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Adolescent and adult circumcision

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Tuli: Add link in SEEALSO Section.
'''Adolescent and adult circumcision''' is rare when compared to the millions upon millions of medically-unnecessary, harmful non-therapeutic [[Circumcision| circumcisions]] of boys that are carried out in [[Islam]]ic nations, [[Israel]], the [[United States]], and elsewhere, however they are promoted by a [[medical trade association| medical trade associations]] and its their membersfor [[Financial incentive| profit]].
[[Rosemary Romberg]] commented on adult circumcision in the [[United States]]:
|accessdate=2023-08-31
|note=
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</blockquote>
==Considerations before consent is granted==
[[Alfonso Cepeda-Emiliani| Cepeda-Emiliani]] et al. (2025) have provided this warning to men who are considering an adult circumcision.
<blockquote>
Regarding adult circumcision, the current knowledge of preputial
and penile neuroanatomy and structure underscores the importance
of meticulous patient selection for this procedure. Specifically, when
adult circumcision is to be performed, factors such as the position of
the [[circumcision scar]] line, the amount of inner prepuce retained, the
tightness of the remaining penile skin, and whether a frenulectomy
is performed should be carefully discussed and agreed upon by both
the patient and the surgeon, with all decisions clearly documented in
the [[informed consent]]. Recent survey findings underscore this need
for dialogue: Callegari et al. showed that preferences regarding the
amount of inner preputial remnant retained after circumcision vary
considerably among individuals, reinforcing the importance of engaging patients in personalized discussions to align surgical decisions with their expectations.<ref name="cepeda2025">{{REFjournal
|last=Cepeda-Emiliani
|first=
|init=A
|author-link=Alfonso Cepeda-Emiliani
|last2=Otero-Alén
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|last3=Suárez-Quintanilla
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|last4=Gándara-Cortés
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|init4=M
|author4-link=
|last5=García-Caballero
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|init5=T
|author5-link=
|last6=García-Caballero
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|init6=R
|author6-link=
|last7=García-Caballero
|first7=
|init7=L
|author7-link=
|etal=no
|title=The sensory penis: A comprehensive immunohistological and ontogenetic exploration of human penile innervation
|trans-title=
|journal=Andrology
|date=2025-09-19
|volume=
|issue=
|article=
|pages=1-41
|url=https://onlinelibrary.wiley.com/doi/epdf/10.1111/andr.70118
|archived=
|quote=
|pubmedID=40970806
|pubmedCID=
|DOI=10.1111/andr.70118
|accessdate=2025-09-29
}}</ref>
</blockquote>
|last=Masood
|init=S
|last2=Patel
|first2=
|init2=HRH
|author2-link=
|last3=Himpson
|first3=
|init3=RC
|author3-link=
|etal=yes
|title=Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly?
|issue=1
|pages=62-6
|url=https://www.kargercirp.comorg/Articlelibrary/Abstractsex_function/masood1/85930
|pubmedID=16037710
|pubmedCID=
[[Issues_with_American_urologists_and_the_practice_of_male_circumcision| Urologic surgeons]] in the [[United States]] derive a substantial fee from the performance of a [[circumcision]], so some may have a [[bias]] in favor of circumcision and may inappropriately recommend adult circumcision to patients when a conservative treatment would be satisfactory or even when no treatment is necessary. Patients should be wary and do their own research before granting consent for an <u>irreversible</u> [[circumcision]].
 
[[Marilyn Fayre Milos| Milos]] (2022) advises:
<blockquote>
* A penis without a foreskin doesn’t work as nature intended for its owner or his sexual partner.
* Amputating the foreskin eliminates the penis’ “command and control” nerve center, the normal skin system that allows for comfortable erections and the gliding mechanism necessary for sensory pleasure, foreplay, and normal intromission (entry during intercourse).
* Circumcision amputates the tens of thousands of specialized, erogenous nerve endings that signal to the man where he is in relation to the orgasmic threshold.
* It denudes and exposes the glans (head of the penis), causing it to become dry, calloused, and desensitized. Circumcised men talk about becoming impotent during their 50s or 60s while intact males tell me the urge doesn’t come around as often but their sensitivity hasn’t diminished.
