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Circumcision (male circumcision)
Last reviewed: 04.07.2025
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[ Indications for circumcision in men
Most often, circumcision is performed for religious reasons, which, as a rule, also regulate the time of the procedure and the person responsible for performing it.
In 1989, the American Academy of Pediatrics' Commission on Circumcision stated that "circumcision of newborn males has potential medical benefits and advantages as well as harms and some risks." The commission also stated that there is no medical indication for circumcision of newborn males.
Circumcision is rarely performed for medical reasons. These indications include non-contractile foreskin (especially when combined with urinary tract obstruction), phimosis and paraphimosis (infringement of the glans penis by the foreskin, manifested by acute pain and swelling of the glans penis due to impaired venous outflow), and possibly recurrent urinary tract infections and/or STIs.
Potential benefits of circumcision
Circumcision (cutting) helps keep the genitals clean. The procedure does not eliminate the need to maintain proper personal hygiene, but it makes it easier to do.
The procedure reduces the incidence of urinary tract infections in male infants from 1% to 0.1%.
May reduce the risk of transmission of certain STDs (such as HIV infection)
Penile cancer is a disease of the elderly, occurring in 1 in 600 men who have not undergone circumcision. Circumcision virtually eliminates the risk of developing this disease. However, poor personal hygiene may be of equal importance in the pathogenesis of penile cancer.
Circumcision may prevent cervical cancer in sexual partners of HPV-infected men who were not circumcised.
Circumcision (cutting) allows to avoid circumcision at a later age, when the procedure is associated with greater difficulties and is more traumatic for the patient. 10% of men who have not undergone circumcision subsequently have to undergo the procedure for medical reasons.
Technique of circumcision surgery
Informed consent from parents must be obtained.
The external genitalia should be examined before the operation. The child should be carefully secured during the operation.
During the operation, the infant experiences pain and discomfort. Anesthesia is not used in all cases. The preferred method of anesthesia is not defined. Local anesthesia (dorsal nerve block of the penis) is effective. Adrenaline should not be used. Topical anesthesia (5% lidocaine/prilocaine gel) may be effective. General anesthesia is not justified.
Contraindications to circumcision in men
Absolute contraindications: the infant has (or has a family history of) excessive bleeding or malformations of the penis (such as hypospadias, in which the skin of the foreskin is used as a flap for surgical correction of the defect). Circumcision is an optional procedure and should only be performed on healthy infants.
Relative contraindications: prematurity, age less than 24 hours and very small penis size (micropenis), which may be the result of adhesion between the head of the penis and the scrotum.
Complications of circumcision
Complications of circumcision occur in 0.2-0.6% of cases. The most common complication is severe bleeding. Other immediate complications include postoperative infection, hematoma formation, damage to the penis, removal of an excessively large skin flap (denudation)
- Infectious complications after circumcision often develop when using the Plastiball device, which is applied to the foreskin for several days until it necroses and falls off.
- Late complications, such as stenosis of the external urethral orifice, are rare. As for the intensity of sexual sensations, Masters and Johnson found no difference between circumcised and uncircumcised men.
- More severe complications occur extremely rarely and in all cases are caused by a violation of the surgical technique (for example, complete destruction of the penis during electrocautery or ischemic necrosis due to the use of a mixture of lidocaine and adrenaline for local anesthesia).