A circumcision is a routine, safe procedure that removes the redundant skin that covers the head of the penis. Circumcisions are popular around the world, and are conducted for three main reasons; religious tradition, cosmetic appearance and medical necessity. With the latter, there may be irritation caused by skin conditions and anatomical irregularities. There are a wide variety of conditions that can cause men penile discomfort, which can lead to pain, embarrassment and further complications if left untreated. Meta-analysis studies have shown that circumcised males have a 68% decrease in the likelihood of developing certain specific medical conditions that cause penile irritation.(1)
Anatomically, the penis can be divided into four distinct areas:
- Dorsal surface (upper side)
- Ventral surface (lower side)
- Shaft (middle)
- Glans (tip)
The foreskin is attached to the underside of the glans by the frenulum of prepuce. This feature is an elastic ridge of blood vessel dense tissue that helps the foreskin contract over the glans. Sometimes, instead of functioning harmoniously, these mechanisms can do the opposite, causing chaffing, swelling and skin irritation. In addition, research has shown that the genitals are exposed to a number of allergens and irritants as a result of personal hygiene and detergents and an individual’s preferred sexual practices.(2) When the condition of your penis results in painful intercourse and is resistant to topical treatment and medication, the answer is almost always circumcision.
Diplomate of the American Board of Urology, and member of the American Urology Association, Dr. Bidair has amassed 33 years of expertise in men’s health. He has formidable experience in the field of urology, and has performed thousands of circumcision procedures with a variety of innovative surgical techniques. He takes pride in his ability to preserve the natural beauty of the male body, freeing his patients from discomfort and leaving them wholly satisfied with the outcomes of their circumcision. Serving patients in the San Diego area and nearby La Mesa, CA, California Adult Circumcision at Alvarado La Mesa Urology Center gives you the opportunity to resolve the painful problems of penile irritation, and uses sophisticated plastic surgery techniques to ensure the best possible cosmetic outcomes. Call us at (619) 486-5005 for more information, or book a personal one-on-one virtual consultation with Dr. Bidair via our website.
- 1 Before and After Photos
- 2 Reasons for Circumcision
- 3 Benefits of Circumcision
- 4 Candidates for Circumcision in San Diego
- 5 Personal Consultation
- 6 Preparing for the Circumcision Procedure
- 7 Circumcision Procedure
- 8 Circumcision Recovery
- 9 Result of a Circumcision Procedure
- 10 Cost of a Circumcision Procedure in San Diego
- 11 FAQ
- 11.1 Is adult circumcision necessary?
- 11.2 Who can perform a circumcision?
- 11.3 I was never circumcised when I was a baby, is this a problem?
- 11.4 Is an erection painful if I am still healing from my circumcision procedure?
- 11.5 I am already circumcised, but I am not satisfied with the results. What should I do?
- 12 References
Before and After Photos
Reasons for Circumcision
Most people are familiar with the cosmetic reasons for having a circumcision. Routine circumcisions are also performed globally because of religious beliefs and cultural customs, making it the most common male surgery worldwide.(3) The purpose of the information below is to provide further detail about some common causes of penile irritation that lead to our patients seeking a circumcision procedure. It should be noted that these are terms used to describe what a medical professional observes during examination, and not diagnostic terms that outline their cause.
Balanitis is the presence of inflammation of the head of the penis, or glans. It can make the glans sensitive to the touch and, in some cases, causes an itchy rash and swelling. Balanitis is commonly caused by inefficient washing and hygiene routines, but it is often a common side effect of dermatitis and infection.
The term posthitis refers to inflammation of the foreskin. This condition is associated with bacterial and fungal infections, skin conditions, and poor hygiene. The skin may feel itchy and sensitive. Posthitis often causes the foreskin to become difficult to retract over the glans, which can lead to further discomfort.
As the name implies, balanoposthitis is a condition in which both the symptoms of balanitis and posthitis are combined. Patients with balanoposthitis experience discomfort in the glans and the foreskin. Factors considered important in the cause of balanoposthitis include poor hygiene and having a tighter foreskin.
Phimosis is a condition that renders the foreskin so tight a patient finds it difficult to retract it over the glans. Physiological phimosis may be corrected at birth with a postnatal circumcision procedure, but pathologic phimosis can occur later in life as a result of infection, inflammation, and scarring from other medical procedures.
