Why circumcision is done ?
Updated: Aug 2
Circumcision is the surgical removal of the foreskin.
The foreskin is the retractable fold of skin that covers the tip of the penis called glans. It's a continuation of the skin that covers the whole of penis. Circumcision may be carried out for a number of reasons.
Circumcision is most commonly carried out when the foreskin is tight and won't pull back (retract), which is known as phinosis. This is the commonest reason for male circumcision. Usually foreskin can be retracted at birth only but in few it may take longer. If by use of ointments and gentle manipulation if we are unable to get the skin retracted by 1 year, it may result in increased back pressure resulting in recurrent uti cystitis and in few occssion it may lead to infection of kidneys with reduced renal function thus requires formal circumcision.
In adults particularly in diabetics it may lead to balanoposthitis thus resulting in scarring and cause phimosis.
Even in chronic balanoposthitis which is due to fungal infection circumcision will result in chronic cure
Other indication are BXO Or balanitis xerotic oblitrans which is precancerous lesion requires circumcision.
Circumcision is a common practice in the Jewish and Islamic communities, and it's also practised by many African communities.
Most non-medical circumcisions are carried out on kids.
Medical reasons for men to have a circumcision
In men, circumcision is sometimes considered a possible treatment option for the following conditions.
Tight foreskin (phimossis) is where the foreskin is too tight to be pulled back over the head of the penis (glans).
This can sometimes cause pain when the penis is erect and, in rare cases, passing urine may be difficult.
Recurrent balanitis is where the foreskin and head of the penis become inflamed and infected.
Paraphimosis is where the foreskin can't be returned to its original position after being pulled back, causing the head of the penis to become swollen and painful. It's a possible complication of a tight foreskin (phimosis).
Immediate treatment is needed to avoid serious complications, such as restricted blood flow to the penis.
Balanitis xerotica obliterans
This condition causes phimosis and, in some cases, also affects the head of the penis, which can become scarred and inflamed. It presents as white patches over the skin
It is a premalignant condition.
Cancer of the penis restricted to the prepuce
Penile cancer) is a very rare type of cancer, where a wart-like growth or ulcer appears on the end of the penis or under the foreskin, or there is bleeding, discharge or changes in the skin of the penis or foreskin.
In most cases, circumcision will only be recommended when other, less invasive and less risky treatments have been tried and haven't worked.
Mild cases of phimosis particularly if it is physiological can be treated with topical steroids to help soften the skin and make it easier for the foreskin to retract. It is used for 4 to 6 weeks not more than that.
In paraphimosis, a healthcare professional may rub xylocain gel onto the glans to help reduce pain and inflammation.
They may then apply pressure to the head of the penis while pushing the foreskin forward.
In severe cases of paraphimosis, local anaesthetic gel can be applied to the penis and a small slit is made in the foreskin to help relieve the pressure.
Balanitis and balanitis xerotica obliterans can sometimes be successfully treated using corticosteroid ointment, gel or cream, antibiotic creams or antifungal creams.
Potential advantages of ritual circumcision
There's evidence from several trials carried out in Africa that circumcised men have a lower risk of acquiring HIV.
But it's unclear whether circumcision can help prevent other sexually transmitted diseases such as syphilis or gonorrhoia.
There have been several studies into circumcision and the risk of other STIs, but the evidence to date has been inconclusive and conflicting.
Reduced Risk of Cancer
Neonatal circumcision is postulated to reduce to risk of penile cancer but evidence is inconclusive
Types of circumcision