Circumcision makes it easier to wash
the penis and improves hygiene. It can be difficult to keep an uncircumcised
penis fresh 100 percent of the time. Although most men that are uncircumcised
do a very good job cleaning below the foreskin, it’s more of a task for them.
Male circumcision may also be done for
social, cultural, religious, or personal reasons and has been practiced for
many years by various social groups. Despite this, it has been one of the most
hotly debated sexual health issues in the medical community today and has
stimulated controversy among religious, cultural and medical authorities,
particularly with regard to its relevance in modern society.
Voluntary male medical circumcision (VMMC)
however has recently been recognized as an important barrier to HIV infection
in men, (about 60% reduction in risk), and it has been recommended as an
important HIV prevention strategy. Lower rates of HIV infection resulting from
medical circumcision in men would mean an equally reduced risk of exposure to
HIV infection among women, translating into an estimated 46% reduction in
women’s risk of infection.
Despite these impressive statistics, many
uncircumcised men in Zambia still express little interest in undergoing VMMC. Reasons
for men’s unwillingness to be circumcised have identified concerns related to
potential effects of VMMC on sexual performance, such as erection and orgasm
and sexual pleasure, the risk of surgical pain, reluctance to abstain from sex
for at least 6 weeks during recovery and partner’s response to the loss of the
foreskin.
However, most men that have undergone
the procedure have been satisfied with the procedure. Most women also have
reported high sexual satisfaction with circumcised partners and believe
circumcision improves appearance, health and hygiene.
How it’s done:
Circumcision in adult males may be
done on an out-patient basis or during a hospital stay. MC Caregivers may do a
circumcision using a dorsal slit or sleeve technique. A local anaesthetic is
used to numb the area of the penis where the incision will be made. The dorsal
slit technique is where a slit is made in the foreskin, which is then pulled
back, and cut off. The sleeve technique is where cuts are made around the base
of the foreskin and the inside of the foreskin forming a sleeve (tube), which
is then pulled over the glans. Both techniques allow the glans and the opening
through which urine and semen pass through to be exposed. The cut edges are
then sewn together or sealed together. Overall the procedure is quick and takes
on average 20 to 30 minutes to complete.
What to expect after procedure:
Some swelling around the penis is
normal in the first few days after the surgery. Some slight bleeding may occur.
If this happens, apply direct but gentle pressure to the area with a clean
cloth or bandage for about 5 to 10 minutes. Follow your doctor's directions
about whether to put clean gauze on your penis or to leave gauze on. If you
need to remove the gauze from the penis, use warm water to soak the gauze and
gently loosen it.
Self-care:
Bathing and wound care: The bandages
may be removed 24 to 48 hours after the procedure. When you are allowed to shower,
carefully wash the incisions with soap (lifebuoy is usually recommended) and
water every day and pat dry. Put petroleum jelly, such as Vaseline, on the
circumcised area. Petroleum jelly keeps the scab from sticking to the bandages.
Do not take a tub bath or get in a hot tub until your caregiver tells you it is
OK. Ask your caregivers for more information about bathing and wound care.
Also, avoid wearing tight-fitting clothes, such as briefs, or tight-fitting
shorts or pants.
A thin yellow film will form over the
circumcision site after surgery. This is part of the normal healing process and
should go away in a few days. Although the penis is beginning to heal, it may
look worse a few days after circumcision. The penis should look like it is
getting better about a week after surgery.
Having sex:
You may need to wait 4 to 6 weeks
after the procedure before you may be able to masturbate or have sexual
intercourse (sex). You may feel awkward or uncomfortable when having sex for
the first time after the procedure. These problems may not last long and most
can be helped. Talk to your caregiver if you are worried, have concerns, or are
having problems when having sex.
Some people have mistakenly viewed
male circumcision to provide complete protection from HIV and as a viable
alternative to more effective forms of protection such as condoms. While MC has
been found to reduce the female to male sexual transmission of HIV, circumcised
men can still become infected with HIV and if HIV positive can still infect
others. Therefore MC should never replace other known effective prevention
methods and should always be considered as part of a comprehensive prevention package,
which includes correct and consistent use of male or female condoms. Male
circumcision is a one-off procedure and once a man has undergone the procedure,
he will benefit from the preventive effect for the rest of his life. In Zambia, VMMC is provided for free at most
government health facilities; go get it done and rock it today!
Advocate of public health preventive strategies and health informatics for improved healthcare services.
