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Friday, August 22, 2014

SL Letter of the Day: Numbed and Confused

Posted by Dan Savage on Fri, Aug 22, 2014 at 10:29 AM

My boyfriend had surgery for phimosis a year ago and while it solved the pain problem he now has total loss of penile sensation and a neurological/physiological disconnect. Another botched circumcision. He can still get erections in response to stimuli and he can ejaculate because there isn't anything wrong with his balls or prostate, but he has completely lost all feeling in his actual cock. (He's not diabetic, doesn't have blood pressure issues, is in shape, and doesn't have erectile dysfunction.) The urologist said either the feeling will come back or it won't, but at this point it probably won't. (Note that it does no good to say, "Why did you let your urologist perform a circumcision when there were a number of alternatives to try first?") While online research mostly just yields results along the line of "YOU NEED MORE SURGERY!" or "BUY VIAGRA ONLINE!", the actual research we've found suggests that if feeling hasn't returned after a year it most likely isn't coming back.

I brought all this up with my doctor and her response was, "Oh, God. That's horrible!" I agree but that isn't helpful. So do you have any suggestions? The only plus from all of this is that he no longer has any pain from the phimosis.

Nasty Urologist Maims Business

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"If one asked me to add numbness to a circumcision I am not sure how I would do it," said Dr. Keith D. Newman, a urologist, a Fellow of the American College of Surgeons, and my go-to guy for dick-related medical questions. "In other words, there is no anatomical basis for 'total penile numbness' resulting from removal of the foreskin. This is not a 'botched circumcision,' unless the deep tissues were somehow, and negligently, violated."

The doctor continues...

"NUMB does say that with the phimosis the BF was having pain, which would indicate a degree of inflammatory change that could damage surface nerve endings over the long term. After circumcision, however, a process of cornification occurs—like developing calluses on the bottom of one’s feet after walking around barefoot for a while—bringing the epidermis of the glans from a few cell layers to many cell layers in thickness; it is this process that is thought to be responsible for the lower rates of STI transmission in circumcised men (in addition to lack of harbor of agents under the foreskin and decreased inflammatory breach of the epidermis). Unfortunately, cornification can dramatically reduce the sensitivity of the glans. Guys who are circumcised at birth have no basis for comparison and are happy as larks*. Adult circumcision patients often complain of decreased sensitivity. Efforts at reducing the callus can improve things somewhat (this would include emollients, Vaseline guaze wraps, and even foreskin restoration—anything designed to protect the glans from the environment. But if NUMB's boyfriend is truly insensate along the entire penis he has a neurological problem (or a psychological one) that needs addressing. Again, it is hard to understand how circumcision introduced that."

Perhaps the opinion of yet another doctor wasn't what you wanted, NUMB, but I honestly didn't know what else to do for you. I'm sorry your boyfriend's dick seems to be damaged, it's too bad he didn't at least try a less radical treatment, and the only upside I can see is that his dick still works.

* Many guys who were circumcised as infants wouldn't describe themselves as "happy as larks." I'm sure we'll be hearing from them in the comments thread.

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