Circumcision

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  • #79680
    MTaylorMTaylor
    Participant

    How do you feel about circumcising baby boys? Advantages, disadvantages….religious concerns, etc. Did you have your son circumsized, why or why not?

    #79682
    YearstogoYearstogo
    Participant

    We did not have our son circumsized. I did not feel that the purported advantages were nearly enough to justify it, and I’m not keen on doing something like that in the knee-jerk manner that it seems it is often done. We also had no religious reason to have it done. So far so good! I’m really not looking forward to seeing them done when I get back to the clinical years — seeing the board on my hospital tour would have decided me against it if I hadn’t already been!

    I suspect that it will be done less and less in this country in the future.

    #79684
    PremedRNPremedRN
    Participant

    If I am remembering correctly, this practice was initially brough by the Jews, Im not sure how it exactly became a norm, as I believe that it was about religious purposes. Correct me if I am wrong. (Obviously, Im not a Jew)
    Both my sons were circumcized. From what I have been taught, it reduces the risk of infection. By the same token, we dont go get our appendixes removed at birth, or in adulthood, for that matter, to reduce the risk of infection.
    From my own knowlege base, it is more common that boys are circumsized. Considering the social aspects, in addition to the reduction of risk of infection, I chose too. My sons would be the ones to live with their penises, not me. Since the majority of boys that I knew were, I figured my boys probably would feel more comfortable about being opposed to not later on. Not all parents would agree to base their decision on social aspects, and that’s fine, but adolescents are very self-conscious if they are “different” than say the other players on the football team. This may not be a valid reason for some, but it was valid enough for me.
    I know a guy who was not cicumsized at birth and in early adulthood developed diabetes, he had problems with infection, and had gotten circumsized at the age of 40.

    #79686
    YearstogoYearstogo
    Participant

    The figure I read most recently is that 40% of baby boys today in the U.S. are left uncircumsized. Either way, they’ll have lots of company.

    #79688
    MTaylorMTaylor
    Participant

    The reason I asked this question is because I’ve been seeing lots of complications, infections, etc. from not circumcising lately. Also, I’ve been doing some reading…I’m on the urology section now, and there are just so many issues with uncircumcised males that it made me wonder why it’s such a controversial issue when you’re having a baby boy. It seems pretty clear that it has many health advantages.

    A couple of stories from the ER…

    A 45 year old diabetic guy with end stage renal disease comes in in DKA. In searching for an infectious source we discover (after *lots* of searching, while attempting to place a foley) the tip of his penis was necrosed. But since his foreskin was (mostly) over the glans, we don’t notice it right away. AND, he doesn’t make urine, and has peripheral neuropathy (so didn’t feel it) – so it’s been unnoticed for the better part of a week. Well, what happened was his foreskin wasn’t completely over the glans, and that formed a constriting band and cause the tip of his penis to rot off. He had to have an emergent dosal slit (cut his foreskin) and admitted for a circumcision and possible amputation.

    Or, another story was this 12 year old boy, not circumsized, brought in because the foreskin wouldn’t retract, and an underlying infection cause swelling significant enough to obstruct the urethra…resulting in obstructive uropathy and renal damage.

    I have a few other recent events…and based on my reading there are many other common scenarios that involve uncircumsized males which result in sometimes catastrophic events. And makes me wonder if parents-to-be *really* know about all of these problems that only happen with the foreskin present. And knowing all of these things, and having seen 5 year olds with their penis necrosed because of tightly retracted foreskin (paraphimosis), why would anyone opt to not circumsize?

    I’m not passing judgement as I do not have a son, nor a penis, so my perspective is based entirely on other people’s experience. I’m just wondering, because it seems like a no brainer to me as I continue reading and seeing these young patients.

    #79690
    EM momEM mom
    Participant

    I guess I fall on the side of circumcision as well. We had decided to this if we had a boy (we had a girl so I can’t speak from any experience as far as handing over my newborn and knowing what was being done, very difficult I’m sure) but after rotating in urology as a med student and getting very sick of doing circs on middle aged men for a whole host of not so pleasant reasons, I too became a believer. Statistically I’m sure my experience was probably extremely biased, but I figured just might as well have it done and avoid all of those problems altogether. Plus there was the locker-room, dating, adolescence arguement…

    #79692
    Med4MomMed4Mom
    Participant

    We had our son circumcised when he was a couple of days old. I really didn’t have strong feelings either way, and hadn’t done much reading on the issue, but deferred to my husband on this one. He felt quite strongly that it was the right thing to do. Perhaps this was a holdover to his Dad’s philosophy (Ob/Gyn, had his three boys circumcised), but in hindsight I am glad we had it done. I have observed several problems among my friends un-circumcised little boys :rolleyes: and am just glad that those things will not be issues for our little guy.

