is a frequently performed as an in-office procedure.

Is there an age limit for having a circumcision?

No, in fact, the more important factor is the state of their general health to allow for minor surgery. However, minimum age is 18.

How is local anesthetic injected?

The injection is at the base of the penis utilizing a combination of a short and long acting Lidocaine and Marcaine. The patient usually only feels one needle stick and after that, no discomfort.

What if I am uncomfortable with having the procedure performed using local anesthesia?

If you are afraid of needles or tend to become faint at the sight of needles, it would be best to have your procedure performed under general anesthesia. Contact your urologist’s office to speak with a member of his staff about scheduling the procedure to be performed under general anesthesia.

Do you perform a frenectomy?

Yes, if the patient desires it, either at the time of circumcision or as a separate procedure.

Do you recommend removal of the frenulum in adult circumcision?

The frenulum is a structure which is not identical in configuration from man to man. Urologists suggest it only if it detracts from the overall aesthetic appearance.

How do you determine how much foreskin to remove?

There are no scientific means for determining the exact length of skin to remove in circumcision. It is a visual estimation only. The penis changes dimensions in response to a variety of stimuli, which will alter the tightness of the skin. Your urologist does his best to aim for the degree of tightness a patient requests, but cannot assure you of any specific outcome concerning tightness.

What is the postoperative care of adult circumcisions?

Your circumcision is sutured with absorbable (dissolvable) sutures. There will be a compressive bandage on the penis. You will be educated to how long to leave the dressing in place after the procedure. After the specified time, the dressing can be removed in the bathtub. The compression dressing should not be changed or removed early. A plastic covering should be placed during bathing. Sexual activity may resume after approximately four weeks.

Will the compression bandage applied to my penis prevent me from being able to wear regular street clothes?

The bandage will not be apparent under your clothing. It is a very lightweight and compact dressing.

Will I have difficulty walking soon after the procedure?

Walking will not be a problem. It will probably be easier and more comfortable, however, if you wear supportive underwear.

Will there be a scar? 

Adult circumcisions are treated as cosmetic procedures. Measurements are taken in the attempt to remove enough skin so that no skin rolls over the corona of the glands and that the incision is symmetrical. The wound is closed with very fine sutures which are used in facial cosmetic surgery. These measures are to make the outcome look very tidy and as free of suture marks as possible.

Why is the compression bandage even necessary?

Your urologist will work on refinement of the surgical technique with the goal of giving all adults a cosmetic result at least as good as neonates. The primary obstacle urologists face in performing adult circumcisions is that adults get very powerful erections as part of their normal sleep cycle. Many urologists approach this issue by utilizing thick, heavy suture material which may leave unsightly scars.  The sutures used are only for skin edge alignment; the dressing holds the wound together while healing occurs. 

Why should I as an adult need a circumcision?

Almost all procedures are performed for cosmetic or social reasons. From discussions with hundreds of men, urologist has learned over the years that many men experience a reduction of self-esteem due to being the “odd man out” in this circumcised American culture. Men seem to appreciate my practice as a discrete and non-threatening solution to getting that mainstream look.

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