This FAQ is wholly written by Shannon Larratt of BMEzine.com.

As of this writing, I have been running BME for about eight years. BME is arguably the only large-scale comprehensive body modification archive to ever exist, let alone one that includes extensive information on "extreme" body modification. That has put me into the unique position of being one of the few people on the planet that has access to enormous number of practioners and enthusiasts and has allowed me to collect a great deal of difficult to find -- and previously unrecorded -- specific information on the subject.

The research that produced this FAQ is the most extensive hands-on research that has ever been done. I have pooled more people than anyone else has access to, including government recognized medical professional. All that said, I'm not a doctor, and this evidence is primarily anecdotal in nature.

I very strongly urge anyone seriously contemplating it to discuss the implications on your personal health with your doctor. Some of these procedures are very risky, and if you have any respect for yourself and your body (and your family and loved ones), you will undertake them RESPONSIBLY.

You can put this FAQ on your website as long as it is posted in unedited and complete form. However, because this FAQ is updated from time to time, it would be better to just link to it instead.

Yes! Please do. However, I do insist that you CREDIT it if you use it. In addition, media is welcome to contact me at media@bmezine.com

There are of course a myriad of reasons, but at it's core, these activities are sexually and emotionally gratifying to many people.

Although this is changing as these subjects become more accessible to the general public, individuals involved in male genital cutting tend to be sexually mature, curious, and overall healthy individuals. In addition, because many of these body modifications are centred around the urethra, many men involved share an interest in urethral stimulation (sounding).

Because this is a largely "secret" activity, it is only possible to make a very rough guess. However, one can make some extrapolations from BME's membership and usage logs. Ignoring people who's interest in just in "looking at something freaky", I would estimate there are several million people in the online Western world with a sincere interest in these subjects. It is shockingly normal.

Again, I can only estimate, but extrapolating from the number of people who've shared their experiences and photos with BME, I would estimate that there are between fifty and one hundred and fifty thousand men in the online Western world that have actually had these procedures performed on them voluntarily as adults.

Almost every culture on the planet has practised pubescent circumcision rites at some point in their history, and many still do, although "modern sensibilities" have stripped away the cultural meaning and replaced them with highly questionable medical backing.

As far as subincision and similar cutting, these modifications were practised by numerous African groups, and are still practised by the Aborigines of Australia.

Of these modifications, urethral reroutes is the only one that appears to be a unique invention of modern Western culture.

Meatotomy is the opening of the urethral exit by incising the bottom half of the glans along the length of the urethra. That is, imagine sticking one blade of a pair of scissors about three quarters of an inch into the urethra, with the second blade resting under the head, along the frenulum. If you closed the scissors, the resulting opening would be a meatotomy.

Ignoring the various medical reasons why people sometimes have this procedure done "legitimately", the primary functional benefit to meatotomy is that it makes urethral access much easier. The urethra is relatively broad down the length of the penis, but tightens up at the end to aid in ejaculation and urination. By eliminating this, larger objects can be easily inserted, leading to more effective stimulation.

Many people simply love the visual aesthetic of a glans that can fold open -- it is not uncommon for men to experience what amounts to a transcendental moment as they first watch and feel it open. In addition, many people (and their partners) greatly enjoy the new manipulations possible in oral and manual play (although from a sensation point of view, a lot of people can't really tell the difference).

Finally, it should be noted that many men simply treat meatotomy as a stepping stone to subincision.

Meatotomy is a very simple procedure and doesn't really create any problems and carries extremely minimal risk. Certainly it carries less risk than circumcision. As is probably clear from the above, outside of easier urethral access, the benefits to meatotmy are largely mental. The only person I know that reversed a meatotomy did so simply because he didn't want to have to explain it to his extremely conservative partner.

Most men choose to perform meatotomies themselves, but there are both professional and non-professional practitioners willing to do this procedure.

