Whether or not parents choose to circumcise their infant sons, there will always be a small group of men who want what they don't have.
Dr. Christopher Saigal, an associate professor of urology at the David Geffen School of Medicine at UCLA, often sees uncircumcised men in his practice seeking circumcisions for medical reasons, including phimosis, recurring urinary tract infections and genital warts. Occasionally he also hears from men who regret having been circumcised.
"A small faction of men feel they have been harmed by circumcision," he says. "Some say they lose sensation."
Though anecdotally men report otherwise, the argument that an uncircumcised penis is more sensitive than a circumcised one is not well supported in the literature, he says.
A recent controlled study published in the January issue of BJU International, the British Journal of Urology, looked at nearly 4,500 Ugandan men, ages 15 to 49, who were all sexually experienced. Researchers randomly selected half to undergo circumcision, and half to have a circumcision in 24 months. They compared the two groups at six, 12 and 24 months to measure sexual satisfaction and performance.
The circumcised group's rate of sexual satisfaction remained constant, with 98.5% reporting sexual satisfaction before circumcision, and 98.4% reporting so two years after the procedure.
Dr. Ira Sharlip, a San Francisco-based urologist and spokesman for the American Urological Assn., says he has done a few foreskin restorations, though it's not a common request. The procedure involves making incisions in the skin around the penis to allow excess skin to be drawn forward. "As it heals, the skin stays over the head of the penis, and re-creates the appearance of foreskin," Sharlip says.
Some physicians use a nonsurgical technique where patients wear a device that stretches the skin around the penis and pulls it forward. Men need to do this every day for several months.
"Patients' reasons for the procedure vary," Sharlip says. "Some are angry at their parents for making this choice for them and want to undo the damage. Some don't like the way it looks."
More common are men at the other end of the spectrum. Dr. David Cornell, a urologist who runs the Circumcision Center in Atlanta, sees men who want a circumcision because they prefer the appearance and because they want to feel more comfortable socially.
"I hear a thousand times a year from men who don't feel that they look like most other men in the locker room. In our society, there's an overriding preference for circumcision," says Cornell, who performs 250 procedures a year on men who, for cosmetic reasons, want a circumcision or a revision to one they don't think looks right.
Circumcision constitutes 30% of Cornell's urology practice. He charges $2,500 for the procedure and does not take insurance. Though frequently attacked by anti-circumcision activists, he says, "I'm doing a cosmetic operation on a consenting adult. Why he's doing it is his business."
The social pressure described by Cornell is what drove Dave, who works in the adult entertainment industry as a producer and actor, to get circumcised eight years ago.
Now 31, Dave was born in England, where infant circumcision is not common. He came to the United States as an infant and recently moved from Irvine to Miami.
As an uncircumcised young man, he says, he felt awkward in gym class. "I read that being circumcised makes the penis easier to clean and less susceptible to sexually transmitted disease. I had friends in medical school telling me, 'Dude, you should do this.' " So he did. But hygiene was not the chief motivation. "I wanted to fit into American culture. When you're circumcised, there's less rejection from women," he says.
Today, he's glad he had the procedure; but, he says, fitting in now is less of an issue in Southern California and Miami because so many more men aren't circumcised.