Medical reasons for circumcision
A circumcision should only be performed in childhood or adolescence if the phimosis (narrowing or tightening of the foreskin) causes complaints or if such issues are very likely to occur later in life. Common reasons for circumcision include difficulties urinating, frequent urinary tract infections, congenital abnormalities of the urinary tract, difficulties with intimate hygiene, recurrent inflammation of the glans (balanitis), paraphimosis, and/or problems during sexual intercourse. In some cases, circumcision may be necessary at a very young age. If phimosis persists beyond puberty, circumcision is generally recommended for all men.
Additionally, phimosis can develop later in life due to scarring of the foreskin, often caused by recurrent balanitis or lichen sclerosus. The latter is always a reason for circumcision, regardless of the patient’s age.
Phimosis in childhood and adolescence is not a disease
It is completely normal for male infants to have a foreskin that is fused to the glans and cannot be retracted. This can be explained by embryonic development, during which the mucous membrane of the foreskin and the tissue of the glans form a single unit. Over the first years of life, the foreskin gradually separates. By around the age of seven, about half of boys can retract their foreskin—at least partially. By age ten, this is the case for about two-thirds, by age 13 for over 90%, and by the end of puberty for almost all boys.
Circumcision as a preventive measure
A long-standing phimosis in adulthood, as well as lichen sclerosus, are risk factors for penile cancer. Circumcision has been proven to prevent this serious condition. However, circumcision is not recommended for men without phimosis, as penile cancer is extremely rare in these cases.
Likewise, circumcision is not recommended as a means of reducing the risk of sexually transmitted infections. The safest way to prevent such diseases is the use of condoms, which are widely accessible in Germany—unlike in many developing countries.
However, these recommendations assume that an uncircumcised man practices thorough intimate hygiene and regularly removes smegma. Proper hygiene plays a crucial role in reducing the risks of penile cancer and sexually transmitted infections. A routine circumcision, as practiced in some cultural traditions—often performed in infancy or childhood—is not recommended from a medical standpoint.
Circumcision: Facts and global statistics
The World Health Organization (WHO) estimates that all Jewish and Muslim men have undergone circumcision. Together, these groups make up about 70% of the circumcised male population worldwide. In Jewish tradition, circumcision is performed on the eighth day after birth, while in Muslim tradition, it typically takes place between the ages of eight and 13.
Circumcision is also widespread among non-Jewish and non-Muslim men in some countries. Examples include:
- Australia (59%)
- USA (63-75%)
- Nigeria (90%)
- Philippines (90%)
- Ethiopia (92%) und
- Madagascar (98%),
Overall, the WHO estimates that about one in three men worldwide has undergone circumcision. Detailed data on the prevalence of circumcision in Germany is not available, but limited studies suggest that circumcision among non-Jewish and non-Muslim boys and men is relatively rare.
Source: German Bundestag, Report WD 9 – 30007092-12, 2012
Different methods and techniques of circumcision
In a radical circumcision (complete circumcision), the foreskin is entirely removed, exposing the glans permanently. In contrast, a plastic circumcision (partial circumcision) leaves a mobile portion of the foreskin intact, covering the glans. Another option is a foreskin widening procedure, which enlarges the opening of the foreskin without significantly removing it.
The best method depends on several factors, including the severity of the phimosis and the patient’s age. Plastic circumcision and foreskin widening procedures are mainly suitable for children, while radical circumcision is typically recommended for adults. Additionally, circumcision can be performed using different surgical techniques.
Medically necessary procedures are performed under general or local anesthesia, usually on an outpatient basis (without hospital admission) by specialized doctors.
Intimate hygiene after circumcision
Circumcision is generally considered a low-risk procedure. However, mild discomfort such as pain, swelling, and redness of the glans and penis may occur afterward. The healing process typically takes about two to three weeks. During this period, it is crucial to carefully follow medical advice to prevent infections and support proper wound healing.
After circumcision, smegma can no longer accumulate between the foreskin and the glans, making hygiene easier. Nevertheless, intimate hygiene should not be neglected to maintain overall genital health, personal comfort, and care for one’s partner. Since the glans is no longer protected by the foreskin, its delicate skin may become drier.
For daily genital care, it is recommended to use Deumavan Protective Ointment, applied as a thin layer after washing, bathing, or showering. For gentle cleansing, Deumavan Washing Lotion is highly suitable and can also be used as a substitute for shaving cream during intimate shaving.
