Adult circumcision can be performed under local or regional anesthesia. Medical indications for this procedure include phimosis, paraphimosis, recurrent balanitis and posthitis (inflammation of the prepuce). Nonmedical reasons may be social, cultural, personal or religious. The procedure is commonly performed using either the dorsal slit or the sleeve technique. The dorsal slit is especially useful in patients who have phimosis. The sleeve technique may provide better control of bleeding in patients with large subcutaneous veins. A dorsal penile nerve block, with or without a circumferential penile block, provides adequate anesthesia. Informed consent must be obtained. Possible complications of adult circumcision include infection, bleeding, poor cosmetic results and a change in sensation during intercourse.

Circumcision is performed on an estimated one out of six male newborns worldwide.1 Over 60 percent of male newborns were circumcised in the United States in 1992.2 Circumcision in adults is performed much less often; however, accurate statistics are not available. Adult patients often have a medical indication for the procedure, but circumcision may also be done for social or purely personal reasons. Adult circumcision is usually performed in the outpatient setting by urologists. However, family physicians who practice in isolated or rural areas and who are adequately trained may also offer this procedure. All family physicians should be prepared to advise their patients about the indications for adult circumcision and, if necessary, make appropriate referrals for the procedure.




Adult Circumcision Surgery Video