To cut or not to cut? Indeed, the choice to circumcise or  not has been the topic of hot debate for many years, probably even centuries. Boys from different cultures and religions are circumcised or left uncircumcised for different reasons. Doctors from different medical specialties advocate circumcision or otherwise for different reasons. It is true that most men are not consulted with before the decision is made for them to be circumcised, and this breach of human rights sometimes do leave major psychological issues in some men. 
However, the decision isn’t always final. The uncircumcised men obviously can choose to have circumcision later in life, but what about the circumcised men who wish they weren’t circumcised? 

Circumcision has been practiced by Jews for over three thousand years, for purely religious reasons. In the bible, Abraham is commanded by God to circumcise himself and all his male descendants. This was to be a sign of the covenant between Abraham and God. Jews do not claim or intend any health benefit from circumcision. On the other hand, human groups or cultures that live in the desert or other hot environments may have adopted the practice to prevent infections initiated by the accumulation of dirt and sand in the prepuce. It has been suggested that the Egyptians could have circumcised themselves and their slaves to prevent schistosomal infection. The evidence of a circumcised mummy at the time the Hebrews inhabited Egypt, together with the illustrations of the operation itself and of circumcised Pharoahs may be an explanation for the Judeo-Muslim to practice circumcision.

Besides those that are still religiously circumcised, are the other baby boys still been circumcised in modern civilization for hygienic reasons? In the past few decades, the advice given to parents of baby boys by the medical profession in Australia has not been consistent. Views have changed following publication of different studies, and the views are also different depending on which medical specialty is giving the advice. A trend not to circumcise started in the mid to late 1970’s following the American Academy of Pediatrics Committee for the Newborn stated that there are “no valid medical indications for circumcision”. However, the same committee changed their views to “new evidence has suggested possible medical benefits…” in 1989. Similarly in Australia, in 1995, a working party from the Australian College of Pediatrics formulated a document that urged medical practitioners to fully inform parents of the benefits of having their male children circumcised. Despite all that, there has been a reduction in the number of circumcisions performed in Australia for social, religious, ethnic or personal reasons in the past 20 years. This could be explained by the results of a survey carried out in Sydney. The result showed that 3% of baby boys were circumcised for religious reasons, only 1 – 2 % for medical, and the remainder of the babies were circumcised simply to be “just like dad”. If a similar proportion of those that were not circumcised was also “to be like dad”, then the increase in immigrants from Asia in the past 20 years could well be the reason why the number of circumcision has dropped.

There are a few common problems with the uncircumcised penis. Phimosis is a term used to describe a foreskin that is unable to be retracted. The non-retractable foreskin may be normal up to the age of 10 in boys, with a wide variability in ages. Pathologic phimosis is when fibrosis and scarring of the foreskin result in permanent non-retractability, causing obstruction to urine flow and recurrent balanoposthitis, in which case circumcision is recommended. Balanoposthitis is infection in the foreskin, requiring topical cleaning and oral antibiotics. Smegma collection is another trouble that worries parents. Smegma is a creamy yellow sebaceous material that is secreted by the glans and often accumulates in clumps under the foreskin. This needs no treatment, and will resolve when the foreskin retracts naturally. An acute condition that might arise is paraphimosis, which develops when the foreskin is fully retracted, but is unable to be returned to the pre-retracted position. This leads to swelling of the tip of the penis and discomfort for the boy. Urgent intervention is required. Ballooning is a rather benign condition when the subpreputial area swells up as a result of urine being temporarily trapped under the foreskin. Although it causes distress to the boy and the parents, generally no treatment is required. All these problems can be avoided or solved by performing circumcision on the boy, however, very few of them are true indications for circumcision. It all comes down to whether the parents are willing to pay more attention to their boy’s genital hygiene, and put up with the minor crises that may occur from time to time, till the boy is older when most of these problems would resolve spontaneously. 

On a lighter note, have you ever wondered what difference would the presence, or absence, of foreskin make in bed? Studies have shown that in general, circumcised men tend to thrust harder and deeper compared to uncircumcised men. This could be explained by the difference in the mechanics of intercourse. The point that is often overlooked in circumcision is that it not only removes 33 – 50% of the penile skin, but it also removes most of the fine touch neuroreceptors, which concentrate on the foreskin and glans penis. On insertion during intercourse, the foreskin is pushed towards the root of the penis, exposing the glans penis. However, when the uncircumcised penile shaft is withdrawn slightly from the receiving lumen, the pushed back foreskin starts to bunch up at the corona (of the glans). Since the foreskin has the highest concentration of fine touch neuroreceptors on the penile skin, as does glans penis on the penis, the juxtaposition of these two parts creates an intense stimulation. This not only discourages the penile shaft from further withdrawal, but at the same time helps to reach orgasm. This series of events explains the short thrusting style noted by partners of uncircumcised men. This intricate ejaculatory trigger and sensory stimulation is discounted in the circumcised penis simply because it has lost all those neuroreceptors together with the foreskin. To compensate for this, in order to achieve orgasm, the circumcised man must stimulate the glans and the rest of the penis by thrusting deeper and harder. This could mean that a circumcised man can have sex at a more “controlled” pace as he would not be rushed into orgasm by all the extra sensory input that an uncircumcised man has.

Another noteworthy observation made by those who have had experiences with both circumcised and uncircumcised men is the level of discomfort experienced during intercourse and the need for artificial lubrication. When the uncircumcised penis thrusts, rather than sliding against the wall of the receiving lumen, it glides on its own skin. This gliding action has been likened to a turtle’s neck gliding in and out of the layers of skin surrounding it. As with the circumcised penis, which has up to half 33 – 50% of the penile skin removed, the skin is stretched taut by the erection, allowing little skin for the underlying penile tissue to slide against. As a result, it rubs against the receiving luminal wall, creating more friction and abrasion and requiring more artificial lubrication. However, circumcised men should not see this as a disadvantage, because with growing awareness of STDs (sexually transmitted diseases) in the society, the well-designed gliding action of an uncircumcised penis is often rendered unusable by the condom.

The circumcised penis is not without its merits in this respect. Amongst other things, it is favoured for oral sex due to its cleanliness. To some, the scent of the poorly cleaned, uncircumcised penis could be nauseating. The deep, long thrusting style adopted by many circumcised men is not necessarily such a bad thing. Afterall, there are those who like a rough edge in bed. It should be no surprise at all that men who are circumcised are good candidates for all-nighters while the uncircumcised ones might be more practical for a quickie, especially if you are short on lubricant. From the procreation point of view, which was what the primitive animals saw, quick sex is good sex, however, in the days of family planning, sex has a whole new meaning. 

Finally, it is important to realise that all is not too late. An uncircumcised man can obviously undergo this minor operation to have himself circumcised, and a circumcised man need not feel robbed of his right to choose either. There is a way to restore the foreskin. It is by stretching the remaining skin of the penis to for a surrogate foreskin. However, it is a very slow and involved process that should only be taken after serious considerations. As for the result, it is probably as controversial as circumcision itself.