Circumcision
Definition of Circumcision
Circumcision is a surgical procedure, up until very recently performed without anesthetic, that removes the foreskin hooding the end of the penis, thereby exposing its tip, the glans.
Description of Circumcision
The operation of circumcision is usually done within days of birth, preferably before the age of two months, with or without local anesthetic or painkillers, at the surgeon's discretion. Some Jewish families have the circumcision performed by a specially trained rabbi called a mohel, as part of a ceremony held on the eighth day of life. After the operation, the scar is protected with gauze and petroleum jelly. Overall, circumcision is a safe, low-risk procedure, provided the operator is well trained and experienced. While certain religious groups, notably Moslems, Jews and some Africans, routinely circumcise new boys, many of the world's peoples have never practiced it. Circumcision was introduced into the English-speaking world in the 19th century for hygienic reasons and as a possible "cure" for masturbation. Widespread during the 1940s and 1950s, the practice is now declining. The British, Americans and New Zealanders no longer routinely circumcise boys; the custom is also waning in Canada.
Management of pain during circumcision
In the past, newborns did not receive any form of pain control during circumcision. There are several acceptable forms of pain management. The preferred approach is a “dorsal penile block”. In this procedure, pain numbing medication is injected at the based of the penis to temporarily reduce sensation at the foreskin. Other approaches include placing anesthetic cream (EMLA) over the end of the penis or a “ring block” to reduce pain sensations during the procedures.
Potential Medical Benefits for Circumcision
Circumcision remains a very controversial procedure. Many feel that it exposes a child to unnecessary surgery and in extremely rare circumstances, can cause disfigurement of the penis. Recent research has demonstrated that men who are circumcised have a lower risk of contacting sexually transmitted diseases. Circumcision may reduce the risk of contracting HIV disease by as much as half. Circumcision also eliminates the risk of a rare form of cancer, penile cancer. Circumcision also reduces the risk of other medical problems such as urinary track infections, swelling/infections of the foreskin, and cervical cancer in female partners.
Risks of Circumcision
Circumcision is generally a safe procedure. Complications do occur in about one in a 1,000 circumcisions. Rarely, scaring can occur at the site of the procedure. Other problems include infection, ulcer at the tip of the penis, and bleeding. There is no evidence that men with circumcisions experience less sexual satisfaction or desire.
Weighing the Risks and Benefits
There are not definitive recommendations with regard to circumcision. Each family should make their own decision.
Questions To Ask Your Doctor About Circumcision
What is your view about circumcision?
Please explain, in detail, how a circumcision is performed?
What happens if the circumcision is unsuccessful?
Can it be repeated?
Will an unsuccessful circumcision cause permanent dysfunction (i.e., difficulty urinating, infections, sexual dysfunction)?
After the circumcision, what should be looked for in terms of possible infections?
When does the gauze come off the penis?
Does any type of medicine need to be applied to the penis after the circumcision?
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