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Old 03-14-2003, 05:05 AM   #11
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Originally posted by Puck
....However, there have been studies that have shown women who's mates are circumcised have a much lower rates of some cancers....
Do you mean higher cancer rates? Do you have any links? (I'd like to see the figures... to see if it is 200% or 300%, etc)
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Old 03-14-2003, 05:06 AM   #12
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BTW, does the skin that is cut receive any sexual sensations of its own? I thought it might just reduce feeling and what's underneath had all the sexual-related nerves - or at least it is more sensitive - I think.
The foreskin can be retracted - and it usually retracts on its own when the penis becomes erect. Therefore, it cannot reduce the feelings in what's underneath (i.e. the glans).

It is blindingly obvious that the foreskin has sexual sensations of its own. How can you believe for a second that something that is an integral part of the penis would not have sexual sensations? Not only that but the outer foreskin is the most sensitive part of the shaft skin (the shaft skin is at its least sensitive toward the body and gets more sensitive the closer you get to the glans). The inner foreskin (the part that faces the glans when the foreskin is not retracted) is not skin, but mucosa. Mucosa is more sensitive than skin, you do the math.

The surface of the glans also is mucosa. As you can guess, mucosal surfaces are not made to be exposed to constant friction and dry air. Which is exactly what happens to the glans of a circumcised man, hence reducing the sensitivity of the glans.

From a sexual point of view, there are no redeeming features to circumcision. The only circumstance in which it might improve pleasure is phimosis - impossibility to retract the foreskin (affecting about 1% of intact men). Even then, there are now medical treatments to phimosis that are less destructive, like loosening the opening of the foreskin by regular strecthing.
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Old 03-14-2003, 05:29 AM   #13
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Originally posted by excreationist
Do you mean higher cancer rates? Do you have any links? (I'd like to see the figures... to see if it is 200% or 300%, etc)
It was once suggested that a woman had a greater chance to get cervical cancer if her partner was circumcised. You can read a long paper (from a pro-foreskin source) here: NOCIRC Position Statement on the Use of Male Circumcision to Prevent Cervical Cancer

To make a long story short: claims that circumcision might reduce cervical cancer have been discredited decades ago. A recent study confirmed this, but found that circumcision might reduce risk of cervical cancer in "high-risk" men (that had sexual intercourse before 17, had had 6 or more partners and had a known history of interacting with prostitutes). However, the failure to account for known factors that influence cervical cancer - smoking and use of oral contraceptives - cast doubt on their results regarding "high-risk" men.
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Old 03-14-2003, 07:05 AM   #14
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I'm not going to dispute any of the medical evidence being given. I just wanted to put in that I'm a circumcised male and I've never felt robbed or mutilated. And now that I know the procedure for cleaning under the foreskin I'm glad I don't have to bother with it. And my penis is plenty sensitive enough, as I'm reminded whenever I wear zipper jeans without underwear. Ow!
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Old 03-14-2003, 07:23 AM   #15
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I'm not going to dispute any of the medical evidence being given. I just wanted to put in that I'm a circumcised male and I've never felt robbed or mutilated. And now that I know the procedure for cleaning under the foreskin I'm glad I don't have to bother with it.
This is a matter of seconds when you're in the shower. It takes far longer to describe than to do.

Quote:
And my penis is plenty sensitive enough, as I'm reminded whenever I wear zipper jeans without underwear. Ow!
This only echoes my previous post. If you still had your foreskin, it would protect your glans and prevent it from rubbing against the jeans. That's precisely the point of the foreskin: protect the most sensitive parts (glans, inner foreskin) by keeping them inside with only the least sensitive parts (shaft skin, including outer foreskin) being exposed.
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Old 03-14-2003, 07:28 AM   #16
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Originally posted by Godless Dave
I'm not going to dispute any of the medical evidence being given. I just wanted to put in that I'm a circumcised male and I've never felt robbed or mutilated. And now that I know the procedure for cleaning under the foreskin I'm glad I don't have to bother with it. And my penis is plenty sensitive enough, as I'm reminded whenever I wear zipper jeans without underwear. Ow!
This was a common practice when I was a kid, and I agree with Godless Dave.

