Circumcision: Risks, Benefits and Postoperative Care


What is circumcision?

Circumcision is a surgical procedure performed on children and adults that involves the removal of the foreskin, the skin covering the glans (head of the penis).

Historically performed for religious reasons, circumcision has become increasingly common for reasons of hygiene and because it is a procedure that reduces the incidence of urological diseases.

In this article, we will explain how and why circumcision is performed, as well as its risks and benefits.

What is the foreskin?

The foreskin is the layer of retractable skin that covers and protects the glans, commonly known as the head of the penis. It has two sides, the outer side, which is made of normal skin, and the inner side, facing the glans, which is a mucous membrane responsible for keeping the penis hydrated and protected from aggression from the external environment.

In adults, the foreskin covers the glans when the penis is flaccid, but retracts when the penis is erect.

The skin that covers the penis begins to form in the first weeks of fetal development. From birth until the early years of a man’s life, the foreskin is attached to the glans, a process called physiological phimosis.

As a man grows, the foreskin gradually separates from the glans until it is entirely retractable when the penis is erect. The detachment of the foreskin should not be forced on children, as it occurs naturally over the years.

Why is circumcision performed?

There are reports of the practice among the Egyptians, over 15,000 years ago, as a way to increase male hygiene and “cleanse the soul”.

Although circumcision is a surgical procedure, it is still often performed today for traditional and religious reasons, without any medical indication, such as the routine circumcision of Jewish and Muslim children.

In the late 19th and early 20th centuries, circumcision became a common medical procedure, even in families without religious motivation. In some countries, such as the USA and Korea, more than 80% of the male population is circumcised.

It is good to clarify that despite the known benefits – which will be explained later – the main pediatric associations in the world do not recommend the routine performance of circumcision without medical indication.

Medically indicated circumcision is usually performed in cases of penile infection (balanoposthitis), pain during sexual intercourse, or pathological phimosis, i.e., inability to retract the foreskin in older children and adolescents.


Circumcision, when performed in childhood, presents some advantages, among which we can mention

Reduction of urinary tract infections

Urinary tract infections are rare in men, but they are more common in uncircumcised children due to the growth of bacteria in the smegma, a kind of white mucus composed of shed cells and skin oils that usually accumulate under the foreskin.

Reduction of penile infections

Balanitis (infection of the glans) and posthitis (infection of the foreskin) are also less common in circumcised children (suggested reading: Male Yeast Infection: Symptoms, Pictures & Treatment).

Reduction in penile cancer

Circumcised men have a reduced risk of penile cancer. However, it should be noted that this disease is rare even in uncircumcised men (about 1 case per 100,000 people). The benefit seems to exist only when circumcision is performed in childhood. Men circumcised after adolescence do not have lower rates of penile cancer.

Reduction of cervical cancer in partners

In addition to reducing penile cancer incidence, female partners of circumcised (and monogamous) men have lower rates of cervical cancer. The explanation seems to be that circumcised men have a lower risk of HPV contamination and transmission.

Reduction of STIs and HIV

In addition to HPV, circumcised men have lower contamination rates with other sexually transmitted infections such as chancroid, genital herpes, trichomoniasis, and HIV.

Interestingly, circumcision shows no evidence of protection against gonorrhea, chlamydia, or syphilis.

Better hygiene

Genital hygiene is crucial for penile health. Circumcised men find it much easier to clean their penis properly while bathing and to keep it clean throughout the day.

Circumcision Risks

Circumcision is a surgical procedure, and, as such, there are risks associated with it. However, the procedure is quick and easy (it takes about 20 minutes) and has a surgical complication rate of less than 0.5%. The most common complications are bleeding, infection, and dissatisfaction with the aesthetic result.

Circumcision, like any other surgery, must be performed under anesthesia, which prevents the child or adult from feeling any pain during the procedure.

Loss of sensation after circumcision

The foreskin is highly innervated and contributes to the sensation of pleasure. One of the arguments against circumcision without medical indication is the risk of reduced sensitivity of the penis. However, despite the logic behind this theory, the fact is that in practice, circumcised men do not experience less satisfaction with their sex lives.

Even in men who have undergone circumcision as adults and already have an active sex life, there is no convincing evidence of changes in the quality of their sex life. There is some anecdotal evidence of decreased sensitivity, but scientific studies with large groups show no difference in the quality of sex. It is a controversial issue.

