The first thing every single guy facing circumcision asks is how much it is going to hurt. Most people in developed countries get a circumcision in a medical setting, and with modern medicine really there should not be any pain.
This post is going to be different from my usually cheerful dismissal of concerns about circumcision pain, and mockery of grown men who claim that they desperately want a circumcised penis but they are too cowardly to go under the knife.
I do think that concerns about circumcision pain are blown out of proportion on the Internet, often for the purpose to serve as propaganda against circumcision. But that is no excuse not to admit that sometimes shit does happen, and people experience far more discomfort than what they have bargained for.
This post may not make the best bed time story if you are going under the knife in the near future.
Just a warning, some parts of this post may be very disturbing, you may end up wishing you haven't read it.
The concerns about how much it is going to hurt may be related to the fact that circumcisions around the world are till this day often done without pain relief.
While some religious and rite of passage initiation ceremonies are supposed to be painful, for the most part they are not meant to be torture. Fortunately humans are fairly good at dealing with a short burst of pain, especially if they are aware that it is temporary not signaling actual danger.
Most traditional circumcision techniques that originated before the invention of anesthesia are very quick which makes pain tolerable.
Even modern versions of e.g. Jewish and various Muslim circumcision methods, that may appear somewhat medical, still tend to remove the foreskin with one cut in mere seconds, thereby keeping the pain inflicted at the minimum. Also the use of anesthetics even during religious circumcisions is becoming more common (although nor universal). Anesthetics combined with a very quick technique should prevent pain as much as possible.
African initiation rites do appear to be excessively painful, and some of the elaborate ones such as creating a "button hole" undoubtedly task the pain tolerance of the initiate, but even the infamous, ostensibly brutal "penis flaying" method usually takes less than a minute to complete.
When you are in agony speed is mercy.
On the other hand most modern surgical techniques were developed around the idea that the patient is anesthetized and does not feel a thing during the procedure. Unlike traditional circumcision methods these can take a long time and they could be exceedingly painful if done without anesthetics, tantamount to torture.
Pain is a particularly sensitive topic when minors are concerned as they have very little say in the matter and they have far fewer mechanisms than adults do to cope with pain. It is true that children are more resilient than adults are and they may rebound from situations when an adult would crumble, but that is no excuse to subject them to needless pain that one would not even think about inflicting on an adult.
It is no accident that circumcision is often used in transition to manhood initiation ceremonies. Intellectually developed adults have some "mind over matter" ability and we are able to override even pain for short periods of time, especially if we believe that whatever is causing the pain isn't actually harming us. Small children haven't developed this ability yet, for them anything that hurts is the end of the world.
I strongly believe that if you think that something hurts so much that there is no way you would allow it to be done to you then you shouldn't do it to a child either.
Even in a medical setting the pain inflicted on children is more likely to be ignored, perhaps because adults can easily file a malpractice lawsuit while children can only cry.
There is no reason why a medical circumcision with adequate anesthesia should be painful. For most surgeries you do not expect pain and you assume you will be properly numbed or knocked out for the duration of the surgery and you would not feel a thing. In a way it is bizarre that there are so many examples when medical personnel ignore the patient's pain.
In fact medicalized circumcision produced some of the worst horror stories by systematically mistreating some classes of patients.
For the better part of the 1900s doctors believed that newborns could not feel pain, so they have operated on them without anesthetics. It was true even for major surgeries, the unfortunate babies were simply paralyzed and then cut open.
Circumcisions were of course performed without any pain relief, somehow everyone failed to make a connection between pain and the blood curling screams coming out of the poor infants during the procedure. That is when an infamous video that is now posted all over the Internet was filmed. It shows a screaming baby boy being circumcised using a Gomco clamp. Modern guidelines call for the use of local anesthetics, but the old recordings are still used by those who oppose circumcision as an argument why circumcision is barbaric and should be banned.
