The Art of Circumcision

The press recently interviewed me about my circumcision experience. Not mine personally, but my surgical experience. Although we can argue until the cows come home about whether or not it should ever be done, honestly one of the biggest concerns that I hear from men considering it is: “Doc, will it still feel normal?”

The Hood

With circumcision, one removes a circumferential “sleeve” of tissue from behind the glans (or head) of the penis and surgically reunites the remaining tissue edges. But all this work is done quite close to the “G-Spot.” That’s right, men, like women, have a G-Spot, and it’s typically located within the “V” shaped groove on the underside of the glans penis. So, the concern about “keeping the sensation” after circumcision is real as we’re working right there near ground zero.

Get the Sensation

I guess it’s the way I’m built, but I constantly try to improve things as a surgeon. One my favorite innovations in circumcision surgery is the “nerve sparing” approach. First described by a dear friend and near retired mentor of mine, Dr. Joel Marmar, this technique is novel in that it tries to preserve as many sensory nerves as possible.

In a standard circumcision, the full thickness of the foreskin is removed. That means that the skin (epidermis) as well as the underlying dermis and nearby adventitial tissue rich with blood vessels and nerves all go bye-bye. With the nerve sparing technique, only the skin (epidermis) is removed and “the good stuff,” the sensory nerve-rich tissue beneath it, is left alone. It is anatomically logical that sensation would be better preserved with this approach.

Use Your Skills, Man

Sparing nerve tissue, though, is more technically demanding than the standard approach. But I’m good with it. Coming from my heavy training in complex penile hypospadias repair in children, I felt right at home adopting the procedure when I first talked to Dr. Marmar about it. The artful circumcision has served both me and my patients well.

So, here’s my response to the concern about sensation: patients don’t really observe a change in erections or orgasm after circumcision. Sure, early on there may be a period of increased sensitivity from the penis’s now constant exposure to the elements without its natural covering, but this usually settles down within a month or so. And then they’re good to go. As a urologist who lives and breathes sexual health, I fully understand the notion of “happy penis, happy man.”