Circumcision

Adults who choose to undergo circumcision may do so for medical reasons, such as, recurrent infections, or inflammation of the foreskin. Some adult men also choose circumcision for personal or cultural reasons.

Phimosis is a condition in which the foreskin of the penis cannot be fully retracted from the head of the penis. The foreskin is a loose flap of skin that covers the head of the penis, and in most men, it can be easily pulled back to reveal the head. In phimosis, however, the foreskin is tight and cannot be retracted, which can cause a number of problems.

There are several reasons why phimosis can occur, including:

• Congenital phimosis: This refers to phimosis that is present at birth and is due to the narrow opening of the foreskin.

• Scarring: Phimosis can also develop as a result of scarring, which can occur due to repeated infections or injury to the foreskin. This commonly happens in diabetic patients. Scarring can lead to discoloration and lightening of the pigment of foreskin in addition to tightening. Occasionally this can also be due to a condition known as balanitis xerotica obliterans (BXO).

• Infections: Infections of the foreskin can cause inflammation, swelling, and scarring, which can lead to phimosis.

Potential complications of phimosis include:

• Painful erections: The tight foreskin can cause pain during an erection, as it is unable to expand and accommodate the increased size of the penis.

• Urinary difficulties: Phimosis can also make it difficult to urinate, as the tight foreskin can obstruct the flow of urine.

• Balanitis: This is an infection of the head of the penis that can occur when urine and semen become trapped under the foreskin.

• Balanoposthitis: This is an infection of both the head of the penis and the foreskin, which can cause pain, swelling, and discharge.

If left untreated, phimosis can lead to serious complications and may impact a man's quality of life. In some cases, circumcision may be recommended as a treatment for phimosis. However, other options, such as topical corticosteroids with stretching exercises, may be tried first. These more conservative therapies have a good chance of success, but almost inevitably the phimosis returns and the man has a choice of repeating conservative therapies or circumcision.

Risks of circumcision include bleeding, infection, scarring, and pain. Some men may also experience sexual dysfunction, including reduced sensitivity or decreased pleasure, as a result of the procedure. However, there are also several potential benefits of circumcision, including reduced risk of urinary tract infections, sexually transmitted infections (such as HIV), and penile cancer. Circumcision can also improve hygiene and reduce the risk of certain types of penile injuries.

Common Complaints:

• Pain and discomfort: Circumcision is a surgical procedure and can cause pain and discomfort during the healing process.

• Scarring: Some men may develop scarring at the site of the circumcision, which can cause cosmetic concerns and a pulling effect with erection.

• Sexual dysfunction: As mentioned, some men may experience sexual dysfunction as a result of circumcision, including decreased sensitivity or pleasure, or shortening of the penis with scarring.

• Regret: Some men may regret their decision to undergo circumcision, particularly if they experience any of the above complications or if they feel that their circumcision has impacted their sexual function or enjoyment.