* Circumcision makes the penis smaller, too.<ref name="milos2022-05-02">{{REFweb
|url=https://intactamerica.org/ask-marilyn-a-19-year-old-considers-circumcision/
|title=Ask Marilyn – 19-year-old Considers Circumcision
|last=Milos
|first=
|init=MF
|author-link=Marilyn Fayre Milos
|publisher=Intact America
|date=2022-05-02
|accessdate=2024-10-24
}}</ref>
</blockquote>
 
Performance of unneccesary circumcision simply to earn a surgical fee is [[Ethics_of_non-therapeutic_child_circumcision#Patient_exploitation| unethical patient exploitation]].
==Reasons for circumcision==
All circumcisions are injurious because they amputate a [http://www.intactaus.org/information/functionsoftheforeskin/ multi-functional body part], but in rare cases the benefit obtained by removing a deformed, diseased, or damaged foreskin may be of more value than the amputated [[foreskin]].
* Deformed foreskins — The common type of deformed foreskin is the narrow non-retractable foreskin of [[phimosis]]. Circumcision was the traditional treatment for phimosis, however circumcision is less performed today because newer conservative treatments are now available that preserve the [[foreskin]] and its many useful functions. There is a wide range of normal in foreskin length. Longer foreskins are not deformed, so do ''not'' justify circumcision.
* Diseased foreskins — Diseases for which circumcision may be indicated include [[Penile cancer|malignant tumor]],[[Balanitis xerotica obliterans| lichen sclerosis]], recurrent yeast infection in diabetic males (after conservative treatment fails),<ref name="verma2011">{{REFjournal
===A word to intact teens===
Boys are born with a [[foreskin]] that is non-retractable for reasons of protectionagainst [[trauma]] and [[infection]]. The inner surface is fused with the [[glans penis]] by a [[synechia]] (similar to a fingernail that is glued to the nail bed of the finger). Also the tip of the foreskin is too narrow to retract. As a boy gets older, the synechia disintegrates and releases the foreskin and the foreskin gets wider as a boy ages, so the foreskin gradually becomes [[Retraction of the foreskin| retractable]]. Some boys go through [[puberty ]] but find that their [[foreskin]] is still too narrow to permit retraction.
Beaugé (1997) reported that boys, who masturbate by pulling their [[foreskin]] away from the body, will not stretch the tight part of the foreskin so non-retractile foreskin will persist. He advised changing the method of [[masturbation]] to the more conventional method of pulling the foreskin toward the body so that the narrow orifice gets stretched.<ref name="beauge1997">{{REFjournal
===Circumcision with a plastic ring device===
Adolescent and adult circumcision may also be carried out with one of several plastic, one-use, disposable ring devices. These devices work by clamping the foreskin tightly so that it is crushed and flow is cut off completely. Ischemic [[necrosis]] ensues and the [[foreskin ]] dies. It may then be cut off or left to fall off. Ring devices include the [[TARA KLamp]], the [[PrePex]], [[AccuCirc]], and the [[Shang Ring]].
==Pain during and after circumcision==
[[Masturbation]] after circumcision may be painful if one doesn’t use lubrication because of lack of [[gliding action]].
==Recovery period==
Recovery from an adult circumcision is frequently said to be six weeks. Recovery does not include restoration of permanently lost functions.
===Complications===
Erections tend to be painful and may cause [[wound dehiscence]].<ref name="wang2023">{{REFjournal
|page=2194
|accessdate=2021-06-04
}}</ref> García-Mesa et al. (2021) reported the [[foreskin]] has an abundance of [[Meissner's corpuscles]] which provide pleasant sexual sensation when mechanically stimulated by motion of the foreskin.<ref name="garcía-mesa2021">{{REFjournal
|last=García-Mesa
|first=Yolanda
|init=
|author-link=
|last2=García-Piqueras
|first2=Jorge
|init2=
|author2-link=
|last3=Cobo
|first3=Ramón
|init3=
|author3-link=
|last4=Martín-Cruces
|first4=José
|init4=
|author4-link=
|last5=Suazo
|first5=Iván
|init5=
|author5-link=
|last6=García-Suárez
|first6=Olivia
|init6=
|author6-link=
|last7=Feito
|first7=Jorge
|init7=
|author7-link=
|last8=
|first8=Vega
|init8=José A.
