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Circumcision In Teenagers: Facts, Complications And Care Tips

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The surgical procedure to remove the foreskin covering the tip of the penis is called male circumcision. Circumcision can be done at any age, although infant circumcision is common, as it may be less risky than teen circumcision.

The acceptability of circumcision may vary in teenage boys, and informed consent is mandatory for this procedure. While circumcision may have some medical benefit, forcing it could impact your teen’s mental well being.

Read this post to know more about teenage circumcision, its advantages, and the recovery after the surgery. We also tell you about the hygiene practices for uncircumcised teen boys.

Facts About Teenage Circumcision

Teenage circumcision can be a ritual in some ethnic groups. Some parents may delay circumcision until the teenage years to let their child be involved in decision making. However, infancy is considered to be the optimal age for clinical circumcision due to a lesser risk of complications and a better cosmetic outcome (1).

These are some facts about circumcision (2).

  1. Ritual circumcision is common in Islam and Judaism.
  1. Newborn circumcision is a ritual of some tribes in Africa and Australia.
  1. Countries with ritual neonatal circumcision often perform the procedure on the seventh or eighth day after birth.
  1. Although routine circumcision for newborn boys is not mandatory, The United States of America has more non-Jewish and non-Islamic men who have undergone circumcision.
  1. Infant circumcisions have fewer risks than adolescent circumcision.
  1. Circumcision may slightly lower the risk of sexually transmitted diseases, such as HIV and urinary tract infections.
  1. Circumcision prevent phimosis, a condition where the foreskin becomes tight and difficult to retract.
  1. Medical conditions, such as recurrent balanoposthitis (recurring inflammation of the foreskin and head of the penis) and phimosis can be the reason for circumcision in adolescent boys.
  1. The use of local anesthetic reduces the pain of circumcision.
  1. It is highly recommended that circumcision be done by a surgeon in a sterile and hygienic environment.
  1. Penile hygiene is easier in circumcised men.
  1. There should be a voluntary consent by the teen for the procedure. Forced circumcision could impact your teen’s mental health.

Circumcision Is A Personal Matter

Parents of young children mostly opt for circumcision due to religious or social reasons. However, the situation can be different when considering circumcision at a later age. Teenagers are more sentient than infants and can have their own perceptions and reservations about the procedure.

You may discuss with your teen regarding his willingness to undergo a circumcision procedure. He may have concerns and queries regarding his reproductive health, especially regarding sexual function. It is always better to seek medical attention and make an informed decision with your teen.

Although male circumcision is chosen for preventive health reasons, a teen can still remain healthy without the procedure. Forced procedures could be considered as “male genital mutilation”, which can have a serious impact on the child’s psychological health.

How Is Circumcision Performed?

The circumcision procedure is done by a general surgeon, urosurgeon, or a pediatric surgeon in a hospital.. Your teen’s primary care doctor may refer to a specialist if circumcision is required due to medical reasons. However, if it is done for religious reasons, it is usually performed in the newborn period after the hospital discharge, as a ceremony. Home circumcision and self-circumcision can often result in complications such as bleeding, infection, etc.

The following are some salient points about the procedure.

  • The American Academy of Pediatrics recommends using local anesthesia before the procedure. It can be administered through anesthetic creams or injections by an expert.
  • The procedure involves the separation of the foreskin from the head of the penis. It is followed by cutting a slit on the foreskin. Clamps are placed, and the entire foreskin is removed after bleeding stops (3).
  • Temporary clamp devices or plastic rings are often placed on the penis for several days after the procedure to prevent bleeding.

Traditional circumcision may involve partial removal or a cut in the foreskin at some places. Surgical circumcision may give better results than traditional procedures. Circumcision may be risky for children or teens with clotting disorders due to bleeding risk.

Circumcision For Phimosis Treatment

Preteens and teens may have to undergo circumcision as a treatment for phimosis or any other medical condition requiring foreskin removal (4). The complications of phimosis can be more severe than those of circumcision and may interfere with the quality of life.

A specialized medical team gives phimosis treatment after informed consent from the adolescent boy.

Complications Of Circumcision In Teens

The complications of circumcision may include (5):

  • Pain
  • Bleeding
  • Swelling
  • Wound infection
  • Delayed wound healing
  • Excess skin removal
  • Insufficient skin removed
  • Erectile dysfunction

Circumcision by an expert may not cause serious complications. Bleeding and pain do occur in most cases but subside eventually.

Some teens may become conscious of the appearance of their penis after the procedure. However, this is most likely when the teen is forced to undergo the procedure.

Care For Children Getting Circumcision Before Adolescence

Infant circumcisions may not have as many complications as teen circumcision could have. However, proper care, as recommended by the doctor, could reduce the possibility of these complications.