I've also heard women say they prefer performing oral sex on a circumcised man. Sorry, not trying to be crude, but this is honeslty something I've heard in discussion on several occasions.
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Old 03-14-2003, 07:37 AM   #17
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AIDS 2001 Aug;15 Suppl 4:S15-30 _
Ecological and individual level analysis of risk factors for HIV infection in four urban populations in sub-Saharan Africa with different levels of HIV infection.

Auvert B, Buve A, Ferry B, Carael M, Morison L, Lagarde E, Robinson NJ, Kahindo M, Chege J, Rutenberg N, Musonda R, Laourou M, Akam E; Study Group on the Heterogeneity of HIV Epidemics in African Cities.
INSERM U88, AP-HP, A-Pare, Saint-Maurice, France. bertran.auvert@paris-ouest.univ-paris5.fr
OBJECTIVE: To identify factors that could explain differences in rate of spread of HIV between different regions in sub-Saharan Africa. DESIGN: Cross-sectional study. METHODS: The study took place in two cities with a relatively low HIV prevalence (Cotonou, Benin and Yaounde, Cameroon), and two cities with a high HIV prevalence (Kisumu, Kenya and Ndola, Zambia). In each of these cities, a representative sample was taken of about 1000 men and 1000 women aged 15-49 years. Consenting men and women were interviewed about their socio-demographic background and sexual behaviour; and were tested for HIV, herpes simplex virus type 2 (HSV-2), syphilis, Chlamydia trachomatis and Neisseria gonorrhoea infection, and (women only) Trichomonas vaginalis. Analysis of risk factors for HIV infection was carried out for each city and each sex separately. Adjusted odds ratios (aOR) were obtained by multivariate logistic regression. RESULTS: The prevalence of HIV infection in sexually active men was 3.9% in Cotonou, 4.4% in Yaounde, 21.1% in Kisumu, and 25.4% in Ndola. For women, the corresponding figures were 4.0, 8.4, 31.6 and 35.1%. High-risk sexual behaviour was not more common in the high HIV prevalence cities than in the low HIV prevalence cities, but HSV-2 infection and lack of circumcision were consistently more prevalent in the high HIV prevalence cities than in the low HIV prevalence cities. In multivariate analysis, the association between HIV infection and sexual behavioural factors was variable across the four cities. Syphilis was associated with HIV infection in Ndola in men [aOR = 2.7, 95% confidence interval (CI) = 1.5-4.91 and in women (aOR = 1.7, 95% CI = 1.1-2.6). HSV-2 infection was strongly associated with HIV infection in all four cities and in both sexes (aOR ranging between 4.4 and 8.0). Circumcision had a strong protective effect against the acquisition of HIV by men in Kisumu (aOR = 0.25, 95% CI = 0.12-0.52). In Ndola, no association was found between circumcision and HIV infection but sample sizes were too small to fully adjust for confounding. CONCLUSION: The strong association between HIV and HSV-2 and male circumcision, and the distribution of the risk factors, led us to conclude that differences in efficiency of HIV transmission as mediated by biological factors outweigh differences in sexual behaviour in explaining the variation in rate of spread of HIV between the four cities.

Newborn circumcision decreases incidence and costs of urinary tract infections during the first year of life.

Schoen EJ, Colby CJ, Ray GT.

Departments of Genetics and Pediatrics, Kaiser Permanente Medical Care Program of Northern California, Oakland, CA 94611, USA. edgar.schoen@ncal.kaiperm.org

The study group consisted of a cohort of 28 812 infants delivered during 1996 at KPNC hospitals; of the 14 893 male infants in the group, 9668 64.9% were circumcised. A second cohort of 20 587 infants born in 1997 and monitored for 12 months was analyzed to determine incidence rates...In 1996, total cost of managing UTI in uncircumcised males ($155 628) was 10 times higher than for circumcised males ($15 466) despite the fact that uncircumcised males made up only 35.1% of the male patient base in 1996, reflecting the more frequent occurrence of UTI in uncircumcised males (132 episodes) than in circumcised males (22 episodes), and the larger number of hospital admissions in uncircumcised males (38) than in circumcised males (4). The incidence of UTI in the first year of life was 1:47 (2.15%) in uncircumcised males, 1:455 (.22%) in circumcised males, and 1:49 (2. 05%) in females. The odds ratio of UTI in uncircumcised:circumcised males was 9.1:1. CONCLUSIONS: Newborn circumcision results in a 9. 1-fold decrease in incidence of UTI during the first year of life as well as markedly lower UTI-related medical costs and rate of hospital admissions. Newborn circumcision during the first year of life is, thus, a valuable preventive health measure, particularly in the first 3 months of life, when uncircumcised males are most likely to be hospitalized with severe UTI.