The obvious medical option is asking a urologist. You could tell them that you're having trouble with urination and ejaculation, but you don't want to try sounding (to exapand the urethra). Try telling the urologist that you think splitting open the glans a little would correct the problem -- many will be very willing. Or, even better, if you have a liberal-minded urologist, just be straight up with them. As long as you're sane, there's no reason why they can't offer this to you.

There are also "cutters", non-medical practitioners offering these services. Please see the medical and legal issues section for more on finding and assessing a cutter.

As I said, many men choose to do meatotomies themselves. It is a relatively simple procedure and complications from simple meatotomy are virtually unheard of. The few cases where people end up in the emergency room are almost always psychosomatic (that is, they just got freaked out and went when they didn't have to). That said, if you're going to do this, you must be in good health, well rested, and be mentally stable and capable of handling stress. If you don't think you meet ALL of those criteria, you really shouldn't be doing this.

Anyway, the time-tested procedure that most people use and agree is the simplest and most trouble free way to do it yourself is:

1. Optionally, apply a small amount of topical or injectable anesthetic to the urethra as well as the external skin. Note that topical anesthetics will take half an hour or more to fully penetrate the external skin, but only seconds to affect the urethra.

2. Optionally you can tie off or clamp the base of the penis. This both minimizes blood flow and deadens any pain. It should go without saying that it is important to not tie off the penis for extended periods.

3. Clamp the tissue to be cut using hemostats (sort of like needle nosed pliers, but with ratchets to lock them closed). This clamp should be tightened FULLY so it's compressing the tissue paper thin. Some people prefer to close these clamps slowly, whereas others prefer to do it instantly.

4. The clamp should be left on between fifteen and forty-five minutes. When the clamp is removed, the tissue should be totally compressed, paper thin, and translucent.

5. Using bandage scissors (the kind with one dull knobbed blade, and one sharp one), cut through this thin tissue. Alternately use a scalpel or other cutting tool.

6. Optionally cauterize the wound chemically or suture it. Most people don't do this for meatotomies, which are far less inclined to close during healing than subincisions and superincisions.

Any bleeding can be controlled with bandaging and pressure. It's not uncommon for men to panic at the amount of blood the first time they do it. Stay calm, and make sure you can differentiate between the effects of any panicing (hightened heart rate, disorientation, etc.) and actual problems. In addition, don't underestimate how much blood you can safely lose.

Again, I am not recommending that people do this, and I absolutely do not accept any liability for your actions.

Meatotomies heal incredibly fast, often in not much more than a week. It is very rare for them to have complications such as infections.

As far as the healing aftercare, overall just leaving it alone is good enough. Sexual contact should DEFINITELY be avoided during the primary healing period, but if you absolutely can't wait, make sure you use a condom. But you REALLY should wait.

Additionally, many people find that saline or salt-water soaks help alleviate swelling and discomfort.

Yes. Meaototmy is perfectly possible for the uncircumcised. In the context of meatotomy, the only anatomical difference may be the presense of a frenulum (a tough band of skin that strings between the bottom of the glans and the shaft). The frenulum can either be cut through, cut beside, or seperately removed.

Finally I should note that uncircumsised men may experience additional swelling during the healing as the foreskin tends to retain water when injured.

Depending on your anatomy as well as the specific orientation and structure of the cut, meatotomy can definitely affect the urinary stream. Don't be surprised if at the urinal you accidentally piss on your foot, or worse, the guy next to you. If you plan on a meatotomy, you should be willing to accept having to sit down.

Think of a running garden hose, and ask yourself what you can do to make it spray farther. To increase the spray's force and distance, given a consisent amount of water, the hole at the end of the hose is constricted (made smaller). The urethra works the same way. A man with a tight urethral opening will "shoot" much further because of this effect. This also has the effect of putting lots of internal pressure on the uretha, which most men agree feels great.

