Male Circumcision commonly known as Voluntary Medical Male Circumcision (VMMC). The foreskin, or skin covering the penile tip, is surgically removed during circumcision. The procedure is common in Zambia and the ministry of health adopted it in 2007. The non medical has been in existence from many years ago though it used to be done traditionary by the Luvale tribe in northwestern province during Muganda ceremony. There are reasons to why circumcision is done with the coming of HIV prevention. These days it's done mainly to reduce the risk of getting HIV and HPV transmission to females.
The surgical procedure is done on males only since we are talking about the foreskin here.
Apart from HIV and HPV risks, male circumcision is done to correct or treat medical conditions of the penis. Circumcision does not guarantee a 100% protection from HIV and STDs. However it reduces the chances of acquiring HIV by 50% to 60% according to a study.
The procedure is named Voluntary Medical Male Circumcision (VMMC) because a man needs to voluntarily opt in. Since its a medical procedure, whoever gets it even for treatment of a condition still will need a consent. You will be given a consent form to sign to endorse the procedure be done on you.
What age is eligible for male circumcision?
Adults and children are both eligible for circumcision. Men who are 50 years and above have less benefits from the procedure or only if the indication for circumcision is a medical treatment to the penis.
Why is male circumcision done
The benefits or reasons for male circumcision include the following:
- Reduces risks of getting HIV by 50% to 60% and other sexually transmitted diseases by 42%
- Reduces the risks of transmitting cervical cancer causing virus called Human papilloma virus.
- Genital hygiene
- To treat medical condition that affect penis such as Phimosis (foreskin is forded around the neck of penis and failing to cover the head), Paraphimosis (foreskin covers the head but failing to retract )
- Prevents the risks of penile cancer
Is male circumcision painful?
An anaesthesia medication is used to make your tissue painless and numb. Commonly used is the local anesthetic drug called lignocaine or a regional anaesthesia with Bupivacaine. General anaesthetic agent maybe used if indicated by your doctor. The injection is given direct into the
What are the different ways in which circumcision is done
Medical male circumcision is provided through different methods. Age of a client and preference are factors that determines which methods to use. Below are various ways used to do the procedure:
Dorsal Slit: After injecting anesthetic drug, In this method a line around the head of the penis outside the foreskin is made using a marker. That is a guide where cutting will be done. Two straight artery forceps are clamped on the foreskin left and right sides of the middle line of the front of the penis. Afterwards the scissors is used to cut through the middle line of the glands penis cutting only the foreskin between the two forceps that were clamped. This process is called making a dorsal slit and gives the name to this method. Immediately and carefully the foreskin around is cut following the line made by a marker earlier so that the foreskin is completely detached from the head of the penis. Closing the bleeding points is done and later suturing to close the wound.
FG: The forceps guided method uses forceps to hold the foreskin while providing guide on where the surgical blade should cut. Markings are done before the cutting is commenced. afterwards the bleeding vessels are tied.
Ring method: ShangRing. Under the foreskin, a plastic ring of the right size is put. To block blood flow, the foreskin is stretched over the plastic ring and fastened with a suture (sterile string). Until the foreskin falls off naturally in 7–10 days, the plastic ring is left on the penis.
Clamp method: Mogen and Gomco claps. The clap simply clamp the foreskin to stop blood from supplying it so it eventually dies off. these methods have less complications.
Which hospitals is male circumcision done in Zambia?
In Zambia VMMC is provided for free when done at government health facility. Some private hospitals and clinics that are supported by certain organizations like JHPIEGO, Society For Family Health and CIDRZ also offer MC for free.
What are problems that may come with male circumcision?
Eve if voluntary male circumcision is beneficial it has some complication that can occur. The rate of complications depends on how skilled the provider is and material used. With modern methods like ShangRing and clamp methods do not have major problems. However, generally complications are rare and not serious. We call them adverse effects in male circumcision.
If complications occurs they may include the following:
- Excessive bleeding. Bleeding during the procedure is normal but can be so profuse which can lead to anemia. Providers knows better how to deal with this problem. Some factors like bleeding disorders that some people have can worsen the complication
- Pain after the procedure. This can be managed by simply taking painkillers enough immediately after the procedure.
- Delayed wound healing. Infected wounds delays to heal. Circumcision wounds after using forceps guided method may delay to heal if enough care is not given. MC wounds needs to be cleaned with soap or antiseptic your provider recommended. Do not move a lot while your wound is still fresh and taking antibiotics prevents secondary bacterial infection. People with lowered immune system may have problems with wound healing not only those by male circumcision.
- Cosmetic issues. While in most cases the shape of the penis does not get changed much because of MC, sometimes the could be a deformed shape after healing. The penis shape maybe changed to undesirable. Curving to any direction are some of the shape changes that penis can have after circumcision. The contributing factor to shape change could be adhesions on he penis.
How long does it take for circumcision wound to heal?
Male circumcision wound takes a month and some weeks to heal completely. The initial healing occurs within 7 to 10 days in which you can do some soft works. No sex before 6 weeks because the healing process can be disturbed due to friction and maneuvers that happens during sex.
How to take care of the wound after circumcision.
To promote circumcision wound healing you need to practice patience and follow the advice given by your provider.
- Keep your penis facing up within few days of the procedure to prevent edema (fluid accumulating on the skin that has remained before the neck of penis). This is true especially after the forceps method.
- Do not move long distances when the wound is still fresh.
- Do not play football
- Take plenty of fluids
- Eat well. Fruits and proteins provides great wound healing.
- Clean your wound thoroughly with recommended antiseptic or soap.
- Make sure to go for review.
- See your provider immediately you see bleeding or any abnormality.
Does circumcision improve sexual performance?
To some extent some men have experienced delayed orgasm due to some lose of insensitivity on the glands penis. Because the circumcision removes the covering skin from the glands penis, it loses its sensitivity thereby pushing the length you take to orgasm farther. The phenomenon has not been researched but many clients have reported it.
Summary
Male circumcision is surgical procedure that benefits men in different ways. It is done within minutes and complications are not very common compared to the benefits. Taking extra care of circumcision wounds promotes its healing and lessen complications.
I have so much to tell you about male circumcision because I am a provider and have done it so many times since 2015.
