Whatâ??s the difference between â??traditionalâ?? and â??medicalâ?? male circumcision?

If youâ??ve ever wondered, here are a few things you should know about male circumcision.

Traditional male circumcision 

When carried out as a rite of passage into manhood, traditional male circumcision (TMC) is performed mainly on adolescents or young men. 

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Such circumcisions, carried out under non-clinical conditions, have significant risk of complications. Often, unsterilized and unwashed blades are used on a dozen or more initiates within a single session. This poses risks in terms of HIV and other infections. Initiates are also significantly dehydrated during their two-week (sometimes longer) period of seclusion, in the belief that this reduces weeping of the wound. After-care may be in the hands of a traditional attendant with no basic medical training.

Medical male circumcision

Medical male circumcision (MMC) is the removal of the entire penis foreskin, fully exposing the head of the penis. The procedure is performed at a medical facility by a trained healthcare worker or doctor. It is a relatively simple, quick and safe procedure, performed in a clinical setting, under sterile conditions, by a trained practitioner, with proper instruments.

What are the risks of male circumcision (TMC or MMC)? 

Complications are both more likely and more serious in TMC, because of unsterile wound care, the tying of a tight thong around the base of the penis, dehydration due to fluid restrictions, and active discouragement from seeking medical care in cases of early complications. The combination of dehydration and septicemia can result in acute renal failure, gangrene, tetanus and even death. The Eastern Cape Provincial Department of Health recorded 2 262 hospital admissions, 115 deaths and 208 cases of genital amputations for traditional male circumcisions between 2001 and 2006. 

In MMC, performed in a clinical setting, under sterile conditions, by a trained practitioner, with proper instruments, complications are seen in only around 1 – 4% of all circumcisions, and in most cases these were mild. Rare and more severe complications associated with circumcision, include penile sepsis, gangrene, loss of penis (partial or complete), dehydration, acute renal failure, septicaemia or death.  

What if Iâ??ve already had a traditional circumcision or am considering one?  

Traditional male circumcision does not always remove as much of the foreskin as a medical male circumcision. This means that men who are circumcised traditionally will be less protected, as the remaining foreskin continues to place the person at risk for HIV infection.

Research on the risk of HIV infection amongst young Xhosa men in Cape Town, shows that those with partial circumcisions had a higher risk of HIV infection than those who were fully circumcised. It is therefore important to motivate for MMC to take place as part of the initiation process. Boys should still be allowed to participate in their cultural practices, but, to have the full HIV preventative benefit, it is recommended that MMC be arranged as a surer, safer alternative.  

Speak to your Healthcare Worker if you are unsure, as they will be able to give you the best advice. 

Additional need-to-know facts

  • Boys under the age of 18 years need parental consent before undergoing the procedure. 

  • HIV testing is not required for the procedure, but it is recommended

Please note that although medical male circumcision significantly reduces a manâ??s risk of contracting HIV from a woman, and reduces a womanâ??s risk of developing cervical cancer, it is NOT a 100% prevention strategy. Therefore, you must always use a condom every time you have sex, even if you or your partner has had a medical male circumcision. 

Stay safe and help reduce your risk of contracting HIV by having a medical male circumcision.

To register or for more information, download the Hello Doctor Mxit app for free or complete this short form and a CareWorks consultant will contact you. Remember, the procedure is done at no cost to you.  

While All4Women endeavours to ensure health articles are based on scientific research, health articles should not be considered as a replacement for professional medical advice. Should you have concerns related to this content, it is advised that you discuss them with your personal healthcare provider.