Male circumcision is performed on an estimated one out of six male newborns worldwide. Over 60 percent of male newborns were circumcised in the United States in 1992. Circumcision in adults is performed much less often; however, accurate statistics are not available. Adult patients often have a medical indication for the procedure, but circumcision may also be done for social or purely personal reasons. Adult circumcision is usually performed in the outpatient setting by an experienced urologist. Adult circumcision is typically performed under local or regional anesthesia. Medical indications for this procedure include phimosis, paraphimosis, recurrent balanitis (penis infections) and posthitis (inflammation of the prepuce). Nonmedical reasons may be social, cultural, personal or religious. The procedure is commonly performed using either the dorsal slit or the sleeve technique. The dorsal slit is especially useful in elderly patients who have phimosis and is not often performed. The more common sleeve circumcision technique may provide better control of bleeding in patients with large subcutaneous veins. A dorsal penile nerve block, with or without a circumferential penile block, provides adequate anesthesia. Informed consent must be obtained. Possible complications of adult circumcision include infection, bleeding, poor cosmetic results and a possible change in sensation during intercourse (all less than 2%). The following educational video will highlight the standardized surgical technique of male adult circumcision by Dr. Zorn. Unique features of the local anesthetic cream and Dermabond glue are also discussed to help reduce complications and lead to better cosmetic outcomes. GREAT RESOURCE SITES INCLUDE: 1) http://www.aafp.org/afp/1999/0315/p1514.html (American Family Physician Association) 2) http://www.circinfo.net/ 3) http://www.circinfo.net/pdfs/GFMen-EN2012.pdf (great PDF for print out)

• published: 21 Oct 2013
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