Adult circumcision: when is it needed?

Written by: Mr Andrew Ballaro
Edited by: Robert Smith

Men can go throughout their lives being uncircumcised, however, there may come a point where it feels necessary to have the procedure. From phimosis to cancer of the penis, there are many reasons why circumcision is sometimes done.

We wanted to clarify with a leading consultant urologist, Mr Andrew Ballaro as to why adult circumcision is sometimes necessary, what the risks are and what can be expected from the procedure.

Why do some adult men need a circumcision?

Most circumcisions are performed to remove a tight foreskin. Sometimes the foreskin can always be a little on the tight side, then as one gets older the quality of the tissue deteriorates and the skin loses elasticity. When this happens it is more prone to damage when stretched, and the damaged skin turns to stiff in-elastic scar tissue thereby further reducing the ability of the skin to stretch and predisposing to more damage. Eventually, the skin becomes rigid and splits and cracks every time it is pulled back, and then a circumcision is required. There are also scarring skin diseases which cause a white scar to form over the tip of the foreskin. Rarely, the foreskin may also have to be removed because of penile cancer.

Is it safe for grown men to have a circumcision? Are there risks?

Circumcision is a very safe procedure and can be performed under both general and local anaesthetic. The risks of the procedure include a change in sexual sensation, as there are some fine touch receptors on the tip of the foreskin that are not present elsewhere and are removed.

What can patients expect on the day of the procedure?

The procedure takes about 20 minutes and we normally put a local anaesthetic in so there is no post-operative pain. The patient goes home soon after the procedure, and it can be a little swollen and sore for a few days afterwards but this is readily managed by simple painkillers.

Is it painful to have done?

There is likely to be a degree of discomfort either directly after the procedure or during the healing process but this is not severe and is readily managed by simple analgesia.

How long does recovery take? What does recovery involve?

The procedure takes a few weeks to heal completely and you should refrain from sexual activity for a month. Despite this the patient is walking around straight after the operation, and may well be able to go back to gentle work activities within a few days.

If you feel you will require circumcision, you may like to get in contact with a leading urologist such as Mr Andrew Ballaro. Visit his Top Doctors profile today for information on appointment availability.

By Mr Andrew Ballaro

Mr Andrew Ballaro is a highly regarded consultant urologist in North London and Essex with over 15 years of experience. He specialises in the management of all urological problems including blood in urine, urinary infections, prostate pain syndromes, general prostate and bladder disease, and the diagnosis of urological cancers including the investigation of raised PSA with MRI Fusion prostate biopsy.

He has specialist surgical expertise in the management of kidney stone disease and benign prostate enlargement (BPE), and consistently publishes UK leading surgical outcomes for complex stone operations. He offers a choice of surgical procedures for benign prostatic enlargement tailored to the patient’s requirements including Holmium Laser prostatectomy (HOLEP) and is highly experienced in dealing with very large prostates and urinary retention, with every patient in a large series going home the day after surgery without a catheter.

Mr Ballaro takes satisfaction in providing second opinions, and is supported by a warm, skilled and responsive managerial team. Together they aim to provide the best possible outcome for each and every patient. Mr Ballaro's extensive training began after graduating from The Royal Free Hospital Medical School in London, and undertaking his surgical training at Oxford. He was awarded a fellowship from the Royal College of Surgeons of London and went on to complete higher urological training on the North London Training Scheme. This was followed by advanced training in complex stone surgery from national and international experts in his field.

Alongside his dedication to education, he is currently teaching trainees at the London Deanery, catering to various levels of expertise. Additionally, he has been honoured with a Hunterian Professorship from the Royal College of Surgeons of England, showcasing his commitment to scholarly pursuits. Holding a master’s degree in urology and an MD in clinical sciences from the Institute of Urology, Mr. Ballaro has extensively published research on bladder physiology and minimally invasive urological surgery. He is the co-author of the latest edition of the popular medical student textbook 'Lecture Notes in Urology'.


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