Post-circumcision precautions and their impact on sexual life

What precautions should be taken after a circumcision?

Circumcision is a simple procedure and relatively safe, but there are some postoperative issues that require attention.

(1) It is best to rest in bed for 1-2 days after the operation, preferably lying flat, and preferably without wearing anything or wearing loose underwear. Try to move around as little as possible to prevent postoperative bleeding. You can resume your daily work after 3 days, but avoid standing or sitting for long periods of time.

(2) The incision site should be kept clean and dry after surgery. It should be cleaned after urination and defecation. When urinating, the foreskin can be pulled back to avoid wetting the dressing. If the dressing is contaminated with urine, it should be changed in time. It is important to urinate in time. Some patients hold their urine for fear of wetting the dressing. A small number of patients cannot urinate after circumcision. It should be noted that if you cannot urinate normally after 6 to 8 hours, you should go to the hospital for treatment.

(3) Avoid sexual arousal as much as possible after surgery. Under the guidance of a doctor, take a sedative or estrogen before bedtime for 3 to 4 days after surgery to reduce penile erection and avoid pain and bleeding.

(4) If there are no abnormalities such as infection or bleeding, go to the hospital for a dressing change on the 3rd day after surgery. The purpose of changing the dressing is to change the dressing and to check the condition of the wound. Under normal circumstances, the wound can be exposed after 3 days.

(5) Bleeding is a common complication of circumcision, manifested as significant penile swelling and continuous oozing from the dressing site. This is related to incomplete hemostasis during surgery or swelling and bleeding at the incision site caused by penile erection after surgery. If the bleeding is minor, local cold compresses and pressure can be applied to stop the bleeding. If the bleeding is severe, the patient should return to the hospital immediately. Mild edema of the glans penis with a pinkish tinge is normal within 3-4 days after surgery. If a small local hematoma forms, local warm compresses can be applied after the incision has healed to promote absorption.

(6) Infection is a common complication; statistics show that the infection rate after circumcision can reach 10%. The bacteria mostly come from the normal parasitic flora of the perineum and are mostly mild infections. Therefore, effective antibiotics should be used for a period of time after surgery. In general, oral antibiotics for 3 to 5 days are sufficient.

(7) Within one week after circumcision, you should eat more nutritious foods, such as meat and eggs, which will help the incision heal. Avoid spicy and other irritating foods.

(8) Sexual life can only be resumed 4 to 6 weeks after the surgery, when the incision has completely healed.

Does circumcision affect sexual life?

Some patients experience decreased erectile function after circumcision, while others want to treat premature ejaculation through circumcision. So, does the surgery affect male sexual function?

Clinically, it has been observed that some patients experience erectile dysfunction after circumcision. In fact, circumcision generally does not damage nerves and blood vessels; even if damage occurs, it is only superficial. These nerves and blood vessels do not play a major role in the erection process, so such superficial nerve and blood vessel damage will not cause significant problems. Erectile dysfunction is unrelated to the surgery itself. Erectile dysfunction is often psychological: ① Circumcision damages some penile blood vessels, nerve endings, and sensory tissues, causing local numbness and decreased sensitivity compared to before surgery. The penis is less likely to generate arousal impulses when stimulated, weakening the reflexive erectile function. ② The foreskin secretes mucus to buffer friction between the penis and vagina; this function is weakened or eliminated after circumcision, causing discomfort for the patient. ③ Because circumcision involves surgery on the male genitalia, it often brings psychological burdens that may affect sexual function. Combined with fear, misunderstanding, and anxiety about postoperative complications, all of these can lead to psychogenic erectile dysfunction.

Regarding whether circumcision can treat premature ejaculation, current medical research is not thorough, and there is no consensus. Theoretically, the glans penis, coronal sulcus, and frenulum are rich in nerve endings, making them the main areas for penile stimulation. When the foreskin is too long or there is phimosis, these sensitive areas are covered, lacking external stimulation, thus becoming more sensitive and more easily aroused during sexual intercourse, leading to premature ejaculation. After circumcision, the glans penis and coronal sulcus are exposed, and prolonged contact with underwear can reduce sensitivity, making the glans penis less sensitive to sexual stimulation. Some domestic scholars believe that circumcision significantly prolongs the ejaculation latency period. However, similar studies by foreign scholars show that after circumcision, there is no difference in patients' libido, erectile function, ejaculation, and sexual satisfaction compared to before the surgery. Therefore, whether phimosis and paraphimosis affect premature ejaculation requires further large-scale investigation to confirm. Of course, psychological factors also play a role in premature ejaculation. If a patient believes that having had their foreskin removed has made them less sensitive, this can be a positive factor in the treatment of premature ejaculation.