A pediatrician may share the following postoperative instructions (6).

  • The penile head may look red for some days
  • Some amount of blood or yellow discharge can be seen generally during the healing process
  • The teen may experience discomfort for a few days
  • It may take one to two weeks for complete healing
  • Keep the penis clean
  • Gauze dressing with antibiotic creams is replaced with fresh dressing as per doctor’s directions

You may seek medical care if your child has a high fever or any other complications during postoperative days.

Postoperative Care For Adolescent Circumcision

The most common complications of teenage circumcision are bleeding and wound infection.

The following measures are recommended for teenage boys after circumcision (7).

  • Physical activity should be limited, while normal activities can be resumed. Rough and active sports should be avoided for up to two weeks. Heavy workouts and games may cause bleeding from the incision.
  • Sponge baths are ideal until the second day of surgery. Bathing or shower can be done as usual after the second day of surgery. Do not rub or scrub the incision while bathing; you may ask your teen to pat it dry.
  • The dressing on the incision is removed on the second day after surgery, if it does not fall off. Let the teen soak in the shower for ten minutes for easy removal.
  • Apply antibiotic ointments prescribed by doctor or vaseline to prevent dry edges that may stick to clothes.
  • Avoid tight clothes to prevent bleeding due to pressure on the penis.
  • Paracetamol may be given for pain.

The follow-up visit can be after two to four weeks of surgery. It is essential to go to the doctor at this time to ensure proper healing.

Advantages Of Circumcision In Teen Boys

The American Academy of Pediatrics (AAP) says that the benefits of circumcision outweigh the risks. AAP leaves the decision making to parents and promotes the use of anesthetics for the procedure (8).

The health benefits of circumcision may include (9):

  • Easy hygiene: It is easy to wash and clean a circumcised penis. However, uncircumcised boys can learn to wash beneath the foreskin.
  • Reduced risk of urinary tract infections (UTIs): Circumcision may reduce the susceptibility towards developing urinary tract infections caused by pathogens.
  • Reduced risk of sexually transmitted diseases: Circumcised males may have less chance of contracting sexually transmitted infections, such as HIV. However, the use of condoms remains essential for HIV prevention.
  • Prevention of phimosis: Circumcision helps in the prevention of phimosis, a condition where the foreskin becomes tight and difficult to retract.
  • Reduced risk of penile cancer in circumcised men.
  • Reduced risk of cervical cancer in female partners of circumcised males.

These risks can be avoided by uncircumcised men, as well, with proper hygiene practices and care. Circumcision does not affect fertility or the ability to experience sexual pleasure in men and their sexual partners.

Penis Care In Uncircumcised Teen Boys

Routine bathing is enough to clean an uncircumcised penis in teens. Retracting or pulling back the foreskin to clean is not advised for babies and toddlers since this may cause scarring and pain (6).

You may teach your teenage boy to retract the foreskin during the shower and clean gently. The foreskin should be placed back to the head of the penis after cleaning. Leaving the foreskin retracted for too long could increase the risk of paraphimosis, which is swelling and pain due to the squeezing of the penile head by the foreskin.

Female Circumcision

Female genital mutilation or female circumcision is a ritual cutting of female genitalia practiced among some communities. This can be the partial or total removal of external female genitalia of female infants and teenage girls for non-medical reasons.

According to the World Health Organization, female genital mutilation has no health benefits and can lead to long-term problems. Female circumcision is a violation of human rights since it may cause long-term physical and psychological complications (10).

Circumcision in teenage boys can be done at any age. However, it can be with fewer adverse effects in younger kids compared to adolescents and adults. Uncircumcised teens can also keep the genitals or sexual organs clean with proper techniques.

It is recommended to get the procedure done by experts to avoid complications. You may also try to approach traditional providers with experience and knowledge about the procedure for ritual circumcisions to avoid complications.

References:

1. Brian J Morris, et al; A ‘snip’ in time: what is the best age to circumcise?; The United States National Library of Medicine
2. Male circumcision; The World Health Organization
3. Abdullahi Abdulwahab-Ahmed and Ismaila A. Mungadi; Techniques of Male Circumcision; The United States National Library of Medicine
4. What are the treatment options for phimosis?; The United States National Library of Medicine
5. Complications of Circumcision; Stanford Medicine
6. Male Circumcision; BetterHealth; Victoria State Government
7. Post-Operative Care for Adolescent Circumcision; UCSF Benioff Children’s Hospital
8. Where We Stand: Circumcision; American Academy of Pediatrics
9. Circumcision; Health Service Executive of Ireland
10. Female genital mutilation; The World Health Organization

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