Why not to circumcise your baby: Cutting to the Point on Circumcision

Posted on 8 сентября, 2023 by alexxlab

Cutting to the Point on Circumcision

From the time Debra Sherman and her husband, Mark Wilcox, learned through prenatal genetic tests that they were having a boy, they agonized over whether to circumcise their baby. «I didn’t want the first decision we make for him to be a bad one,» Sherman says.

In the end, the Chicago couple decided against taking that extra surgical snip of foreskin from their son’s penis. Without overwhelming medical evidence favoring circumcision, Sherman says, it would have seemed to her like deciding to cut off his ear lobes.

«From everything we read and everyone we talked to, it seemed like there was no medical reason to do it,» says Sherman, whose son, Alex, is 7 months old. «Plus, I’m not religious, Mark’s not religious, and I just thought it was an awful thing to do to a baby.»

The fact is, the circumcision decision is a very personal one. Experts say parents need to understand the advantages and disadvantages, then decide what’s right for them. Here are the latest facts and a look at how some parents are choosing.

Locker rooms have a way of reducing each sex to its least common denominator. Peel away the Levi’s and Jockeys, put aside sizes and shapes, and the equipment is all basically the same — at least that was the case when today’s generation of new dads were kids.

Parents in the United States have routinely circumcised their sons since the 1940s, in large part because doctors believed it promoted good hygiene and prevented disease. To Jews and Muslims, circumcision is a sacred ritual symbolizing their covenant with God. By the mid-1960s and early 1970s, about 90% of all boys were circumcised.

But that trend is shifting. In 1996, circumcision rates declined to about 65%, although rates differ depending on demographics: 80% in the Midwest, 68% in the Northeast, 64% in the South and 34% in the West. Among whites, the rate is 81%, compared with 65% among blacks and 54% among Hispanics.

In fact, many observers predict that by the time the first generation of boys born in the new millennium is old enough to hit the locker-room showers, the haves and have-nots may be about equally divided.

The biggest reason for the change is mounting evidence that the medical benefits aren’t as compelling as once believed. In addition, anti-circumcision groups have turned up the heat on the debate. They claim the practice is cruel and unnecessary and are spreading the word via Web sites, mailings, bumper stickers, T-shirts and international conferences.

Circumcision rates are much lower in other parts of the world, including most of Europe, Asia and Latin America. Only 48% of boys in Canada, 24% in the United Kingdom and 15% of boys worldwide are circumcised.

Probably the strongest cause for pause among parents, however, came this year when the American Academy of Pediatrics issued a policy statement saying it does not endorse routine circumcision.

«There are potential benefits as well as risks, but the data wasn’t sufficient for us to say every newborn male needs to be circumcised,» says Dr. Carole Lannon, clinical associate professor of pediatrics and internal medicine at the University of North Carolina, Chapel Hill, and chairwoman of the task force on circumcision. «Each parent needs to make that decision.»

A circumcision is usually performed within 48 hours of birth by an obstetrician or pediatrician in the hospital, or on the eighth day after birth for the Jewish ritual, called brit milah or bris. The baby is restrained, then the layer of tissue that covers the tip of the penis is surgically removed. It should take no more than five minutes in skilled hands.

When weighing the pros and cons of circumcising your baby, the most clear-cut medical benefits of circumcision are a four- to 10-fold decrease in the risk of urinary-tract infections during the first year of life, and a three-fold reduction in the risk of penile cancer among adult men.

However, urinary-tract infections and cancer of the penis are rare. The risk of developing a urinary-tract infection in an uncircumcised male infant is no more than 1%, and breast-feeding has been shown to protect against these infections among this group, according to the AAP. Only 10 or fewer men per 1 million get cancer of the penis each year worldwide.

Studies also show a somewhat higher incidence among uncircumcised men of sexually transmitted diseases, including syphilis and human immunodeficiency virus. However, the AAP says that the data are conflicting and highly controversial since behavioral factors play a larger role in contracting STDs than the existence or absence of foreskin.

