Do adults still need to be circumcised?

  The clinic often meets many adult patients with typically long foreskin, and due to the lack of diligent cleaning, repeated inflammation of the foreskin, resulting in thickening of the foreskin, and gradually narrowing the foreskin mouth inflammatory stimulation. When these patients are advised to remove the foreskin, many people think that they are already adults, and not children still developing, removing the foreskin is useless. This shows the bias in people’s perception of circumcision.  Since the adult penis is already developed, the purpose of surgery is no longer to prevent abnormal development, so the purpose of surgery is different from that of a pediatrician.  There are often patients who ask for circumcision on their own initiative, and many of them want the surgery because they feel their sex time is short and want to extend it through surgery. So can circumcision really have a time-delay effect? In a search engine search, the answer to this question is very diverse, so that urologists look at the laughter, some answers for the non-specialist users may also play a misleading role, we should look at the “big data” how to say it.  A 2014 study that included a large sample of 1198 premature ejaculation patients found that IELT (intravaginal ejaculation latency) was mildly reduced 90 days after circumcision, and that IELT was prolonged by about 25% after 1 year of postoperative follow-up, and that control of ejaculation and satisfaction with intercourse were significantly improved. However, there are no long-term follow-up data (>1 year) for circumcision in healthy subjects. It can be seen that although the sensitivity will increase in the short term after circumcision, the long-term follow-up suggests that there is still some prolongation effect.  Even so, we do not recommend circumcision for the purpose of prolonging sexual intercourse. So what is the correct motivation for circumcision?  One, cleanliness. The cavity between the foreskin and the glans is a place where dirt is hidden, so if you don’t clean it often, you will accumulate foreskin scale, which not only smells bad but also induces infection and inflammation. Modern people have superior hygiene and do not find it difficult to wash every day, but have you ever considered the state of hygiene after old age. During my consultations, I commonly see elderly men who cannot take care of themselves with poor genital hygiene, and their foreskin is badly infected or even ulcerated, which is disastrous. For the cleanliness of male external genitalia, circumcision is almost a once-and-for-all solution to the problem.  Second, to prevent infection in both husband and wife. Bacteria are easily adsorbed on the moist mucous membrane on the inner surface of the foreskin, causing recurrent episodes of glansitis and urinary tract infections, which can lead to genitourinary tract infections in the female partner during sexual intercourse, which is very common in outpatient clinics, and simple anti-infection treatment cannot solve the problem at the root. Statistics have found that circumcision has a much lower chance of future STD infection than uncircumcised patients, and even the chance of HIV infection can be reduced by 40%.  Third, reduce the risk of invasive penile cancer and partner cervical cancer. The incidence of penile cancer in Jewish newborns who are routinely circumcised is close to zero. In countries without circumcision tradition, the incidence of penile cancer accounts for 10%-20% of male malignant tumors. Treatment of penile cancer often requires partial or even total penile amputation, as well as subsequent chemotherapy and radiotherapy, which are both physically and mentally traumatic for men. However, invasive penile cancer is one of the most preventable of all cancers, and studies have shown that circumcision has a powerful preventive effect on penile cancer comparable to the prevention of lung cancer and heart disease by stopping smoking. Also, circumcised men are less likely to be infected with HPV and their female partners have a significantly lower risk of cervical cancer.  Finally, improved aesthetics and sexual function. Let’s hear from women on this point of explanation. A survey of American women showed that 75% of women prefer a circumcised penis, and when asked why, their answers were cleaner (92%), look sexier (90%), and feel better (85%).  There are traditional methods of circumcision as well as the emerging disposable circumcision sutures. These methods generally solve the basic problems of circumcision. The traditional method bleeds a lot, is painful and has scars, while the suture method has almost no bleeding, is lightly painful, and crucially, cuts neatly and beautifully without scars, with 3-5 days rest before going to work.  In conclusion, circumcision is an individualized and customized fine plastic surgery, although the foreskin is small, the surgery cannot be treated as small, the benefits of removing the foreskin are still many, and currently with the application of new technologies, the surgical results are becoming more and more satisfactory.