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PaperclipPerfector  11mo ago (text post)   2351 thread views

Wellness Wednesday for May 31, 2023

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I’m finally getting circumcised later this month as a 24 year old to treat mild phimosis and severe frenulum breve. Hoping this will give me the ability to have some semblance of a normal sex life. Has anyone had this procedure as a teen/adult?

I had phimosis as a young man, but was able to stretch out the foreskin manually and desensitise the glans gradually in the shower. It took a couple of months but since then my sex life has been fine.

I also had mild frenulum breve (I think) and I was also able to rectify that through gradual stretching and simply letting my erection stay with the foreskin fuly retracted.

Are you in the US? I wonder if the use of circumcision to treat phimosis is an artefact of the fact the procedure is common there. When I spoke to my doctor about my phimosis, I don't think he even considered circumcision, although I don't think I asked about it either.

I'm American, yes. Honestly my urologist barely walked me through the alternative options. Right now I'm considering just replacing my circumcision with a frenuloplasty and seeing how that works out. But I'm concerned that scarring in the frenulum might make my issues worse. I suppose I could just have it removed if the scarring is problematic? I'm not sure. Medical sites say the recovery from a frenuloplasty takes 6 weeks but people on forums seem to suggest it can easily be months.

I had phimosis and frenulum breve. I was completely unable to retract my foreskin. But instead of circumcision, I opted for a prescription topical steroid cream that loosens the skin. After applying that regularly for a few months, I was finally able to retract my foreskin at about age 15. It was still pretty tight for a while, but it kept getting better over the years (I didn't have to keep applying the cream, though). By my late teens to 20s, I was completely functional and everything was working as it should be, with no complaints.

By the way, when I was first able to retract my foreskin at 15, I was so incredibly sensitive that I would wince in pain if water touched my glans in the shower. I think that illustrates just how sensitive the penis is when it has a foreskin to protect it for the first dozen or so years of life. It's not as sensitive as that anymore, but it's still too sensitive to comfortably touch with, say, dry fingers. That's a good thing.

Anyway, if it's not too late, I would definitely recommend trying steroid creams first. There's no harm in it, and there's presumably no urgency to resolve this in weeks rather than, say, months, right? The foreskin is just so amazing; it'd be tragic to lose it.

This is interesting, I was under the impression that steroid creams could not treat frenulum breve. My phimosis itself is actually relatively mild, I can retract with no issue, it just pinches the head when I'm erect and doesn't slide up and down during sex. The frenulum breve is much worse and causes most of my issues. Your case seems worse than mine (unless your frenulum is longer) so if you solved yours with creams and stretching maybe that's a safe route for me. Is there any downside to trying a less invasive approach first? Just thinking out loud here but I guess I could try:

In this order:

  1. stretching exercises

  2. stretching exercises with steroid creams (the steroid concentration is quite low and shouldn’t affect my body outside of making the skin stretchier)

  3. frenuloplasty (where they reshape the frenulum to lengthen it slightly)

  4. frenulectomy (where they just remove it)

  5. circumcision as a last resort if that fails after several months

I certainly can't think of any downsides of trying the less invasive options first. It may be that your frenulum breve is worse than mine was, I don't know. I'd try to find a urologist that seems sympathetic to wanting to remain as intact as possible and see what they think about the feasibility of these options given your particular anatomy.

Yes, under similar circumstances.

The operation itself is pretty unpleasant. I only had local anes, so I was awake, but it doesn't take too long. The recovery is more psychically unpleasant than anything else. Morning wood is uh, going to be really painful until the stitches dissolve.

After-effects - you're going to be incredibly sensitive. Even some years on I'm still more sensitive than before and I more or less have to wear tight boxer briefs. The sensitivity does decrease with time, though. That said it's still better than the unpleasant situation I had before. To be honest I have sex only very rarely, but in terms of my experience masturbating, it's about the same experience I had before, except now I have to use lubricant.

Thanks for the input. I’ll be under general. Why is it that most men circumcised as adults seem to need lube to masturbate but the ones who had it as infants don’t? Can you explain how the sensation is less unpleasant? And how it changes sex for you?

