Adult Male Circumcision Specialist

DuPont Institute

Mary C. DuPont, MD, FPMRS, FACS

Aesthetic Specialist & Surgeon located in Chevy Chase, MD

Adult Male Circumcision

Circumcision is a procedure that removes the penile foreskin.  Adult circumcision is most often performed for aesthetic reasons, medical reasons (skin conditions such as lichen sclerosis, foreskin tightening due to infection or inflammation, and genital warts), or a religious rite of passage

In December 2014, the CDC noted that circumcision drastically lowered a man's risk of contracting sexually transmitted diseases (STDs) via heterosexual sex: HPV by 30 percent, genital herpes by 30 to 35 percent, and HIV by 50 to 60 percent.  Most American men are circumcised.  Circumcision does not adversely affect sexual function and has no impact on fertility. 

Two main types of circumcision:

  1. Dorsal slit:  single incision, removing the top portion of the foreskin to expose the glans.  No tissue is removed.
  2. Coronal:  removes the skin circumferentially to expose the glans.  Remaining skin is sutured back.

 

Benefits:

 

  • Decreased risk of urinary tract infection and penile cancer (although these are rare in men)
  • Cervical cancer is less common in the female sexual partners of circumcised men
  • Lower risk of HIV
  • Lower risk of STD’s
  • Easier hygiene

 

Risks:

 

  • Low risk of bleeding
  • Low risk of infection
  • Rare risk of foreskin being cut too short or left too long
  • Longer time to ejaculate

 

Circumcision doesn't affect fertility, nor is circumcision generally thought to enhance or detract from sexual pleasure for men or their partners.

Risks

The most common complications associated with circumcision are bleeding, pain, and infection.   

How you prepare

Wash the genital area with antibacterial solution (Hibiclens) the day before and morning of your procedure.  Wear loose pants such as sweatpants.  It is recommended that you bring a pair of snug fitting, brief style, underwear that will hold the penis upright after surgery to help the swelling go down.  A mild sedative will be prescribed to take prior to the procedure.  Someone over the age of 18 will need to drive you home.

During the procedure

Local anesthetic (penile nerve block) will be injected into the base of the penis.   The foreskin will be removed by laser or surgical scalpel and the skin edges reapproximated with absorbable suture.  Use of the laser is associated with less postoperative bleeding and pain.  Afterward, the penis will be covered with an ointment, such as a topical antibiotic or petroleum jelly, and wrapped loosely with gauze and Coban dressing. The procedure generally takes about 30-45  minutes.

After the procedure

It usually takes seven to 10 days for the penis to heal. The tip of the penis is likely to be sore at first, and the penis might look red, swollen or bruised. You might notice a small amount of yellowish-whitish film as well.  This is normal and not indicative of infection.   Patients are asked to refrain from sexual activities for approximately four to six weeks to allow for proper healing.  Additionally, it is recommended to avoid strenuous exercise (bicycling, jogging, weight lifting, aerobic exercise) for four to six weeks.  Light exercise can resume in one week.  Showering may resume in 48 hours after the bandage is removed.  Apply a cold pack or ice pack to the groin for 10-20 minutes every 1-2 hours on the first day.  Patients are given antibiotics and pain medications to use during the first postoperative week.  Often extra strength acetaminophen suffices but we want to ensure a pain-free recovery. Most men can return to work within 3-7 days, depending on their type of work.

Does Insurance Cover Circumcision?

Unless you have a medical problem that can be corrected by circumcision, it is unlikely that your insurance would cover the procedure.