Boys who are circumcised avoid the risk of phimosis, a condition that makes foreskin retraction impossible. However, the overall risk of penile problems for uncircumcised boys is unclear. The AAP cited one study that followed 500 boys up to age 8 and found higher rates of penile problems — typically inflammation — in infants who were circumcised, but more problems among older boys who were not circumcised.

As for the argument that circumcision improves hygiene, «that one doesn’t really hold up,» says Dr. George Kaplan, a clinical professor of surgery and pediatrics at University of California at San Diego and AAP task force member. «If you’re not circumcised, I think that as long as you wash your penis, that’s probably fine,» Dr. Kaplan says. Bathing an uncircumcised baby simply requires washing the penis with soap and water. After the foreskin becomes retractable (typically by age 5), boys can be taught to gently pull back the foreskin to clean the tip of the penis.

On the other side of the coin, circumcision also presents some clear disadvantages.

For one thing, it hurts. Doctors used to think that infants didn’t feel pain like adults and that circumcision didn’t require anesthetic. Not anymore. Although it’s hard to know just what they’re feeling, it’s clear that babies who are circumcised experience temporary changes in heart rate, blood pressure, oxygen saturation and hormone levels.

New research even shows that early exposure to pain may have long-term effects. One study found that infants who underwent circumcision without analgesics were more sensitive to pain during immunizations at four months and six months. Another found that newborns exposed to pain by circumcision or illness were more anxious about pain as children and adolescents.

If parents choose to circumcise their baby, the AAP recommends local anesthesia. Doctors can use a topical anesthetic, a dorsal penile-nerve block (injected with a needle), or a newer procedure called a subcutaneous ring block, which proved to be more effective than the other two methods in one study.

Another disadvantage of circumcision is the risk of surgical complications, although they are rare — maybe 0.2% to 0.6%. Bleeding is the most common complication, occurring in 0.1% of circumcisions, although it’s rarely bad enough to warrant a transfusion. Minor infection is the second most common problem.

Less common are complications, such as improper or excessive cutting, which can impair function. In a few instances, circumcision has resulted in loss of the penis or even death. A 1-month-old infant in Cleveland, Ohio, died last year from anesthesia complications as doctors were repairing their circumcision.

It’s also more expensive. About 1.2 million newborn males are circumcised annually at a cost of $150 million to $270 million. An individual circumcision can range from $225 to $500.

Opponents of circumcision also claim that the procedure desensitizes the penis and decreases sexual pleasure. That’s because the foreskin, which makes up about half the skin of the penis, contains highly sensitive nerve endings.

No studies have been done to back those claims, although some men who were circumcised as adults reportedly say that sensitivity decreased significantly. On the other hand, one study found that circumcised men remained sexually active longer.

For Hugh and Kalei Damon, of Newport Beach, Calif., the decision to circumcise Cole, now 14 months, came down to conformity. Not only is Hugh Damon circumcised, but he’s banking on the fact that most boys Cole’s age will be, too.

«I remember growing up seeing my dad naked and his looked the same as mine. I just felt psychologically, if it didn’t there might be questions why,» says Damon. «Mostly, I just didn’t want him to feel different in the locker room or from me.»

Religious tradition was the determining factor for Doug Gertner and Maggie Miller, of Denver, Colo. Just as Gertner’s own Jewish ritual ceremony connected him to his ancestors and heritage, so too would his son’s. Jordan is now 1.

«It was a powerful, beautiful event, and the community went out of its way to be there and support him as he went through this rite of passage,» says Gertner. «Hopefully he’ll appreciate that anything I did to him was chosen thoughtfully, and not just pain inflicted.»

However, some Jews are among those questioning the ancient ritual. Michael Kimmel and Amy Aronson of Brooklyn, N.Y., came up with a creative alternative. They found a mohel, who performs ritual circumcisions, to perform the ceremony — without the circumcision.

«We discovered that there is a long tradition of opposition to circumcision within the Jewish community, mostly from women,» Kimmel says. «Circumcision is wrong and cruel and medically unnecessary, but we didn’t want the occasion of his birth to go unmarked or to feel that to our family he wasn’t being brought in as a Jew.»