In the most severe cases, a condition known as paraphimosis can occur. Classified as a medical emergency, paraphimosis is the inability to retract a very tight foreskin, causing it to become swollen and stuck in the retracted position which, if not treated promptly, can deprive penile tissues of their blood supply.
Often referred to as a short frenulum, patients presenting with frenulum breve frequently find that the tension between frenulum and foreskin is too high. This tension may increase during an erection or during foreskin retraction, causing irritation.
Benefits of Circumcision
Adult circumcision has a number of advantages, the most striking of which being the lowered risk of transmitting sexually transmitted disease, such as HIV. (4) It is also a highly effective way to mitigate the effects of many common yet undesirable conditions that cause irritation, such as dermatitis, yeast infections and bacterial infections. A recent study, part of the largest randomized control trial on male circumcision, found that men who were circumcised had 33.3% less bacteria present on the penis than those men who remained uncircumcised one year into the trial.(5) You may consider a circumcision procedure if you are experiencing any of the following genital symptoms:
- Pain, tenderness
- Itching, burning
- Foul odor
- Unusual discharge
- Dry skin
- Skin lesions
- Skin discoloration, change in skin texture
If you are experiencing genital discomfort and irritation and you would like to be proactive in the prevention of these symptoms, call our San Diego location at (619) 486-5005 to discuss the advantages of adult circumcision. Alternatively, you can use our website to find out more about how a circumcision procedure from Dr. Bidair can benefit you.
Candidates for Circumcision in San Diego
A typical candidate for adult circumcision may have aesthetic or medical concerns, or both. Dr. Bidair stands out as a uniquely skilled surgeon because he has trained with the sensitivities of his patients in mind, and is devoted to preserving the natural appeal of your anatomical features. After performing countless circumcision procedures since 1988, some of the most common candidates for adult circumcision are men who:
- Have found other non-surgical treatments to be ineffective for their penis irritation
- Have persistent pain as a result of a tight foreskin
- Experience pain from erection and sexual intercourse due to a tight foreskin
- Experience persistent irritation and discomfort because of their tight foreskin
Dr. Bidair’s substantial expertise in the field of men’s urological health provides peace of mind for all of his patients. Your comfort and health are our number one priority. See the real difference circumcision has made for men who have undergone an adult circumcision procedure at California Adult Circumcision by viewing our photo gallery.
Dr. Bidair recommends a personalized consultation before every circumcision procedure. He will use this time to listen and respond with sensitivity to your concerns about your foreskin, and the problems that have arisen in your life as a result. We provide professionalism and discretion at all times, ensuring that you are completely comfortable with every aspect of your circumcision procedure. Dr. Bidair offers in-person consultation and phone consultations. Skype consultations may also be a convenient option for some patients.
Preparing for the Circumcision Procedure
There are some importants steps to take before you undergo circumcision surgery. These include:
- Discussing and understanding your circumcision treatment plan with Dr. Bidair in a personal consultation
- Stopping the use of nicotine (cigarettes, vape pens, patches, etc.) up to two weeks before your procedure
- Ceasing the use of certain blood thinning medications (aspirin, Eliquis, Pradaxa, etc.)
- Cleaning and shaving the pubic area for easier visibility and access to the genitals
- Avoiding drinking alcohol up to 48 hours before your circumcision procedure
- Bringing a tight pair of underwear to put on after the circumcision procedure
Your adult circumcision treatment should be a simple, effective process from start to finish. Visit our blog for more information about circumcision.
Dr. Bidair is proud to offer a selection of personalisations to commonly requested circumcision methods. He will ensure that you are completely at ease with your chosen procedure, and will tailor a treatment plan that will provide the optimum results for your individual needs.
High and Tight
In a high and tight procedure, the foreskin is retracted until its interior wall is on the exterior. Dr. Bidair will then carefully remove foreskin tissue, and suture the incision. A small scar will be present high up the shaft of the penis, leaving more inner skin. The amount of skin removed gives a tighter look when flaccid and when erect.
High and Loose
A high and loose circumcision procedure also leaves more inner skin with a more relaxed look when the penis is flaccid. The area below the coronal ridge (the ridge of tissue that separates the glans and shaft of the penis) may still be covered by some of the remaining foreskin.
Low and Loose
With the low and loose option, Dr. Bidair will remove more inner skin keeping the scar line close to the head of the penis, leaving the remaining tissue with a more relaxed configuration.
Low and Tight
A low and tight cut will also keep the scar line close to the head of the penis but there is minimal redundancy of the penile skin giving a tight look when soft.
