Posts Tagged ‘male circumcision’

Lop It Off- What You Need To Know About Circumcision

May 25, 2015

Circumcision has been performed on men and baby boys from the beginning of recorded history. The procedure is certainly controversial. This blog will discuss the pros and cons of circumcision and a hope that the article will help you make an informed decision for yourself and for your little boys.
Circumcision is the removal of the skin that covers the tip of a baby’s penis. In recent years, newborn circumcision has been a hot topic of debate. Differing opinions and advice may leave many new parents with more questions than answers.
Your choice of whether to circumcise your son may be a question of religion or custom. For instance, circumcision is part of Jewish and Muslim traditions. In other cases, parents may simply want their son to look like his father or other male family members.
But the trend in the United States is clearly changing. The rate of circumcision is falling. In the 1970s and 1980s, about 8 of every 10 boys born in the US were circumcised. Today, 5 or 6 of every 10 boys are circumcised. Circumcision rates in the US vary by region. Fewer boys in Western states are circumcised. The north central region has the highest rates of circumcision.
Only about one in three males are circumcised worldwide. Around the world, the highest rates for circumcision are in the Middle East, South Korea and the US. In Latin America, most of Asia and in Europe, circumcision is rare. It is on the rise in Africa, where studies have shown that circumcision lowers the risk of getting HIV. This is because the foreskin is different from skin on other parts of your body. It’s not like the skin on your arm, for instance. The foreskin has a type of cell called Langerhans cells, which are more likely to attach to HIV cells. Based on these findings, in 2007 the World Health Organization endorsed circumcision as a way to help stop the spread of HIV. Still, this thinking has not
taken hold in parts of the world where HIV is not as wide spread. In fact, the Royal Dutch Medical Association in the Netherlands called for a ban on circumcision in 2010. They stated that the procedure is “medically unnecessary and violates children’s rights.”
In the US, the American Urological Association (AUA) and the American Academy of Pediatrics (AAP) each have policy statements on circumcision. Both groups recommend the procedure be offered as a choice to parents. The AUA “believes that neonatal circumcision has potential medical benefits and advantages as well as disadvantages and risks.” The AAP states that “health benefits [from circumcision] are not great enough to recommend routine circumcision for all male newborns… [But are enough] to justify access for families choosing it.” Parents should talk with their child’s doctor about the health risks and benefits. With those facts, parents should then think over what will work for their family. They should keep in mind their own religious, ethical, and cultural beliefs and practices.
So what should parents know about the health risks and benefits of circumcision? Of course, circumcision can cause pain and stress for the patient. To lessen pain for newborns, an anesthetic (pain killer) may be used. With newborns, there is some evidence that babies may be less likely to feel discomfort 7 to 10 days after birth. This is because newborns have a high level of endorphins (substances made by the body that reduce pain). Also, as with any surgery—even a minor one—there is also a risk of bad
side effects. When circumcision is not done properly, the urethra (the tube that carries urine out of the body) or penis may be hurt. In rare cases, death has even occurred. Still, circumcisions done by skilled doctors rarely have bad side effects. And the problems that result are often not serious. The most common side effect is bleeding or infection. To help avoid problems, parents choosing to circumcise should make sure that whoever is doing it is skilled and practiced. Parents should also feel free to ask any questions they may have.
After circumcision, caring for the penis is simple but important. Wash the area gently with warm water. Pat dry and put on a new bandage with antibiotic ointment each time you change the diaper. The healing process should take about a week. It is normal for there to be a little swelling, redness and maybe blood at first. Still, it is important to have your baby seen by his doctor if these problems last several days or get worse. Also talk to a doctor if the baby gets a fever or does not have a wet diaper within 12 hours of circumcision. Almost all side effects are easily treated.
On the plus side, circumcised boys are less likely to have a urinary tract infection (UTI) in their first six months. As they grow older, circumcised males are also less likely to get penile cancer. Still, this type of cancer is rare in the US. And uncircumcised males can prevent penile cancer with good hygiene and keeping the area under the foreskin clean.
Parents who opt out of circumcision should wash their baby’s penis with soap and water with each bath. Parents should also be sure to teach their son good hygiene and care for his penis as he grows older. Treat the foreskin gently and make sure not to pull it back forcibly. Once it starts to retract, often around age five, it is important to clean under the foreskin with soap and water often. See a doctor if there is any swelling, pain or if the foreskin is itchy.
Bottom Line: The circumcision decision is not an easy one for parents to make. However, there are advantages for having this procedure on your little boys. Speak to your doctor for more information and more details.

Some thoughts on Male Circumcision

November 24, 2011

This is a blog post by Nicholas Fogelson thought would be of interest to my fellow bloggers. Although I am of the Jewish faith and have been circumcised, I thought this was a balanced discussion by fellow physician. I am interested in reading your comments and opinions on this very controversial topic.