In truth, the circumcision of children without formal medical indication is currently a controversial procedure. There are anti-circumcision groups that make the following arguments:

  • Circumcision causes pain in newborns, which puts unnecessary stress on the baby.
  • The trauma of circumcision as a baby is carried out for the rest of life, even if the individual is unaware of it (there is no substantial evidence to support this argument).
  • Circumcision violates human rights because it mutilates a being incapable of making decisions.

The position of most pediatric societies is not to recommend circumcision for the entire male population without a clear medical reason. However, there are no contraindications to performing circumcision for religious reasons or if it is the patient’s wish (in the case of an adult) or his parents (in the case of a child).

Frequently Asked Questions

What kind of anesthesia is used for circumcision?

Local anesthesia with blockade of the dorsal penile nerve is used in most cases.

What is the best age for circumcision?

Circumcision can be performed at any age. However, infants have a faster recovery and a lower complication rate than older children and adults.

How many days after circumcision should the stitches be removed?

There is no need to remove the stitches, since the circumcision suture is made with absorbable thread. Within 3 to 4 weeks, the threads are absorbed.

How long does the circumcision procedure take?

On average, the circumcision procedure takes 20 minutes.

How long is the recommended period of rest after a circumcision?

Recovery time depends on how the body reacts to the surgery. In general, we recommend that the patient rest for at least five days before returning to normal activities. Exertion should be avoided for 10 to 15 days, and sexual activity (including masturbation) should not be resumed for 2 to 4 weeks, depending on the progress of the surgical wound and the absorption of the stitches. After six weeks, there are usually no more restrictions, including sports and cycling.

Does every patient with phimosis need circumcision?

Not necessarily. Often, the urologist may opt for a conservative procedure that preserves the foreskin. But most patients end up choosing circumcision for its benefits.

Can circumcision cause impotence?

No, erectile dysfunction is not a complication of circumcision.

What is the most common complication of circumcision?

The most common complication is local bleeding, which occurs in about 8 out of 10,000 procedures (0.08%).



Pedro Pinheiro holds a medical degree from the Federal University of Rio de Janeiro (UFRJ) and is a specialist in Internal Medicine and Nephrology, certified by the State University of Rio de Janeiro (UERJ) and the Brazilian Society of Nephrology (SBN). He is currently based in Lisbon, Portugal, with his credentials recognized by the University of Porto and the Portuguese Nephrology Specialty College.

You might also like...
Pictures of shingles (herpes zoster) Pictures of shingles (herpes zoster)
Shingles (Herpes Zoster): Causes, Symptoms, and Treatment Shingles (Herpes Zoster): Causes, Symptoms, and Treatment
Anal Itching (Pruritus Ani): 12 Causes and Treatment Anal Itching (Pruritus Ani): 12 Causes and Treatment
hCG Blood Test: How to Interpret Pregnancy Test levels hCG Blood Test: How to Interpret Pregnancy Test levels
Main Causes of Abdominal Pain during Pregnancy Main Causes of Abdominal Pain during Pregnancy
Syphilis: Symptoms, Tests, Transmission, Treatment, and Cure Syphilis: Symptoms, Tests, Transmission, Treatment, and Cure
Vaginal Discharge: White, Yellow, Brown, Smelly... Vaginal Discharge: White, Yellow, Brown, Smelly, Thick…
What are Braxton Hicks Contractions (AKA False Labor)? What are Braxton Hicks Contractions (AKA False Labor)?
Male Yeast Infection: Symptoms, Pictures & Treatment Male Yeast Infection: Symptoms, Pictures & Treatment
25 Early Pregnancy Symptoms (in Chronological Order)
Tinnitus (ear ringing): Causes, Types and Treatment Tinnitus (ear ringing): Causes, Types and Treatment
Hiccups: Causes and Tips to Get Rid of Them (Baby or Adult)
Maternal Diet During Breastfeeding - Do's and Don'ts Maternal Diet During Breastfeeding – Do’s and Don’ts
Pictures: Syphilis – All stages [Warning: Strong Images] Pictures: Syphilis – All stages [Warning: Strong Images]
The Benefits of Folic Acid in Pregnancy for a Healthy Baby The Benefits of Folic Acid in Pregnancy for a Healthy Baby
Can You Have Your Period While Pregnant? Can You Have Your Period While Pregnant?
Why is my period late? 15 reasons besides pregnancy Why is my period late? 15 reasons besides pregnancy

Leave a Comment