The other noteworthy horrific example would be the works of Dr John Harvey Kellogg, who was probably insane or just a religious nutcase. He was dead set against masturbation and advocated circumcision without anesthetic as punishment for boys who were caught masturbating. In his own words:
A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of phimosis. The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. The soreness which continues for several weeks interrupts the practice, and if it had not previously become too firmly fixed, it may be forgotten and not resumed.
Apparently at one point people in the USA as well as some other countries believed this crap and and acted on it. I am not sure if it still happens, but it seems in the USA it is still legal for the parents to circumcise a teenager for whatever reason they see fit, including as a punishment. I don't know exactly how that works, will someone who is almost a grown man be forcefully dragged to an operating theater against his will so that his foreskin can be cut off as a punishment. It just sounds bizarre. I hope doctors at least will not agree to torture the patient during the procedure.
Other times simple negligence can cause the patient a lot of pain.
Ever since I have started writing about the topic of circumcision I have also read many personal accounts from men about their circumcision experiences.
In the vast majority of cases they are quite mundane, guy goes into a hospital, he gets his penis injected with some local anesthetic, he feels nothing after the first injection, and half an hour of so later he is a circumcised man. Then the tedious but rewarding process of healing begins.
Occasionally someone has a bit more discomfort, the most common ones are that someone can feel when the frenulum is clipped or the suturing at the end. These are somewhat expected.
The frenulum has innervation coming from a different nerve than what is going to the foreskin and it needs to be numbed separately which is often done with an injection right into the area. Even if everything else is numb some people may feel a brief sharp pain when the frenulum is cut, especially if electrocautery is used.
Suturing is the last step, so if the anesthetic is wearing off it will most likely happen as your doctor is putting in the stitches. Some people feel a mild discomfort, others do experience some pain as the last stitches are placed. Doctors usually really don't want to give extra shots of local anesthetic at this point, since the operation is essentially finished.
Another unexpected source of pain is the disinfectant. Especially if one has barely retractable phimosis and some inflammation. If the area is being disinfected before anesthesia is administered (which is usually the case in order to avoid introducing germs into the skin with the needle) the foreskin is usually retracted at this stage if it can be pulled back at all. Some disinfectants can burn even normal skin. When a disinfectant is applied to an already inflamed or otherwise sensitive glans that may hurt a bit or if you are unlucky it may hurt a lot (as in grown men trembling in pain). Also the affected skin will most likely peel off (like a sunburn) a few days after the operation (that part is usually painless) after that everything should be normal.
But these are usually not too serious and they only cause some discomfort.
There were also accounts when after waking up from general anesthesia one has experienced quite severe pain. If your doctor wants to be nice to you they will inject some local anesthetics during the procedure even if you are under, which tends to provide some post op pain relief. You are also supposed to be medicated with pain killers when you wake up. Apparently some hospitals try to save money on drugs.
A few people seem to run into a bigger problem. I recall about a dozen or so stories where people have felt significant pain, even after they have allegedly been injected with an adequate amount of local anesthetics.
Experiences range from being able to feel every cut, but not really pain, to pretty much going through torture. Most cases seem to have happened in various countries in Eastern Europe, perhaps related to the fact that at least until recently, it wasn't easy there to sue your doctor even if he tortured you, while e.g. in the US one could unleash an army of lawyers if he wasn't satisfied with the pain management during the procedure. This would suggest that the skill of your doctor and his commitment to provide a pain free experience does make a difference.
Even a grown man is in a helpless situation lying on an operating table with his dick half cut, so it is definitely not OK to needlessly torture a patient. Yet several people had the experience when they have been flat out refused additional anesthetic in spite of being in pain and asking for relief. Unfortunately there are actual limits how much local anesthetic can be injected in a short period of time without risking serious side effects. So if you have reached your limit you are out of luck, but a competent doctor should be able to get you numb before that happens.
In many parts of the world where circumcision is common pain is often downplayed. Fortunately "assembly line" circumcisions tend to use clamps or disposable devices which at least make the procedure go faster which reduces discomfort and the outcome is less dependent on the surgeon's skills.