Meatotomy opens the urethra, which means that even though the same amount of ejaculate is being produced, it may not leave the penis with the same amount of force. This has a threefold effect:

1. Ejaculate may flow or dribble out, rather than shooting. If you or your partner have manual access to the penis at the time of ejaculation, slight finger pressure appled to the urethra just before the exit point can create an artificial sphincter of any tightness you desire.

2. Ejaculation may not feel as good from the male's point of view. This can be to some extent minimized by masturbating nearly to the point of orgasm (but not to orgasm), as well as by having much longer sexual encounters. Both of these things will increase the volume of ejaculate, which goes a long way to compensate for a widened uretra. The finger technique I mentioned above may help as well.

3. You may be slightly more likely to have female children. If you are concerned about combatting this, follow the advice in any number of books that discuss natural methods for selecting the gender of your child.

Not at all, at least not for any physical reasons. Under normal circumstances, there are no nerves that could be damaged in a meatotomy that would affect erection, nor are there any blood vessels or penile structural elements that could be damaged.

To be perfectly honest, most people won't notice a difference in normal penetrative sex (either gay or straight) until the meatotomy is cut deeper, becoming a subincision. That said, mentally many people will enjoy sex more. Most "good sex" stems from being relaxed and comfortable, and meatotomy helps many people achieve that.

Yes, a plastic surgeon can reverse a meatotomy. However, it's going to cost you a lot of money, and you will still have a scarred frenulum. I would strongly urge people to not consider any of these modifications if they're not sure about them. Wait a year if you have doubts that you're up to a lifetime commitment.

First of all, realize that doctors have a responsibility to keep you healthy, and that to some extent includes protecting you from yourself. So if you're not healthy -- including mentally healthy and stable -- there's little chance that a doctor will work on you. And, to be blunt, if you're not mentally stable, NO ONE, including yourself, should be working on you.

Assuming you are sane, if you know your doctor and they are liberal thinking, you can probably just be honest with them. Bring them this FAQ, along with some files from BME so they no that this is "normal" and you're not asking them for something that's far out.

Some of the procedures -- meatotomy and circumcision -- are relatively simple to convince doctors to do on an elective basis with minimal screening, but anything past that will require a bit more work. In addition, you can check BME's (currently in development) list of heavy mod-friendly doctors to find a surgeon who is willing to do the heavier procedures.

These services are also offered by underground "cutters", as well as by some piercing studios. Please note that practitioners working out of piercing studios are almost always operating illegally, and that governments have started cracking down on them. In addition, compared both to doctors and cutters, these practitioners tend to be very inexperienced. I personally would not recommend approaching a piercer for this unless they are a friend of yours (in which case they will be assisting you on the procedure, rather than performing a service for you).

The best cutters maintain a very low profile. They can be contacted most easily through various SM related channels, often through one or more intermediaries who are usually former cusomters. Cutters are out there. If you're determined and patient, you'll find one.

First of all, I'm not a lawyer... but... Most likely, YES, it is legal. Few countries restrict what a person can do to themselves by themselves, assuming you're not using restricted supplies (for example, some forms of anesthetics are restricted to possession by doctors only).

That said, if you walk into a hospital after doing it, they may well decide that you are putting your life at risk and hold you for mental assessment. So don't get in over your head!

Technically it probably isn't. However, legislating what people do in their bedrooms is very difficult and I personally believe that prosecuting someone for a consensual procedure on their partners in private would be very difficult. Unless something goes very wrong complication-wise or you advertise your procedure very publicly, I think this is safe territory legally.

I really want to emphasize though that I am not a lawyer.

Definitely not. Unless you are a doctor, you have no legal right to offer these procedures to the general public as a commercial transaction. If you do, you're playing with a ticking time bomb that will eventually land you in an unpleasant trial, if not in prison.

I really want to emphasize this: It is not legal to do these procedures on the public. If you choose to, you are putting yourself at risk. If you choose to, it is essential that your clients understand that they need to be discrete.

One last time: If you offer these procedures to the general public, you are probably breaking the law.