According to The Native Tribes of Central Australia by Baldwin Spencer and F. J. Gillen, the operation of Ariltha is regarded as being of at least equal importance to circumcision. Unlike the latter, however, women are completely excluded and are not allowed to take any part in it.

The person upon whom the rite is to be performed lies at full length on his back on top of the Tapunga. Another man then sits astride his body, grasps the penis, and puts the urethra on the stretch. The operator approaches and quickly lays open the urethra from below with a stone knife.

Following this, the initiate, having now passed the Avakurta stage, becomes an Ertwa-kurka, or initiated man. The initiates are led to one side to squat over shields, allowing the blood to drain into them. After this, the Okilia men come to him and tie the pubic tassels on. They tell him that he is now Ertwa-kurka, that he has no more operations to fear, and that he has been admitted to the ranks of the men.