    #79694
    rockfeverrockfever
    Participant

    although not a med student at the time, i decided to hav emy son circumsized because of the health risks. my husband thinks it was done because HE is cricumsized and wanted his son to “look” just like him.

    #79696
    mommd2bmommd2b
    Participant

    Three boys….all uncircumcised. The health risks in my opinion are not high enough to warrant circumcision. My husband is from europe and they do not have substantial penis problems over there ) 😀 There are no high rates of penile cancer :rolleyes: , UTI or phimosis there.

    Perhaps the reason that you are all seeing the problems that can results is that you are dealing with sick/hospitalized patients? To my husband, every gay man is hiv positive and every surgical procedure causes an infection. :p (He’s an ID doc).

    My oldest son had a tightening of the foreskin. 3 years ago they would have recommended circumcision. Instead, he was treated very conservatively with great success. If the treatment had not worked the next step would have been a short term treatment of cream with cortisone in it applied to the foreskin only in order to thin out the skin/weaken it a little.

    I think this is a personal decision that has more to do today with looking like dad than medical need…unless you happen to live in West Africa where HIV is extremely prevalent and condoms aren’t.

    kris

    #79698
    HeatherHeather
    Participant

    This may be a little off topic, but I was wondering how they treated Mommd2b’s son conservatively -“My oldest son had a tightening of the foreskin. 3 years ago they would have recommended circumcision. Instead, he was treated very conservatively with great success.”

    I have 3 boys (the last 2 are not circed) my 4 year old still has very minimal retraction, and I am starting to worry. He doesn’t have pain or any problems, but I do not even really know it I should be doing anything with it. ( My brothers were all circed as is my husband ) We don’t learn alot about this in med school, or residency so far. Any info would be appreciated.
    Heather

    #79700
    MTaylorMTaylor
    Participant

    Heather,
    I remember reading that the condition you’re describing is actually very okay for young boys to have, and no treatment is necessary as long as it’s not causing him any problems. The chance of “problems” is very low…

    I love emedicine…here’s a link to a good article (in my opinion) to help explain how “normal” this can be.
    http://www.emedicine.com/emerg/topic423.htm

    Hope you find your answers.

    #79702
    MTaylorMTaylor
    Participant

    Have you guys heard that uncircumsized men contribute to cervical cancer in women by harboring HPV (human papilloma virus) beneath their foreskin? Some of my colleagues have shared this with me, and I plan to look into it myself.

    Heather, why did you decide not to circumsize your boys?

    -Mya

    #79704
    ReneeRenee
    Participant

    Both of my boys are circumcised and I’m a bit embarassed to admit that we didn’t put a lot of thought or study into making that decision. We were both for it because it just seemed “the thing to do”. Also, my husband is circumcised so again, it was a practice and “look” we were familiar with. I had also heard some vague references to hygiene, etc.

    In response to Mya’s question re: uncircumcised males and cervical cancer, I know of one anecdotal story regarding this subject.

    My friend’s husband’s(uncircumcised) 1st wife died of cervical cancer about 6 months after she was diagnosed in an aggressive stage during her 4-5th month of pregnancy. Turns out the previous 2 papsmears neglected to detect the abnormal cells. I remember my friend telling me that she’s very careful about getting regular exams just in case the fact that her husband is uncircumcised had anything to do w/ the cause.

    I certainly don’t know for a fact, but I don’t believe there’s been any scientific studies or proof that would say that uncircumcised males have a greater risk of passing on HPV (& thus potentially cervical cancer) than do circumcised males. One can certainly contract HPV from circumcised males as well.

    #79706
    mommd2bmommd2b
    Participant

    Heather,

    I felt a bit funny about posting it….talk to your pediatrician first, but our pediatrician had him “clean” beneath the foreskin gently using a q-tip with vaseline on it after he got out of the bath :blush: I have to admit that I was unable to take part in this at all…..I wouldn’t make a good urologist, I guess! :p In any case, it took several months, but it was successful for him. I think that at age 4 this is still not such a big deal….my son was 7 at the time so we were a bit more concerned….though I’ve heard of boys who have had little retraction until the age of 11 or 12…I guess it varies depending on the individual.

    As the the whole HPV thing…there is a minimal increase in risk for women with ‘high risk’ sexual partners. From what I understand though, in most of the studies undertaken, when uncircumcised men who had not been to a prostitute or had multiple sex partners without using protection were compared with circumcised men the risks were the same.

    I’d still rather teach my child the proper way to put on a condom than circumcise him. Sure, I guess I run the risk that he is going to be promiscuous and not use protection…but I’ll try and educate him properly when the time comes.

    In any case, I think that this is a very personal decision and though I didn’t choose this for my sons I don’t have a problem with those who choose to circumcise.

    kris

    #79708
    sisriversisriver
    Participant

    No one has really mentioned the pain to the infant undergoing circumcision in his first days outside the womb. The photos they showed us in the childbirth class were very memorable.

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