Neonatal circumcision revisited.

Fetus and Newborn Committee, Canadian Paediatric Society.

OBJECTIVE: To assist physicians in providing guidance to parents regarding neonatal circumcision. OPTIONS: Whether to recommend the routine circumcision of newborn male infants. OUTCOMES: Costs and complications of neonatal circumcision, the incidence of urinary tract infections, sexually transmitted diseases and cancer of the penis in circumcised and uncircumcised males, and of cervical cancer in their partners, and the costs of treating these diseases. EVIDENCE: The literature on circumcision was reviewed by the Fetus and Newborn Committee of the Canadian Paediatric Society. During extensive discussion at meetings of the committee over a 24-month period, the strength of the evidence was carefully weighed and the perspective of the committee developed. VALUES: The literature was assessed to determine whether neonatal circumcision improves the health of boys and men and is a cost-effective approach to preventing penile problems and associated urinary tract conditions. Religious and personal values were not included in the assessment. BENEFITS, HARMS AND COSTS: The effect of neonatal circumcision on the incidence of urinary tract infection, sexually transmitted diseases, cancer of the penis, cervical cancer and penile problems; the complications of circumcision; and estimates of the costs of neonatal circumcision and of the treatment of later penile conditions, urinary tract infections and complications of circumcision. RECOMMENDATION: Circumcision of newborns should not be routinely performed. VALIDATION: This recommendation is in keeping with previous statements on neonatal circumcision by the Canadian Paediatric Society and the American Academy of Pediatrics. The statement was reviewed by the Infectious Disease Committee of the Canadian Paediatric Society. The Board of Directors of the Canadian Paediatric Society has reviewed its content and approved it for publication. SPONSOR: This is an official statement of the Canadian Paediatric Society. No external financial support has been received by the Canadian Paediatric Society, or its members, for any portion of the statement's preparation.


Sex Transm Infect 1998 Oct;74(5):368-73 Related Articles,

Male circumcision: assessment of health benefits and risks.

Moses S, Bailey RC, Ronald AR.

Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.

OBJECTIVES: Globally approximately 25% of men are circumcised for religious, cultural, medical, or parental choice reasons. However, controversy surrounds the procedure, and its benefits and risks to health. We review current knowledge of the health benefits and risks associated with male circumcision. METHODS: We have used, where available, previously conducted reviews of the relation between male circumcision and specific outcomes as "benchmarks", and updated them by searching the Medline database for more recent information. RESULTS: There is substantial evidence that circumcision protects males from HIV infection, penile carcinoma, urinary tract infections, and ulcerative sexually transmitted diseases. We could find little scientific evidence of adverse effects on sexual, psychological, or emotional health. Surgical risks associated with circumcision, particularly bleeding, penile injury, and local infection, as well as the consequences of the pain experienced with neonatal circumcision, are valid concerns that require appropriate responses. CONCLUSION: Further analyses of the utility and cost effectiveness of male circumcision as a preventive health measure should, in the light of this information, be research and policy priorities. A decision as to whether to recommend male circumcision in a given society should be based upon an assessment of the risk for and occurrence of the diseases which are associated with the presence of the foreskin, versus the risk of the complications of the procedure. In order for individuals and their families to make an informed decision, they should be provided with the best available evidence regarding the known benefits and risks.

Pediatrics2000 Jan;105(1 Pt 3):246-9

Trade-off analysis of routine newborn circumcision.

Christakis DA, Harvey E, Zerr DM, Feudtner C, Wright JA, Connell FA.

