” It is the most practiced gesture in the worldall surgery combined, but it is not a trivial operation “, insists Antoine Faix, urologist-andrologist doctor. Here is what you need to know about circumcision.
Circumcision, also called posthectomy by urologists, is a surgical act which consists of completely or partially removing the foreskin“in other words, the skin that covers the glans of the penis,” explains the surgeon.
It is often performed for cultural or religious reasons said “of personal convenience” in early childhood or before puberty. But it can also be done for medical reasons (medical circumcision), at any age of adult life.
“A lot of information circulates around this operation”, notes the urologist. In fact, the main consequence of a posthectomy, is that the skin of the glans changes texture and epidermises: “It will change color slightly and become thicker,” says Antoine Faix.
It can be specified in certain malformations or pathologies of the genital organs masculine. For example in the case of “an inability to retract, pain in the foreskin, skin disease in the foreskin which causes significant discomfort, or even urethritis which causes difficulty in urinating”, specifies the urologist.
Posthectomy can also be performed in case of functional phimosis, this affection of the penis which makes that, during erection, the foreskin cannot retract easily behind the glans or retracts painfully.
“ If you don’t have a problem with capping at rest or in erection, circumcision is not useful. “says the professional. To note : it is normal for a little boy not to bend his head until he is 2-3 years old. Foreskin adhesions peel off over time. “In most cases, the situation resolves itself.” For its part, the French Society of Pediatric Surgery (SFCP) recommendswait until the age of 6 to 7 years before a circumcision for medical indication. Except in case of complications of infections or pain, especially during urination.
In the medical setting, this operation must be carried out by a surgeonideally a urologist. The intervention consists of cut off part of the foreskin, to release adhesions between the foreskin and the glans, then to sew the skin around the glans. Absorbable stitches are put in place.
This surgery is performed on an outpatient basis, under short general or local anesthesia. After ensuring the absence of local complications and good recovery from anesthesia, we are allowed to leave the hospital in the afternoon. “ We go home a few hours after the operation, after urinating, with a bandage, and local hygiene instructions (application of antiseptic ointment for example)”, summarizes the expert.
THE stitches are absorbable and resolve on their own after three to four weeks, healing time. During the first days following the operation, it is advisable to wear loose clothing to avoid friction and the risk of irritation.
“ It’s not a very painful procedure. ” (except sometimes during nocturnal erections), indicates Antoine Faix who underlines that “as long as the healing is not finished, it is necessary avoid baths, sauna or hammam, swimming and sexual intercourse”. Showers are possible.
There loss of sensation or sensitivity in the glans is actually a complication of the operation, not a consequence. This loss of sensitivity may be linked to damage to the nerves of the penis. “It’s quite rare, but it can happen”, indicates Antoine Faix for whom circumcision is a falsely trivialized gesture.
When the operation is performed in a medical environment, “ the complications are of the order of the exceptional “. The least exceptional being bleeding or hematoma. “Infections, lesions of the urinary tract or accidental section of the glans are complications that are almost never seen in France, when the operation is performed in a medical environment”, concludes the urologist.
According to a widespread belief, circumcision would prevent the proliferation of bacteria causing diseases of sexually transmitted infections (STIs) within the foreskin. Indeed, some foreign studies, notably carried out in South Africa, have shown that circumcised populations are less prone to sexually transmitted diseases (especially HIV). “But this has never been proven in France, insists the urologist. Under no circumstances should a posthectomy replace the wearing of a condom. It is not an effective barrier against STIs “.
And the surgeon recalls: “Circumcision nor should it be made to be cleaner. Basic hygiene is enough to protect against infections. It is therefore important that men retract and wash the inner face of the foreskin every day since it is there that certain bacteria can lodge.
When this intervention is carried out in adulthood, “it is possible that it is felt during penetration”, notes the urologist. In the facts, there should be no negative sexual consequences. On the contrary, this operation can even relieve difficult, painful or even impossible sexual intercourse.
“It has not been demonstrated that the sensations felt during sexual intercourse are modified, in a good or bad way”, indicates the surgeon. A circumcised man keeps normal ejaculation. We can think that this operation makes it possible to prolong the sexual intercourse, because of a small loss of sensitivity of the glans. However, “this operation is in no way a solution to the problems of premature ejaculation”, recalls the expert.
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