They ended up having the naming ceremony and communal gathering but replaced the traditional circumcision with another common ritual among desert cultures they discovered after doing some research: They welcomed Zachary into their home by washing his feet. «In the end, the family, even our fathers, felt OK with that.»

Pain was the deciding factor for Sherman and Wilcox in choosing not to circumcise their son Alex. They talked about all the ramifications, including what it might do to his sex life. Indeed, one survey indicated American women prefer a circumcised penis by a margin of 3 to 1.

Sherman admits he was concerned how a future girlfriend might react to his son’s uncircumcised penis. His ultimate answer? «If she’s never seen one before, she’s going to freak out anyway, and if she’s already seen a lot of them, she’ll probably appreciate the diversity. «

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Should the Baby be Circumcised?

Ages & Stages

If you have a boy, you’ll need to decide whether to have him circumcised. Unless you are sure you’re having a girl, it’s a good idea to make a decision about circumcision ahead of time, so you don’t have to struggle with it amid the fatigue and excitement following delivery.

Circumcision has been practiced as a religious rite for thousands of years. In the United States, most boys are circumcised for religious or social reasons. At present, there is discussion over whether circumcision is advisable from a medical standpoint. There are potential medical benefits to circumcision as well as risks. A recent analysis by the American Academy of Pediatrics concluded that the medical benefits of circumcision outweigh the risks. Studies have concluded that circumcised infants have a slightly lower risk of urinary tract infections, although these are not common in boys and occur less often in circumcised boys mostly in the first year of life. Neonatal circumcision also provides some protection from penile cancer, a very rare condition.

Some research also suggests a reduced likelihood of developing sexually transmitted diseases and HIV infections in circumcised men, and possibly a reduced risk for cervical cancer in female partners of circumcised men. However, while there are potential medical benefits, these data are not sufficient to recommend routine neonatal circumcision of all boys. We recommend that the decision to circumcise is one best made by parents in consultation with their pediatrician, taking into account what is in the best interests of the child, including medical, religious, cultural, and ethnic traditions and personal beliefs.

Circumcision does, however, pose certain risks, such bleeding and swelling. While they may occur, however, bleeding and swelling are rare.

Although the evidence also is clear that infants experience pain, there are several safe and effective ways to reduce the pain. If the baby is born prematurely, has an illness at birth, or has congenital abnormalities or blood problems, he should not be circumcised immediately. For example, if a condition called hypospadias is present, in which the infant’s urinary opening has not formed normally, your doctor will probably recommend that your baby boy not be circumcised at birth. In fact, circumcision should be performed only on stable, healthy infants.

At birth, most boys have skin that completely covers, or almost covers, the end of the penis. Circumcision removes some of this foreskin so that the tip of the penis (glans) and the opening of the urethra, through which the baby urinates, are exposed to air. Routine circumcisions are performed in the hospital within a few days of birth. When done by an experienced physician, circumcision takes only a few minutes and is rarely complicated. After consultation with you, your doctor will provide local anesthesia to reduce the pain the baby experiences during the procedure; the doctor should inform you in advance about the type of anesthesia she recommends.

Last Updated: 8/27/2012

Source: Adapted from Caring for Your Baby and Young Child: Birth to Age Five (Copyright © 2009 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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04/03/2018

Trim or not?

Circumcision in the clinic «Panacea 21 century» Kharkov:

reduces the risk of developing prostate cancer;

Researchers from the University of Quebec in Montreal (Canada) came to this conclusion. They found that compared to uncircumcised men, they develop prostate cancer 14% less.

Reduces the risk of sexually transmitted diseases including human immunodeficiency virus (HIV) in men by half. Removal of the foreskin changes the bacterial community, resulting in improved protection against HIV infection;
Circumcision is one of the treatments for recurrent herpes; and genital warts;
Visually enlarges the penis;
Lengthens sexual intercourse.

