Adult Circumcision – Questions Answered

By Dr. Harold Reed

1. Will Sensitivity Be Lost Following Circumcision?
   Among the most common questions we’re asked about adult circumcision is whether or not there will be a loss of sensitivity following the procedure.

   One way to measure sensitivity is ejaculatory latency time or how long once you are actively in the vagina to have orgasm. Someone who is less sensitive will take longer. Another word for average is “mean”.

   Based on studies of a large number of patients from Kaiser-Permanente Clinics (thousands), there is no difference in mean ejaculatory latency time between circumcised men (on average) and uncircumcised men.

   We have an instrument in our office called a penile biothesiometer, which relates to nerve conduction.

   A normal penis has sensitivity comparable to the pulp pads on the fingers and thumb (about 5 to 6 on a scale of 1 to 50). We have compared the lateral shaft and glans skin on numerous circumcised patients and they generally ring out 5 to 6, indicating no change in sensitivity.

   Remember a circumcision is about removing skin and skin only. Stay with experienced operators, but you should do well with most urologists. Please visit our web-site http://adult-male-circumcision.com and click on photographic examples to get an idea of how beautiful we can make your circumcision look.

2. Is there Pain after Circumcision?
   Depending on the style and technique used in an adult circumcision, there can be some discomfort during the first days following the surgery. The first half month is still considered to be an “early recovery phase” and it’s possible that some pain could occur during that time if the right directions are not followed.

   The following is a letter we send to prospective patients who are considering circumcision.

   A circumcision is perhaps the highest cosmetic calling given to a urologist.

   We do several circumcisions and a few revisions here every week, as we enjoy a reputation for excellence and exactitude when it comes to cosmetically performed adult circumcisions. We operate within tolerances of 1/32 or about 1/2 mm.

   Pain is virtually non-existent among our patients. They smile as they leave the office, and by and large remain free of discomfort as evidenced by our follow-up contact with them.

   After seeing so many circumcised men who look very much like they were done later in life, because of large suture tracts, and irregularly meeting skin, I developed perhaps a unique approach to be sure this did not happen to my patients, and have found no need to vary over the past 15 years.

   Firstly, I confer with the patient to find out exactly what type of result he is looking for, tight or loose, high low or moderate, removal of the frenulum or preservation of the frenulum, etc. Secondly, only fine plastic surgery suture is used to create perfect alignment.

3. How to Correct Suture Tracks from Circumcision
   Ninety nine percent of all sutures employed for circumcision will melt out. But 10% of patients have permanent cross hatch marks, sometimes called railroad ties, especially if the sutures were placed too tightly.

   Suture placement is an art. They should be placed on a slight angle not perpendicular to the skin so the underside is more represented.

   The delicate forceps is used the grasp the vascular layer, not the skin where marks from forceps trauma may show. Tensile strength and healing takes place just underneath the skin. When tied the goal is to just approximate the skin not to strangle it.

   If you treat nature right, it is amazing how our innate capability of wonderful wound healing will out.

4. When is Circumcision Correction Needed?
   Following various types of procedures – for example, bilateral inguinal hernia surgery – can change the result of a circumcision. For example, a high and tight circumcision can suddenly develop issues with shape and look of the head of the penis and may cause lymphatic drainage which can come with odors and appearances that are unpleasant.

   In that type of circumstance, my approach would be conservative as bilateral inguinal surgery will temporarily dispute the lymphatic drainage from your penis creating the aforementioned situation.

   Corrective action should not be taken too early. Give the area the chance to fully heal over a span of at least 2 to 3 months. Take a picture of the progress over time so it will be easier to use as a reference in order to know exactly what changes are happening over time, as they may be difficult to see from one day to the next. In the meantime practice good hygiene. The lymphatic drainage will reconstitute.

5. What to Eat on the Day of an Adult Circumcision?
   If you are having an adult circumcision and if you’re being done strictly under local as 50% of our patients are, you can have a light breakfast before you come in.

   If you are being done under local with IV sedation, you need to be fasting for 6 hours before the procedure.

   Given a morning appointment, you could have whatever you wish for dinner, and follow that with a midnight snack if desired.

   Please don’t be too apprehensive about circumcision as the procedure and recovery is usually very mild and pleasant.

For more information, please visit http://adult-male-circumcision.com. We are available for consultation. Our E-mail address: [email protected]

• Harold M. Reed, M.D. FICS
• Senior Member of the American Urological Association
• Member Society of Genito-Urinary Reconstructive Surgeons
• Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
• Founding Member Sexual Society of North America
• International Society for Sexual Medicine
• 305-865-2000; http://adult-male-circumcision.com