Technology meets tradition: 'Laser' circumcision emerging path to manhood

Isay Reyes, ABS-CBN

Posted at Apr 08 2019 10:44 AM | Updated as of Apr 08 2019 12:27 PM

MANILA - Shawn, an 11-year old Filipino based in England, is flying to the Philippines for a rite of passage for Filipino boys - circumcision. 

"Well, my parents told me that I would be a man afterwards so I believe them," he said.

Circumcision is not a popular practice in England, according to Shawn's mother, and scouting for the best clinic led them to several shady places. "I can't imagine how they do it there and how they will do it," she said. 

After rigorous research, they finally decided Shawn will have his operation done in the Philippines. 

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The Philippines has a lot of specialists who perform circumcision. Basically any clinic with a surgeon and right machines can do it, Dr. Noel Cruz, EENT Surgeon of SAA Clinic in Pasig City, told ABS-CBN News.

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Dr. Noel Cruz M.D of SAA Clinic in Pasig City has been doing circumcision for all ages for almost 20 years

"I specialize in EENT surgery but I've been practicing circumcision for the past 17 years or so. Kahit general medicine nga eh, as long as you are a doctor. Yung iba gusto urologist kasi they have the specialty sa male genital organs but all doctors who can do cut and suture can do circumcision. A licensed doctor specially," Dr. Cruz said. 

SAA Medical Clinic in Pasig offers laser-cautery circumcision. The technique uses laser-cautery that produces lesser bleeding and makes healing faster. The 20-minute procedure under local anesthesia is done by a board-certified surgeon.

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In laser-cautery, a cautery machine cuts through the foreskin while decreasing bleeding and pain. This is different from the traditional way of circumcision, which uses a scalpel or medical scissors. 

"When you cut it, it coagulates na rin. Imbes na tatahiin mo pa, i-coagulate mo lang, i-cauterize and then mag stop na 'yung bleeding. Then a little portion na lang ang tatahiin mo. All the bleeders, na-stop na so it helps in healing. It helps to make the procedure faster. Unlike 'yung traditional na cut and suture, 'yung blood vessels na tatamaan mo will create more bleeding," Cruz said. 

Different cuts through laser-cautery can be achieved. 

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Common circumcision cuts dorsal slit vs. coronal cut

1. Dorsal slit
2. Coronal cut
3. V-cut 

Dorsal slit is done by doing a single incision, removing the top part of the foreskin or excess skin to expose the glans or the top part of the penis. No tissue is removed in this procedure and leaves a "lambi", as Filipinos would call it. This is also the type of cut for circumcision done in remote areas called "pukpok."

Coronal cut, also known as the German cut or clean cut, is done by removing the skin around the circumference of the penis to expose the glans. The remaining skin is then sutured back in a crown like style. 

V-cut is the most unpopular one where the triangle shaped area of the foreskin is is cut in a v-shape manner to expose the glans. 

Since dorsal slit is the most popular among the three cuts, and is also the easiest, Dr. Cruz said, a big percentage of Filipinos have this done but some end up unhappy since the foreskin is still there and it covers the glans when the penis is not erected. 

Healing also varies depending on the patient. Usual recovery time is 7 days but for some, it reaches up to 2 weeks. 

In the Philippines, tradition and peer pressure push boys to get circumcised but hygiene should be the most important reason to get this done, Cruz said. 

"Pag wala kang skin, 'yung excess skin doon, mas malinis mo ng maigi yung genitals ng lalaki. May cases na masyadong masikip 'yung skin na hindi nakabuka. Tendency is nare-retain yung urine, whatever discharges. Chances are mas mataas ang infection, recurring infections sa kanila," he said. 

Summer is the season for boys to get circumcised but with the technology of laser-cautery, overseas Filipino boys can travel to the Philippines to get this procedure done whole year round. 

Laser-cautery circumcision for dorsal cut at the SAA Clinic is priced at 3,500 pesos. Coronal or german cut costs 4,000 pesos. In some clinics, procedure reach up to 8,000 pesos. Since it is summer season, promotions are given by different clinics until the month of May.