When circumcising, know that:

The doctor will not cut off too much. Do not be afraid of circumcision and think that the doctor can «grab off» an extra piece. For this to happen, the doctor must be a complete amateur. The cutting operation is quite simple. In order to be 100% safe from trouble, carefully approach the choice of a doctor;
Painfulness of the procedure . During the operation, local anesthesia is used, so the operation is painless;
The risk of complications after circumcision increases with age . Possible complications associated with circumcision such as bleeding, infection, scarring. With age, the risk of their development increases. That is why many doctors urge to do this procedure at an early age;
Do not worry about scarring after surgery. Modern methods of circumcision in no way harm the appearance of the penis, during the operation, doctors also take care of the cosmetic side of the issue. So it’s not worth thinking about the fact that after the procedure the penis can be disfigured. Ugly scars can form if there was poor postoperative care (wounds festered). If all of a sudden this happened in the future, there is an opportunity to correct it with the help of cosmetic methods;
The foreskin is not lost forever, it can be regenerated! This is stated by representatives of the American company Foregen, who have developed a new technology that allows regenerating the foreskin. Today, the company’s research group is based in Italy and is testing various technologies that are used in regenerative medicine. It should be noted that in recent years science has made great strides in this direction. So, it is already possible to partially regenerate living human hearts, vaginal tissues, and also completely grow the bladder. In the course of research, American scientists managed to regenerate a normally functioning penis of rabbits. In the near future, experiments will begin to recreate the foreskin on animals, after the success of which the technology will be tested on humans.

In the medical center «Panacea XX I century» circumcision / circumcision operations are performed.

If you have any questions, ask the professionals!

Tel (057) 732 76 20; (057) 732 09 67.

Medical center «Panacea XXI century» Kharkiv city, st. Cooperative, 28

Male circumcision: what is it and why is it needed?

In the West, male circumcision, the removal of the foreskin, is very popular. It is made for boys at a very early age. Why this operation is needed and how it affects the body of a man, Yegor Kolyshnitsyn, a urologist-andrologist at the Alone Clinic, helped us figure it out.

— Egor Yurievich, what are the origins of the practice of circumcision?

— Circumcision — the removal of the foreskin (the tissue that covers the head of the penis) — originates from the times of ancient Egypt and Mesopotamia as a religious rite. Usually circumcision is performed on the first or second day after the birth of a boy, among Jews on the eighth day, and among Muslims at 7-10 years of age. The tradition of circumcision has not only religious and cultural, but also domestic justifications, and it is probably the latter that are the reason for the wide spread of the procedure in the countries of the south.

Men know perfectly well what it’s like not to take a shower in the summer. Sweat, dirt accumulate under the foreskin, and the heat provokes the growth of bacteria. Due to the banal non-compliance with the rules of hygiene, the consequences for men’s health can be devastating. During my practice, I have repeatedly had to treat men — fishermen, hunters, long-distance drivers — who, due to the lack of appropriate living conditions, cannot provide themselves with proper hygiene.

– Why is this procedure not as widespread in Russia as, for example, in America and southern countries?

— The American Academy of Pediatrics has concluded that there are more advantages to circumcision than disadvantages. Here are a few facts to back it up: Penile cancer is rare, but more common in uncircumcised men. Cervical cancer is more common among male partners with uncircumcised foreskins. Research by Australian scientists suggests that sexually transmitted diseases are more likely to occur in uncircumcised men. Gonorrhea and herpes — 2 times, and syphilis and fungal diseases — 5 times.
In Russia, the expediency of circumcision causes very heated discussions. Each organ has its own function. The foreskin is no exception. Its glands clean and moisturize the surface of the glans penis, their secretion reduces the possibility of bacteria breeding. The foreskin prevents injury and damage. In early childhood, it protects the head and external opening of the urethra from infection.

In my opinion, the value of circumcision cannot be overestimated. If a man leads a promiscuous sex life, does not follow the rules of personal hygiene and hopes that the circumcised foreskin will save him from dangerous ailments, he is deeply mistaken.
I take a very definite position here: circumcision surgery is advisable only for medical reasons.

– What are the medical indications?

— Firstly, this is phimosis, that is, the narrowing of the foreskin, as a result of which it becomes impossible to expose the glans penis. It can be either a birth defect or a complication after inflammatory processes. The next indication is chronic recurrent balanoposthitis — inflammation of the foreskin.