What’s the difference between infant and adult circumcision

Circumcision is not something we think about until a baby boy is born into the family. However, for most parents, deciding whether to circumcise their son is one of the first big decisions they make. The procedure is generally safe, and complication rates are low, but parents should consider the pros and cons of circumcision before making a decision.

Here we will discuss the key differences between infant circumcision in terms of reasons for circumcision, types of circumcision, and complications associated with each.

What is Circumcision?

Circumcision is a surgical procedure in which the foreskin, or loose skin covering the head of the penis, is removed. The procedure is ‌performed soon after birth, but can also be done later in life. In the United States, about 58.3% of male infants and 80.5% of males aged 14-59 years are circumcised.

Reasons for Circumcision

There are many reasons why parents may choose to circumcise their sons. For some, it’s a religious or cultural tradition. For example, Jews and Muslims have followed the tradition of circumcising male newborns for centuries. Others believe that circumcision can improve hygiene and reduce the risk of certain medical conditions, such as:

● Urinary tract infections

● Sexually transmitted infections

● Penile cancer

Another reason ‌parents would want their sons to undergo infant circumcision is that they don’t want them to look different from the father or other boys. But there’s no medical need for circumcision in healthy newborn boys.

As for adults, the reasons for opting for circumcision are often medical. For example, uncircumcised men may choose to get circumcised later in life if they’re experiencing problems with the foreskin, including:

● Phimosis: Difficulty retracting the foreskin

● Paraphimosis: Inability to return the retracted foreskin to its original position

On the other hand, some men choose to undergo circumcision because of religious reasons or aesthetic purposes.

3 Types of Circumcision

The foreskin naturally adheres to the penis shaft when baby boys are born. So in every circumcision procedure, the foreskin needs to be freed from the shaft, allowing it to retract or extend at will. Doing so lets the doctor have access to the skin for removal.

There are three main types of circumcision:

  1. Gomco clamp circumcision

The Gomco clamp is the traditional way of circumcision and is the most common type of circumcision performed in the United States. It’s a surgical procedure where the bell-shaped section of the Gomco clamp is slipped underneath the foreskin to cover the glans penis. Once the bell’s in place, the foreskin is pulled up. Then the doctor tightens the clamp to cut off the blood flow. Then, the doctor cuts the skin and completes the procedure. Typically, no sutures are required in this method.

  1. Mogen Clamp

Compared to the previous method, this involves a less invasive circumcision surgery as there’s decreased handling of the tissue. In this method, the first step is to apply a numbing cream to the penis and scrotum area to eliminate discomfort from anesthesia. Then, the doctor uses a hemostat to separate the foreskin from the penis shaft.

After, the doctor extends the foreskin over the penis head and captures it on a Mogen clamp to cut off blood flow to the foreskin. The clamp stays while the doctor cuts the foreskin to prevent bleeding during the procedure. This method requires no incision.

  1. Plastibell

This is a unique circumcision procedure because the doctor will not remove the foreskin during the procedure. Instead, ‌ a bell-shaped ring is left in place to allow the foreskin to desiccate over time and fall off. The process typically lasts over 10 days.

Let’s take a quick look at the key differences between the 3 types of circumcision:

Use of Anesthesia

Traditionally, newborn babies have been circumcised without injecting anesthesia because of the belief that newborn babies don’t feel pain during the circumcision procedure. However, studies suggest that babies do feel pain, so almost all circumcisions now involve giving patients anesthesia. The doctor can perform circumcision using either general, local, or regional anesthesia.

Infants

There are several methods that doctors can use to anesthetize an infant. These processes may include:

● Application of anesthetic cream to the foreskin

● Application of a dorsal penile nerve block to the nerve which controls feeling in the penis

● Use of a penile ring block by injecting anesthesia under the penis skin at several points around the circumference

Adults

For adult men, they can be anesthetized using a dorsal nerve block or a penile ring block for added pain relief.

Risks of Circumcision

As with any surgical procedure, circumcision also poses some risks. However, in general, infant circumcision is a low-risk procedure. Complications are rare for newborn circumcision, but the risks increase with age.

The rate of procedure-related complications during and after circumcision for boys aged 0-1 month is around 2 to 6 per 1,000. However, by the time the boys undergo circumcision between 1-9 years of age, this rate increases by 20-fold. And it increases 10-fold more for those circumcised after 10 years old.

For infants, the two most common risks are bleeding and infection. Here are other complications that may arise:

● If the family has a history of bleeding disorders, there’s a slim chance that the baby can develop an infection in the incision.

● There’s a risk of a surgical error in which the doctor removes the tip of the penis. But, this is almost always repairable.

Similarly, the circumcision procedure for adults also poses the same common risks of bleeding and infection. Adult circumcision may also increase the chances of experiencing the following complications:

● The formation of a skin-bridge between the penile shaft and glans.

● Loss of penile sensitivity

● Sexual dysfunction

● Edema of the glans penis

Although, losing penile sensitivity and sexual dysfunctions are considered remote complications.

Aftercare Post-Surgery

The aftercare for infant circumcision is simple. In every baby’s diaper change within the first 48 hours, the parent will apply a 3×3 gauze pad with ointment over the affected area.

However, there are common things that parents will see during the aftercare that they shouldn’t worry about. These are:

● The glans look very bruised with color shades of light blues, light purples, and red. This is normal and is part of the healing process.

● There’s a production of yellowish-white color fluid or granulation tissue. It’s not pus or a sign of infection. It signifies that the body is healing. All infants experience this during the first few days post-surgery.

● There’s swelling of the baby’s penis. It usually dissipates within a few days, although it can last longer for some.

Compared to infants, aftercare for adults requires more attention and consideration. Here are some of the ways to take care of the penis after circumcision:

● Ensure that you remove the wound dressing within 24-48 hours after the surgery.

● Be conscious of avoiding pulling or scratching the penis to allow complete healing.

● Avoid engaging in sexual activities for at least 4 weeks after the procedure.

● Prevent doing strenuous activities for at least one-week post-surgery.

Circumcision At Any Age

Circumcision is a surgical procedure for a wide range of reasons. The procedure can be performed on both infants and adults, but the risks and aftercare considerations are what’s different. In general, circumcision is a low-risk procedure with minimal complications. And the best way to reduce these risks is by entrusting the procedure to a certified doctor or a licensed circumcision clinic.

If you’re considering circumcision, you can discuss it with our doctors, and we will be more than happy to help you make a safe and informed decision.

Schedule a free consultation with us to learn more about circumcision. Contact us today!

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