|author8-link=
|etal=no
|title=Sensory innervation of the human male prepuce: Meissner's corpuscles predominate
|trans-title=
|language=
|journal=Journal of Anatomy
|location=
|date=2021-10
|volume=239
|issue=4
|article=
|page=
|pages=892-902
|url=https://onlinelibrary.wiley.com/doi/full/10.1111/joa.13481
|pubmedID=34120333
|pubmedCID=8450466
|DOI=10.1111/joa.13481
|accessdate=2021-11-15
}}</ref>
</blockquote>
García-Mesa et al. Remennick (2021) reported Jewish men from the former Soviet Union who migrated to [[foreskinIsrael]] has an abundance of and received their [[Meissner's corpusclesBrit Milah| ritual circumcision]] which provide pleasant as sexually active adults were very displeased with their loss of [[Sexual sensation of the foreskin| sexual sensation when mechanically stimulated ]]:<blockquote>Driven by motion social pressure and the need to belong, most young men (and their parents) consented to the operation without proper counselling and unaware of its ramifications. Men share their intimate memories of the foreskinrapid surgical procedure, painful recuperation, and their belated regrets, both aesthetic and sexual. The willingness to expose their lingering trauma signals evolving concepts of masculinity and vulnerability among these former Soviet men. Their voices join the local and international movement opposing medically-unnecessary genital surgeries of any kind – on men, women and intersex people.<ref name="garcía-mesa2021remennick2021">{{REFjournal |last=García-MesaRemennick |first=Yolanda |init=L
|author-link=
|last2=García-Piqueras
|first2=Jorge
|init2=
|author2-link=
|last3=Cobo
|first3=Ramón
|init3=
|author3-link=
|last4=Martín-Cruces
|first4=José
|init4=
|author4-link=
|last5=Suazo
|first5=Iván
|init5=
|author5-link=
|last6=García-Suárez
|first6=Olivia
|init6=
|author6-link=
|last7=Feito
|first7=Jorge
|init7=
|author7-link=
|last8=
|first8=Vega
|init8=José A.
|author8-link=
|etal=no
|title=Sensory innervation of Joining the human male prepucetribe: Meissner's corpuscles predominateadult circumcision among immigrant men in Israel and its traumatic aftermath
|trans-title=
|language=
|journal=Journal of AnatomyCult Health Sex
|location=
|date=2021-1001-29 |volume=23924 |issue=4 |article= |page=5 |pages=892702-90216 |url=https://onlinelibrarywww.wileytandfonline.com/doi/fullabs/10.11111080/joa13691058.2021.134811879272?journalCode=tchs20 |archived= |quote= |pubmedID=3412033333512277 |pubmedCID=8450466 |DOI=10.11111080/joa13691058.2021.13481 1879272 |accessdate=20212025-1101-1508
}}</ref>
</blockquote>
 
Many [[circumcised]] men say they are unable to feel anything if a condom is used.
===Other adverse effects===
# Circumcision causes both physical and psychic [[trauma]].
# Circumcision severs blood vessels and disrupts blood circulation in the [[penis]]. This frequently causes [[lymphoedema]] and [[erection]] difficulties.
# Circumcision invariably excises the [[ridged band]], resulting in partial loss of sensation.
# Circumcision is a surgical [[amputation]] of functional tissue. The various [https://foreskinfunction.org/ functions] cease to operate. If the patient does not like the results, it cannot be reversed or undone.
# Recovery from adolescent or adult circumcision is slow and painful. [[Erection]]s are painful because the [[skin]] is stretched and the sutures are stressed. [[Wound dehiscence]] may occur.
# The exposed [[glans penis]] will protect itself from friction by developing a layer of [[keratin]] and become cracked and hardened. The [[keratinization]] of the [[glans penis]] will reduce its sensitivity.
# There are possible [[Psychological issues of male circumcision| emotional issues]] secondary to a partial loss of the [[penis]] through circumcision.
