Considering Circumcision?
Sometime during the course of your pregnancy, the question of circumcision will surface and invade the pleasantries of "being with child". "I want to do what to my son?" Why? When? Where? What for? Seeking answers to these conundrums will be a memorable part of your becoming two in one flesh with your spouse as you prepare for the birth of your child. It will be these very questions that this brief summary will address.
Historically, the first representation of circumcision was found in an Egyptian hieroglyphic from 2400 BC. However the initial and central reason for circumcision is found in the 17th chapter of Genesis where God uses the removal of the male foreskin as a sign of the covenant between Him and His chosen people. This is the basis for the use of circumcision by Muslims and Jews alike. Christians, who are spiritual Semites, have through the centuries, followed or departed from this prescription via their individual cultural backgrounds since circumcision was no longer necessary for salvation.
Practically, circumcision is the removal of the male foreskin. We now can use an anesthetic cream, Emla, to numb the area prior to removal, and betadine to clean the penis prior to the removal of the foreskin. The cream is placed by the nursing staff one to three hours prior to the circumcision. The most common instruments used are the Gomco, the Mogen and the Plastibell. The procedure is done in the nursery while you and the baby are still in the hospital. The child is gently secured on an operating surface as the procedure takes about ten minutes. Some of you may want to wait the eight days from birth like the Israelites to perform the circumcision, however, a pediatrician or rabbi can help you with those plans. Insurance coverage of the circumcision is a variable proposition, and we at the present time do not do this procedure at our Center.
Are there risks with the procedure? The most common issue with risk is taking too much, or too little foreskin off the penis. Approximately 1 in 100 have excessive bleeding from the dorsal vein to the penis that warrants intervention at the time of circumcision. Occasionally, a membrane is left over the head of the penis; this may or may not be handled by us at the time of the circumcision. Usually an urologist at a later date redoes the membrane removal. Now if you do not have the circumcision done at the time of birth, there is 8% chance of needing it done at a later date due to adhesions or infections developing.
Is it necessary? That is the questions we want to have answered with assurance. None of us want to hurt our children, especially our newborns if there is not a great reason for doing so. And yet extrapolating data from the general to the individual or in the reverse is fraught with statistical and personal pitfalls since babies, penises, situations, and physicians are all variable each time the procedure is done. What we in the scientific community can agree on are:
- There is a slightly increased risk with cervical cancer in women whose partners were not circumcised. But sexual behavior, i.e. multiple partners, smoking and early age of sexual initiation, were far greater risks for cervical cancer.
- Epidemiologic evidence suggests that you have a 3.2 times greater risk of penile cancer if you are not circumcised. However, this cancer is so rare, (2.2 per 100,000) that we would have to perform 140 circumcisions per week for 25 years to prevent just one case.
- Circumcision is an independent variable to getting, or giving an STD, with no protective effect noted.
- In 1996, substantial evidence accumulated that circumcision provided protection against HIV infection, with uncircumcised men being between 1.5 and 9.6 times more likely to become infected with the virus than circumcised men.
- There is a twelve-fold increase in urinary tract infections in uncircumcised boys.
The ambiguity in data caused the American Academy of Pediatrics in 1999 to issue their "Circumcision Policy Statement" which read: "Existing evidence demonstrates potential medical benefits of new born circumcision; however, these data are not sufficient to recommend routine neonatal circumcision."
We at the Tepeyac Family Center want you to make an informed decision about this most common of surgical procedures. We find the procedure awkward because our patients are usually adults, not babies fresh from their Mom's wombs. We perform the procedure daily at Fair Oaks Hospital. Fathers and Mothers are welcomed to be present if they so desire to lend "moral support". Circumcisions are done by our hospital doctor when they have some free time between surgeries in the operating room and deliveries on labor and delivery. We do not believe that it leaves psychological or post traumatic issues with the child.
The decision to circumcise is entirely yours. We want to strongly remind our families that they should pray for their children, especially their boys. We want these boys to grow into men that honor and cherish the women in their lives, never using their penises to traumatize women while desensitizing themselves. Women are never to be seen as objects and obviously never treated as such. Please talk to us at an appointment if you have any further questions. God Bless.
Bibliography
- American Academy of Pediatrics, Task Force on Circumcision
"Circumcision Policy Statement,"
Pediatrics 103 (1999), 686-93. - Circumcision: A History of the World's Most Controversial Surgery,
David Gollaher, Basic Books, New York, 2000