Circumcision

Circumcision is a minor, short surgical procedure to remove the foreskin, which usually completely covers the glans.

Circumcision can be performed for functional, aesthetic or religious reasons. In adulthood, the procedure is usually performed for medical or aesthetic reasons.

Medical reasons for circumcision

• Tight foreskin (also called phimosis): phimosis can be congenital or can develop in adulthood as a result of recurrent infections or tearing of the foreskin.
• Recurrent infections: Recurrent infections of the foreskin or head of the penis (balanitis) may require circumcision.
• Too short foreskin (frenulum breve): Men with foreskin problems often have a frenulum that is too short. Depending on the severity of the problem, the foreskin may need to be lengthened (frenulotomy) or circumcised.

General motivations for circumcision

• Hygiene: from a hygienic point of view, circumcision is beneficial because it prevents dead skin cells (smegma) from accumulating in the folds of the foreskin.
• Cultural and religious reasons: in many cultures and religions, circumcision is performed on newborns or children.
• Aesthetics: Some men find a circumcised penis more aesthetically pleasing than an uncircumcised one. Circumcision can help to achieve this aesthetic goal.

Circumcision does not only have aesthetic advantages for the man, it can also have positive medical aspects. These include the reduction of the risk of the following problems

• Penile cancer: Due to better hygienic conditions, circumcision reduces the risk of contracting penile cancer.
• Sexually transmitted diseases: Studies show that circumcision is associated with a reduction in the risk of contracting sexually transmitted diseases. However, circumcision does not protect against these diseases.
• Chronic Inflammation of the Skin: Circumcision can eliminate chronic inflammation of the foreskin and thus prevent the development of penile cancer from this chronic inflammation.
• Premature ejaculation: Circumcision can have a positive effect on this problem.

As an alternative to conventional types of circumcision, there is the option of a so-called “aesthetic” circumcision in the absence of phimosis.

Cosmetic circumcision is the preservation of the foreskin during circumcision. In contrast to the removal of the foreskin in traditional circumcision, only part of the skin on the shaft of the penis is removed in cosmetic circumcision.

The result of the above mentioned circumcision technique is similar to that of the traditional circumcision, except for the location of the incision. In cosmetic circumcision, the incision is made in the fold of skin at the base of the penis and is therefore barely visible to the eye.

With the classic methods, the incision is made below the head of the penis, which can make the scar visible, depending on the style of the circumcision:

Here you can see a video comparison of the two methods of surgery:

The advantages of the aesthetic surgical technique are the preservation of the sensitive inner foreskin and the achievement of a scar-free transition from the head of the penis to the shaft of the penis. A contraindication to this surgical method is the presence of phimosis. There are also different styles of conventional circumcision, which differ in what parts of the skin are removed and where the scar is placed. A prior examination and evaluation of your penis is therefore a prerequisite for making a decision.

Although circumcision is considered a routine procedure, it also requires the surgeon to have the necessary routine and experience to achieve a cosmetically satisfactory result and prevent complications.

A poorly performed circumcision can have far-reaching effects on the function and aesthetics of the penis. If the circumcision has been performed inadequately, the aesthetic appearance can usually be improved and restored with reconstructive surgery.

In a consultation, Dr. Kuehhas will explain the options & risks of the procedure in detail. The circumcision is usually performed under local anesthesia. This guarantees a complete elimination of pain. The procedure takes about twenty minutes. A bandage must be worn for 24 hours.

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Dr. med. Franklin Kuehhas is a medical specialist in the field of urology and andrology. He received his specialization training at the University College London. He also underwent his training at the prestigious University Hospital in Heidelberg (Germany) and at the University Hospital of Vienna (Austria). Dr Kuehhas focuses on the treatment of congenital and acquired penile curvatures (Peyronie’s disease). His research activities have resulted in many publications and improvements of surgical techniques such as the STAGE technique for congenital penile curvature treatment.