Why do men consider circumcision?

Circumcision dates back thousands of years. In some cultures like in Africa, some tribes perform it as a rite of passage from childhood to adulthood. Only after going through circumcision, are they allowed to be included into the warrior tribe and get married. Among the Australian aborigines and Pacific Islanders, it is also an important part of an intricate coming of age ritual.

Locally, this procedure is more commonly practiced among Muslims. For Muslim boys, it’s strongly encouraged for them to undergo circumcision for its cleanliness. In Islam, before prayers, it is very important to be clean. When circumcised it becomes much easier to keep the penis clean especially after urination.

According to the Ministry of Health, in 2017, there were about 1921 adult and child male circumcisions carried out in one year. This number does not include those done in private hospitals, clinics or non-medical personnel. Around one-fifth of these procedures are done for non-religious reasons.

Among adult men, there is also an increasing number of men going for the procedure. So why do these adult men undergo circumcision? Let me share with you some of the reasons.

1. The uninformed young man

Some have a condition called phimosis. This is when the foreskin becomes too tight and is unable to be retracted fully. This may cause pain during intercourse and may also give rise to infections and poor hygiene. I say uninformed as most of these men were not advised by anyone to pull back their foreskin ever. As a result, their foreskin becomes too tight and they have no choice but to get circumcised.

One of my patients, Mr A, who is in his early twenties complained that he is unable to retract the foreskin at all. This leads to urine ballooning up beneath the foreskin before the urine is evacuated out every time he urinates. He had severe phimosis and the opening was so tight that he even had difficulty passing urine. With phimosis, there is a higher risk of getting balanitis ( infection of the penis) and also smegma, which is a collection of debris and dead skin within the foreskin. Some call smegma ‘dick cheese’ as it resembles cheese in terms of texture, consistency and smell.

2. The Pearl

Another patient, Mr B had severe phimosis. He was unaware of it but felt a hard lump on his penis beneath the foreskin. He was a virgin so he never had a reason to retract his foreskin or to realise that his condition requires treatment. During the circumcision, when the foreskin was removed, it revealed that the hard lump was actually a smegma pearl. The smegma had been accumulated for so long that it hardened to form a pearl-like appearance. Circumcision cured him of his ‘condition’.

3. Fast shooter

Another group of men may get circumcised in order to delay ejaculation. These men usually have a problem called premature ejaculation. Typically, men on average ejaculate around 5-7 minutes. Men who ejaculate within 1 minute or less is diagnosed to have premature ejaculation. With the foreskin removed, the penis becomes less sensitive and hence will be able to last longer in bed. For some men, the frenulum (attachment between foreskin and head of the penis) also gets removed. The frenulum is also responsible for most of the sensitivity in the penis. Removing the frenulum will allow the man to last longer in bed. Some of my patients even gave feedback that sex becomes more enjoyable after circumcision.

4. Sexual healing

Sometimes patients come in only after a ‘mishap’ during intercourse. Due to tight foreskin or a tight frenulum, they may get pain or discomfort during intercourse. Some may even get tears or cuts due to tightness and friction during intercourse. These tears may get infected and swollen. Even though the infection and cuts can get treated and can heal, the problem doesn’t end there. Each time the foreskin heals, it becomes thicker. When it becomes thicker, the foreskin gets tighter. This will increase the likelihood of recurrent tears. As the foreskin continues to tear and heal, it also gets thicker and tighter. The problem then just gets worse. The real solution to this problem is to remove the foreskin as soon as possible. After circumcision, they no longer will have to worry about tightness or cuts anymore and they get to have a healthy sex life with their partners.

5. Aesthetically speaking

There are a group of men who have no medical problems or issues with their foreskin. In fact, most of them can fully retract and keep it very clean. So why do they do it? Simply because they prefer the look and/or feel of a circumcised penis. For some, their partners are the ones who might have asked them to do it. These men usually would have been thinking about it for some time and have done lots of research on the best and latest methods of circumcision. They are usually just waiting for the right moment and time to go through with it.

6. Diabetics

For men who have diabetes, they are prone to getting fissures or cuts in their foreskin. This is due to poor blood circulation and also poor healing in the extremities. Another predisposing factor to this condition is obesity. Some men may not have diabetes but their weight predisposes them to recurrent foreskin fissures. These fissures cause a lot of pain and discomfort for these men. Many of them end up having to go for circumcision to solve the problem once and for all. No foreskin, no problem.

I hope this sheds some light on reasons for adult circumcision, and encourage adult men who are considering circumcision to discuss with their doctors a range of issues including medical history before making the choice.

Article contributed by Dr Muhd Taufiq, DTAP Clinic Group (Dr. Tan & Partners)

Dr Muhd Taufiq Rashid is the resident doctor at DTAP Clinic Somerset, a GP (NUS) with over 10 years of clinical experience. He is focusing on sexual and reproductive health, anti-aging, weight control and healthy lifestyles. He believes that everyone should be empowered to take charge of their health. He has a special interest in Men’s health, Sexual health, HIV prevention. His warm, professional and approachable personality has sets his patient at ease. He is the author of health articles featured in Berita Minggu, Berita Harian and the online magazine “Big Is Gorgeous”, he has also participated in health expert panels, most notably on television, as the Resident Wellness Consultant for YKK: Makeover Edition as well as Suria Channel talk show Suara Singapura.

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