It is our priority to ensure that your decisions are guided by your own aesthetic sensibilities and individual medical needs. Every aspect of your circumcision procedure will be clarified during your consultation with Dr. Bidair, and on his recommendation, you can make an informed decision about your own personal choice of circumcision procedure.
Our patients often remark that the positive impact their adult circumcision has made on their lives vastly outweighs the temporary discomfort of their recovery. It is important to note the following things during your circumcision recovery:
- Wear tight underwear for the first few weeks after your treatment
- The penis may be very sensitive in the first two weeks after your circumcision
- Your stitches will dissolve 2-3 weeks after your surgery date
- You should keep the area dry for up to 48 hours after the procedure
- You should avoid swimming for up to 4 weeks
- Refrain from sexual activity for up to 4 weeks after your circumcision
- Over-the-counter NSAID medications such as ibuprofen and topical unguants such as petroleum jelly may reduce itching associated with healing
You will need an estimated 6 weeks to recover from your treatment but healing will still continue for a number of months afterwards, so it is imperative to follow through with all of Dr. Bidair’s recommendations after your circumcision procedure.
Result of a Circumcision Procedure
Dr. Bidair’s goal for all of his patients is to provide the highest standard of care. He ensures that his patients are not only satisfied with the medical outcomes of their circumcision procedure, but also that they are pleased with the aesthetic results. Men who undergo adult circumcision may feel a sense of accomplishment and relief and a new boost of confidence once they feel comfortable and irritation-free.
Cost of a Circumcision Procedure in San Diego
The price of a circumcision procedure varies depending on the age and the individual needs of each patient. In addition, adult circumcision prices will depend on whether or not the new procedure is a revised circumcision, and if general anesthesia will be used. Contact our office for further information about the circumcision care Dr. Bidair offers.
Is adult circumcision necessary?
Many doctors would say yes. In certain medical and hygiene-related situations a circumcision may be the only course of action, especially if a patient has experienced no relief from other non-surgical means.
Who can perform a circumcision?
Licensed urologists, obstetricians and pediatricians all perform circumcisions. A trained professional known as a mohel performs the circumcision procedure in a bris.
I was never circumcised when I was a baby, is this a problem?
If your foreskin is causing you pain or irritation, seek help from a medical professional who can assess and advise you on whether an adult circumcision is the right choice for you.
Is an erection painful if I am still healing from my circumcision procedure?
You may experience some temporary pain in the first few days after your circumcision. This discomfort usually subsides as the erection does, and can be relieved with medication.
I am already circumcised, but I am not satisfied with the results. What should I do?
Men who are dissatisfied with the outcome of a prior circumcision procedure may benefit from a revised circumcision. This delicate plastic surgery procedure focuses on readdressing the delicate tissues and presenting them in a more aesthetically pleasing way. Speak to a licensed circumcision specialist for more information.
- Morris, B. J., & Krieger, J. N. (2017). Penile Inflammatory Skin Disorders and the Preventive Role of Circumcision. International journal of preventive medicine, 8, 32. https://doi.org/10.4103/ijpvm.IJPVM_377_16
- Marfatia, Y. S., Patel, D., Menon, D. S., & Naswa, S. (2016). Genital contact allergy: A diagnosis missed. Indian journal of sexually transmitted diseases and AIDS, 37(1), 1–6. https://doi.org/10.4103/0253-7184.180286
- Malone, P., & Steinbrecher, H. (2007). Medical aspects of male circumcision. BMJ (Clinical research ed.), 335(7631), 1206–1290. https://doi.org/10.1136/bmj.39385.382708.AD
- Friedman, B., Khoury, J.,Petersiel, N.,Yahalomi, T., Paul, M., Neuberger, A.,(2016). Pros and cons of circumcision: an evidence-based overview. Clinical Microbiology and Infection, 22(9), 768-774. doi: https://doi.org/10.1016/j.cmi.2016.07.030
- The Translational Genomics Research Institute. (2013, April 16). Dramatic changes in bacteria following male circumcision. ScienceDaily. Retrieved November 10, 2021 from www.sciencedaily.com/releases/2013/04/130416102314.htm
- Morris, B. J. & Eley, C. (2011). Male circumcision: An appraisal of current instrumentation. Biomedical Engineering, University of Rijeka, Rijeka, 315-354. https://doi.org/10.5772/18543