Well, I had phimosis as well. It was very painful and difficult to retract and the only time I ever had sex before circumcision, I couldn't get my foreskin back over the head and ended up in hospital. That was pretty shitty and put me off sex for years. I couldn't explain how it's different for adult circumcisees, but it is, and speaking to other men who did it it seems pretty typical.

Circumcision makes sex less pleasant for men. No idea why being uncircumcised would be a problem for women; sounds like they've been watching too much porn.

Wait what? Where does this idea come from?

I’m sure it makes sex less pleasant for men who have no medical reason to get one but I’m not in that category. I would never have the procedure done to an infant son. No woman I’ve slept with has complained about its appearance or taste, they don’t notice. But they do notice I can rarely last longer than 90 secs before having to stop due to discomfort.

Circumcision makes sex less pleasant for men.

Seems like this would be a good thing to ask the guy after he gets the procedure, instead of aver without evidence? (unless you have also been circumcised later in life?)

IIRC the last time this came up somebody who had experienced sex both ways said that he didn't notice much/any difference.

@TheGodhead please do report back!

Will do. Curious if you have a link to that discussion. A search of the site only turned up culture war content.

It may have been on the reddit site -- the circumcision discussion always does seem to turn CW in a hurry so it could be hard to sift out.

You may be thinking of this SSC article. This was an entry in the "Adversarial Collaboration Contest" Scott hosted a few years ago.

Sensitivity and Sexual satisfaction

There is a highly plausible mechanism by which circumcision could reduce sexual sensitivity: the foreskin is highly innervated (20,000 nerve endings is often repeated, but this appears to be a case of citogenesis and is likely far too high), produces lubrication for the penis, and is sensitive to light touch. Several studies demonstrate that the foreskin is more sensitive to certain forms of nonsexual stimulation than other parts of the penis. The glans itself does not change in sensitivity from circumcision.

Sexual satisfaction, particularly in sexually active heterosexual men, seems to be unchanged with adult circumcision. During studies of adult circumcision for HIV prevention, in which large numbers of men were randomized to receive circumcision at the time of the study or after, sexual satisfaction of did not significantly differ between the two groups. On the other hand, a South Korean study of men circumcised as adults (as has become traditional there) found decreased pleasure from masturbation after circumcision. It is certainly possible that both these things are true – that masturbation is impaired by adult circumcision while intercourse is not. It is also possible that the Korean study (retrospective, smaller than the African studies, and with much higher rates of scarring than are observed in the US) was unrepresentative. There are two European studies which are frequently cited: cohort studies look at circumcised and uncircumcised men in Denmark and Belgium. However, circumcision is quite rare in these countries, and the majority of the circumcisions in the study groups were performed to correct problems such as phimosis. They are thus comparing men who had penile problems requiring surgical correction to men who did not; it is therefore unclear why they are frequently cited in discussions of elective circumcision.

No available studies actually measure sensitivity to sexual stimulation, which is of course an important topic – but one requiring consummate professionalism on the part of the researcher. We are left waiting for such a study, but in the meantime may reasonably fear that there is some decrease in at least masturbatory pleasure due to circumcision even though the evidence for this is weak. The evidence does not support any change in sexual pleasure otherwise.

Infant circumcision may be different than adult circumcision, in addition. If circumcision eliminates important nerves, due to brain plasticity infants are likely better able than adults to reassign the portions of the brain processing the foreskin to other areas of the penis. A large survey of circumcised and uncircumcised men in the US (where infant circumcision is the most common) found similar sensation in circumcised and uncircumcised men. The uncircumcised men appear to have had slightly higher incidences of sexual dysfunction. Also of interest, circumcised men appear to have an easier time obtaining oral sex, which may relate to subtle aspects of class or may have to do with the perceived cleanliness of circumcised penis.

No, it was well after that -- the usual argument was going on and somebody who'd been circumcised for medical reasons showed up to say it was NBD in terms of pleasurability of sex. Probably on Reddit.

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