One of the interesting things about running a semi-popular blog is that from time to time the blog community decides to take up a topic and run with it, completely without any stimulation from me. This happened recently on the Academic OB/GYN Facebook page, where a group of concerned individuals carried on a serious and passionate discussion about the merits of circumcision. As such discussions tend to be, this one was dominated by the anti-circumcision activists, with occasional interjections by those that were less concerned about the issue, including myself.
Circumcision is an interesting issue because it crosses multiple boundaries. It is a social tradition in many cultures, and in some cases considered a religious mandate. It is also an ethical issue for many, with some feeling that it is an assault on an infant with long term negative impact on their psychosocial health. For some it is just cosmetic.
As a young person, I always thought that my penis looked like penises were supposed to look. It looked like my father’s and my brother’s, and anyone else’s I had ever seen. For the most part, I was blissfully unaware that a penis could look any other way, until one day in high school when my world completely changed. I happened to see a friend’s penis we were showering after wrestling practice, and in that flash of a moment all kinds of things went through my mind. Did he have some kind of growth on his penis? Could he pee out of that thing? A few other choice thoughts. I can still remember the shock to this day. All I had ever seen looked like mine, and in that moment what I saw was foreign, revolting even. You see, from my frame of reference he looked like an alien. It took me a few minutes and SNAP! it came to me like a ton of bricks – he has a foreskin. He probably doesn’t have an alien death ray then. I can relax about that one.

Of course now I realize that I also was born with a foreskin, and at some point in early life had it cut off. Despite what was no doubt a anesthesia free surgical procedure, I have no memory of ever having had a foreskin, or of any trauma of it having been removed. It never occurred to me to miss my foreskin, but apparently others do.
I hear stories from various anti-circumcision activists about how men are traumatized by their lack of foreskin, or even that some use strange devices to try to restore their foreskin in some way. I am struck with these stories, and have one burning question – when did they start missing their foreskin? From the moment they had the capability to store long term memories, they had no foreskin. Being circumcised was their frame of reference; it was their ‘normal’. The only way they could ever ‘miss’ their foreskin would be through some outside influence that convinced them of some new ‘normal’, and that they were somehow incomplete. Some of these men express anger at their parents or doctors for circumcising them as an infant, it seems to me that this anger is misplaced. It would make far more sense for them to be angry at the person who felt the need to drive a message into one’s head they were somehow incomplete, a message without which the feeling of loss never could have occurred.
I also hear stories of how the lack of a foreskin somehow interferes with sexual pleasure. I just don’t understand how this can be verified. I can say that from a personal point of view, everything down there seems to work just fine. I also don’t notice a preponderance of Jews who do not enjoy sex. Anecdote aside, one can only know what one has, and so again, anyone that feels that their sexual pleasure was supposed to be better than what it was got that idea from some other person, not from their personal experience. There’s plenty of people with foreskins that feel like their sexual pleasure was supposed to be better as well.
My biggest question in all of this is just why? Why do people care so much about this? Its really hard to say that an infant is being victimized by the procedure. Their frame of reference is being changed, no doubt, but as that frame is changed so early in their life there will be no sense of loss unless someone feels the need to convince them of it.
One could just as easily ask ‘why circumcise?”. There are plenty of data to suggest that circumcision decreases horizontal transmission of some STDs and the rate of penile cancer, though these effects are small. The anti-circumcision folks like to act like this data doesn’t exist, but this is just their ignorance. When I first thought of writing this blog post I was going to lay all this data out, but as I now write I realize that it doesn’t really matter. Those that believe or don’t care will see the strength in the data, those that are against will call it faulty or corrupt in some way. So goes academia. In the end, circumcision is a cultural practice that is done for cultural reasons, not for medical benefit. In Jewish tradition, circumcision is done as a way of honoring the covenant between God and Abraham, a covenant which commanded that all of Abraham’s sons and male servants, and their descendants, as a mark of allegiance and agreement. Though I have Jewish heritage, I am atheist. Nonetheless, I would feel a cultural desire to circumcise my son when and if I have one.
Some of my comenters, of which there no doubt will be many, will call this stance unethical. To this I say “grow up”. We are hard pressed to find ethical principles on which all humans agree, and this is certainly not one of them. A very large part of this world feels completely fine with male circumcision, and if one doesn’t, they certainly are under no pressure to circumcise their son. This is one of the many things that we don’t all agree on.
Other commenters will say “I’m not against circumcision, I’m against forcing it on newborns.” This is the same as saying that we shouldn’t do ritual circumcision at all. That’s a perfectly fine goal if one is really against the procedure, but just state it that way. Male circumcision is a cultural rite performed on newborns. Its pretty obvious that by 18 years old, very few boys are going to choose to have their foreskins removed. Their frame of reference has already been set, and they are fine with who they are. If we did that, we would be just fine, just as we are with a large part of the population circumcised. A cultural tradition would be lost, but that would also be ok. It just wouldn’t really matter.
Other commenters will say “they are dangerous and cause complications.” This is a half-truth. By in large, they are not very dangerous. That said, like any surgical procedure, there are some small risks. There have even been babies that have died from complications of the procedure. Ultimately, it is very important that anyone doing circumcisions know what they are doing and doesn’t do them wrong.
In truth, its an issue that I don’t care a great deal about, and as such am vexed on why it matters so much to others. Sometimes when someone writes a piece on the net, they are instantly labeled as an activist for that cause. People certainly label me as an activist for delayed cord clamping, which I would deny. I just wrote an article about the topic and lots of people read it. They can make up their own mind. I just wish people would treat this issue the same way. Everyone is free to circumcise their child or not, and the boy will grow up just fine either way.

Bottom Line: Circumcision is probably the most common surgical procedure performed on men for thousands of years. For many boys the decision is made by their parents and is done for religious reasons. For others it is a matter of looking like dad and grandpa and the parents don’t want any differences in the genitals of men in the family. Others have the procedure for hygenic purposes. To circumcise or not may be a difficult decision for those who are not motivated bh religious reasons. I hope this article helps with that decision.