In most places where circumcision is rare almost always a freehand method is used, not a clamp, which requires the patient to be relatively still for the doctor to be able to work. Probably for this reason more than anything else often general anesthesia is used when operating on children, thus the child is spared the experience of the surgery altogether as he is put to sleep for the duration of the operation. Adults are more likely to be done under local anesthesia but restraints are often used to immobilize the patient.
Nevertheless I have read at least one account where a man described that when he was circumcised as a child it was done using only local anesthetics that did not seem to work, he was screaming in pain the entire time while being both in restraints and also held down. Apparently the results were also very bad cosmetically, which is not surprising as it is unlikely that a child in pain would hold himself still which would be necessary to do a decent job free hand.
I do tend to take these stories with a little bit of skepticism, after all if someone was injected with local anesthetics that should at the very least dull the pain, so it is hard to tell when someone claims that he felt everything as if not given pain relief at all, would that reflect reality or merely a subjective experience that at the moment felt worse than it really was. Is it even plausible that a doctor would actually operate while the patient is in pain because of insufficient anesthetics? What is the worst thing that can happen? Well, apparently it is really bad.....
I am not exactly squeamish but I saw a video on YouTube that I found utterly horrific. The video showed a circumcision procedure performed on a supposedly anesthetized boy. He was obviously in excruciating pain but his screams were ignored as the surgeon kept clipping off pieces of skin from his penis with complete indifference for several minutes, basically operating as if the patient was fully anesthetized instead weeping in agony.
In all fairness he was even given another shot of anesthetic after several minutes of tortured screams. It did not seem to help at all, his screams even intensified when they started cutting him again. The recording stopped before the operation was finished when the patient has managed to wiggle himself free and he just curled up on the operating table in a fetal position sobbing in agony. Perhaps it is better not to even guess what must have happened after that.
It definitely looked more like some inhuman medieval torture, slow and cruel causing an inordinate amount of pain when it could really have been done painlessly and quickly.
Now I have no choice but to believe that at least some of the horror stories are true.
So it seems that the answer is yes, it is indeed possible to be in severe pain in spite of being injected with local anesthetics. I have no idea what the reason for that is, some people may not react to the drugs normally, or someone has messed up the dosage, or the doctor is just not very good at administering anesthetic to the right spot to numb the intended area.
I cannot even imagine anyone doing that to a grown man and getting away with it, but some of the stories I have read sounded pretty bad. Some doctors may not even realize how much it hurts when they keep cutting slowly and meticulously when the anesthesia does not work. While it is certainly common in some parts of the world to perform circumcisions without any pain relief, typically those are at least done quickly. Even intense pain for a few seconds can be tolerable whereas slowly cutting a patient who is in severe pain for minutes or even even half an hour is akin to torture.
I am fairly certain that if a doctor is determined to provide a reasonably pain pain free experience they should be able to do so with all the options for anesthetics and pain killers available and there is no real justification for torturing a patient. Unfortunately doctors, especially the ones who have have never been on the other end of the scalpel, may not even realize the difference between some mild discomfort and agony. Others may not care since it is the patient and not the surgeon who is in pain.
No, I don't think that the existence of incompetent or unethical doctors is an actual argument against circumcision.
People who oppose circumcision often take the worst examples they can find and present them as typical. But screw ups can happen during any medical procedure. Most just aren't talked about or recorded on video as often as circumcision is because of its religious and cultural significance.
In this post I talk about worst case scenarios. In reality the probability that you will experience any serious pain during your circumcision is quite low. Just find a good doctor who actually cares about his work and has good references.
Afterthought: Circumcision has been practiced for millennia and people somehow tolerated the pain even though for most of history they did not even have access to anesthetics or really anything to make it hurt less. Somehow techniques honed over a long time played a significant role in making the procedure more bearable and more humane. In some parts of the world a quick procedure is still all the pain relief the patient gets. It is a shame when modern medicine that is supposed to make it completely painless ends up resembling torture.