# The shaft of the penis becomes narrrower because of the loss of a double layer of skin
 
==Financial considerations==
Medical insurance policies vary with the provider of insurance. Most will pay for circumcision only if it is done to treat a medical condition. When circumcision is carried out for cosmetic reasons or personal desire, it is very unlikely that medical insurance would pay. The cost of an adult circumcision would include a facility fee, a surgeon's fee, an anesthesiologists anesthesiologist's fee, and pre-operative and post-operative care. Garrett (2024) says the cost may range from $1,650 to $6,450.<ref name="garrett2024-03-07">{{REFweb
|url=https://intactamerica.org/adult-circumcision-cost/
|title=Adult Circumcision Cost: The Profit Motives and Hidden Toll
==== Circumcised at 18 ====
<youtube>v=NAHGFx95D80</youtube>
====Circumcised at 46====
<youtube>v=pZ3n8CtcmRY</youtube>
==== Why I Regret Getting Circumcised At 19 ====
==== Got Circumcised as an Adult (Just saw the Penn & Teller episode) ====
<youtube>v=QtN7JmMUfZE</youtube>
==== Circumcision Care - After Circumcision - 5 Post Circumcision Surgery Recovery Tips!====
<youtube>v=xdrvq_10vTM</youtube>
====Why can’t I sleep after my circumcision operation?? Day 12 ====
<youtube>v=CLmxdbV3Uyc</youtube>
== Rite of passage ==
=== Ulwaluko ===
Traditional [[Circumcision]] and Initiation into Manhood (ulwaluko) is an ancient initiation ritual practiced by the amaXhosa of the Eastern Cape region Province of [[South Africa]]. The ritual is traditionally intended as a teaching institution to prepare boys for the responsibilities of manhood. The principles that lie at the very core of the ritual are respect for self (including self control and integrity), respect for family (not to bring shame to them), and respect for community (to protect them from harm).
Every single initiation season the media writes about complications accompanying the ritual of Traditional [[Circumcision]] and Initiation into Manhood ''(ulwaluko)''. The magnitude of these complications is horrific: From 1995 till 2014, 919 boys have lost their lives in the mountains and hills of the Eastern Cape. Many others were mutilated or even lost their manhood. [[Ulwaluko|Many of these mutilations are documented (graphic content).]]
{{SEEALSO}}
* [[Circumcision: Effect upon erectile function]]
* [[Circumcision methods]]
* [[Circumcision scar]]
* [[Development of retractable foreskin]]
* [[Doctors Cut Off Man’s Penis During Circumcision]]
* [[Ethics of non-therapeutic child circumcision]]
* [[Foreskin]]
* [[Foreskin sensitivity]]
* [[Frenectomy]]
* [[Frenuloplasty]]
* [[Fusions and adhesions]]
* [[Ischemia of the glans penis]]
* [[Issues with American urologists and the practice of male circumcision]]* [[Neurotomy]]
* [[Penis]]
* [[Phimosis]]
* [[Sexual effects of circumcision]]
* [[Stretching]]
* [[Surrogate consent]]
* [[Trauma]]
{{LINKS}}
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|accessdate=2020-12-29
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|quote=
}}
* {{REFweb
|url=http://www.intactaus.org/information/functionsoftheforeskin/
|title=Functions of the Foreskin
|last=Helard
|first=Lou
|author-link=
|publisher=Intact Australia
|website=
|date=2014-08-01
|accessdate=2020-05-29
|format=
|quote=
|date=2019-08-02
|accessdate=2021-06-05
}}
* {{REFweb
|url=https://wikionlymen.com/?s=circumcision
|title=Disadvantages Of Circumcision In Man
|publisher=Wiki Only Men
|date=2021-11-05
|accessdate=2024-10-05
}}
* {{REFjournal
|date=2024-03-07
|accessdate=2024-03-10
}}
* {{REFweb
|url=https://4skin-health.alderhey.nhs.uk/teenagers-young-adults/
|title=Advice for teenagers and young adults
|last=Kenny
|first=
|init=S
|author-link=
|publisher=NHS Children's Hospital at Alder Hey
|date=
|accessdate=2025-02-21
}}
* {{REFweb
|url=https://archive.md/Au7cV#selection-98.0-707.8
|title=Unjustifiable reason 1: Parents are clueless about the functions of the foreskin
|last=Anonymous
|first=
|init=
|author-link=
|publisher=REDDIT Intactivism
|date=2025-06-17
|accessdate=2025-06-24
}}
====Traditional circumcision====
* {{NSFW }} [[Ulwaluko]]
{{REF}}
[[Category:Male genital mutilation]]
[[Category:Penile surgery]]
[[Category:Penis]]
[[Category:Teen]]
[[de:Jugendlichen- und Erwachsenenbeschneidung]]
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