Should I Get Circumcised? Concerns About Sensation and Sexual Function - Urology

Dr. Li Yilun reply Urology

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It is essential to clarify that a simple description cannot determine a medical condition.
Therefore, if symptoms do not improve or worsen, it is recommended to seek consultation and examination from a professional physician to avoid delaying the diagnosis.
Physicians often need to inquire about medical history, conduct visual examinations, palpation, and tests to confirm the diagnosis and treatment plan.
1.
What is the foreskin? The foreskin is an anatomical structure that extends from the coronal sulcus at the back of the glans penis and covers the glans itself.
The foreskin is characterized by its looseness and excellent elasticity, providing sufficient space for the penis to expand.
2.
How is phimosis defined in medical terms? If the foreskin cannot be retracted to reveal the glans, this is typically seen in newborns and infants, which is normal.
However, by the age of 3-4 years, about 90% of children can easily retract the foreskin, with only a small percentage needing more time for retraction.
If, after puberty, the foreskin still cannot be retracted, it is considered complete phimosis, which may require surgery.
3.
What is the function of the foreskin? In primitive times, the foreskin served to protect the glans.
Since humans began wearing clothing, the foreskin may seem redundant.
However, it still holds significant value.
For instance, modern infants are often diapered for convenience, and without the foreskin's protection, the urethral opening may rub against the diaper, potentially leading to scarring and narrowing of the urethra.
In newborns, if there is a hypospadias, the foreskin can be used for urethral reconstruction.
In adults, a loose and elastic foreskin allows for free movement of the penis, reducing pain or injury during intercourse or masturbation.
4.
Under what circumstances is circumcision necessary? Foreskin conditions can be categorized as follows:
a.
If the opening at the tip of the foreskin is very small, and the glans cannot be seen even when retracted, or if urination resembles inflating a balloon, it should be addressed promptly.
b.
If the foreskin can be retracted to fully expose the glans without tightness or adhesion, and it can be cleaned properly, circumcision may not be necessary.
c.
If the foreskin can be retracted to see part of the glans but feels tight or adherent, making cleaning difficult and leading to smegma accumulation, circumcision may be cleaner but is not urgently required.
Other indications for circumcision include recurrent inflammation of the glans and foreskin more than twice a year, or if there is a constricting ring around the glans causing edema during erection.
However, those with buried penis, hypospadias, or bleeding disorders are not suitable candidates for surgery.
5.
How should the foreskin be cleaned properly? Generally, instructions on how to care for the foreskin are unnecessary.
It is sufficient to rinse the area around the opening with clean water during bathing to reduce redness and swelling at the foreskin's tip due to urine residue.
Adults should retract the foreskin to clean the inner part, minimizing smegma buildup.
6.
What is smegma? When the foreskin is not easily retractable, smegma can accumulate between the foreskin and the glans, sometimes forming pearl-like structures.
This smegma does not affect health, and one should not forcefully retract the foreskin for cleaning, as doing so can be painful and may cause scarring.
Circumcision is only necessary if, after the age of ten, the foreskin remains difficult to retract, leading to ballooning during urination, or if the foreskin is too tight to clean properly, often resulting in urethritis, or if it adheres to the glans.
7.
What are the benefits of circumcision? Past research indicates that circumcision can reduce the risk of penile cancer and cervical cancer in partners, as well as provide some protection against urinary tract infections, but it does not decrease the risk of sexually transmitted infections.
As for enhancing sexual function, reducing premature ejaculation, or improving penile development, particularly if performed in childhood or infancy, there is no definitive conclusion.
It is advisable to thoroughly understand the benefits and drawbacks of circumcision and discuss the indications and potential complications post-surgery, such as pain, bleeding, and temporary swelling of the penis, with a physician.
Many public perceptions and expectations differ from actual medical considerations, so it is essential to communicate with a physician before deciding on circumcision.

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Reply Date: 2014/01/29