Department of Pediatrics, University of Washington, Seattle, USA. dachris@u.washington.edu

BACKGROUND. The risks associated with newborn circumcision have not been as extensively evaluated as the benefits. OBJECTIVES. The goals of this study were threefold: 1) to derive a population-based complication rate for newborn circumcision; 2) to calculate the number needed to harm for newborn circumcision based on this rate; and 3) to establish trade-offs based on our complication rates and published estimates of the benefits of circumcision including the prevention of urinary tract infections and penile cancer. METHODS. Using the Comprehensive Hospital Abstract Reporting System for Washington State, we retrospectively examined routine newborn circumcisions performed over 9 years (1987-1996). We used International Classification of Diseases, Ninth Revision codes to identify both circumcisions and complications and limited our analyses to children without other surgical procedures performed during their initial birth hospitalization. RESULTS. Of 354, 297 male infants born during the study period, 130,475 (37%) were circumcised during their newborn stay. Overall 287 (.2%) of circumcised children and 33 (.01%) of uncircumcised children had complications potentially associated with circumcision coded as a discharge diagnosis. Based on our findings, a complication can be expected in 1 out every 476 circumcisions. Six urinary tract infections can be prevented for every complication endured and almost 2 complications can be expected for every case of penile cancer prevented. CONCLUSIONS. Circumcision remains a relatively safe procedure. However, for some parents, the risks we report may outweigh the potential benefits. This information may help parents seeking guidance to make an informed decision.

American Journal of Pathology 2002 Sep;161(3):867-73

Susceptibility to human immunodeficiency virus-1 infection of human foreskin and cervical tissue grown in explant culture.

Patterson BK, et. al.
Department of Pediatrics, Division of Infectious Diseases, Children's Memorial Hospital, Chicago.

"Numerous studies have indicated a protective effect of male circumcision against acquisition of human immunodeficiency virus (HIV)-1. We investigated mechanisms responsible for the possible increased HIV-1 susceptibility of human foreskin. Foreskins from eight pediatric and six adult patients with (n = 3) and without (n = 11) histories of sexually transmitted disease were evaluated. Six cervical biopsies from HIV-1-seronegative women were included as controls. CD4(+) T cells, macrophages, and Langerhans' cells (LCs) were quantified using image analysis. Cells expressing HIV-1 co-receptors CCR5 and CXCR4 were quantified using immunofluorescence and image analysis. Foreskin biopsies were infected ex vivo in organotypic culture with HIV-1. HIV-1 DNA copies in foreskin and cervical mucosal tissue were compared and the infected cell phenotype was determined. Foreskin mucosa contained higher mean proportions of CD4(+) T cells (22.4%), macrophages (2.4%), and LCs (11.5%) in adults than in children (4.9%, 0.3%, and 6.2%, respectively) or in cervical mucosa (6.2%, 1.4%, and 1.5%, respectively). The highest proportions of CD4(+) T cells and LCs occurred in patients with a history of infection. Foreskin immune cells expressed predominantly the CCR5 HIV-1 co-receptor. Adult foreskin mucosa had greater susceptibility to infection with HIV(bal) than cervical mucosa or the external surface of foreskin tissue. Circumcision likely reduces risk of HIV-1 acquisition in men by decreasing HIV-1 target cells.

Scand J Urol Nephrol 2000. Etiology of squamous cell carcinoma of the penis. Dillner J, von Krogh G, Horenblas S, Meijer CJ. Microbiology & Tumor Biology Center, Karolinska Institute, Stockholm, Sweden.

...circumcision neonatally, but not after the neonatal period, was associated with a 3-fold decreased risk [of penile carcinoma]...

N Engl J Med. 2002 Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. Castellsague X, Bosch FX, Munoz N, Meijer CJ, Shah KV, de Sanjose S, Eluf-Neto J, Ngelangel CA, Chichareon S, Smith JS, Herrero R, Moreno V, Franceschi S; The International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Servei d'Epidemiologia i Registre del Cancer, Institut Catala d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain.


...After adjustment for...potential confounders, circumcised men were less likely than uncircumcised men to have HPV infection (odds ratio, 0.37...)Monogamous women whose male partners had six or more sexual partners and were circumcised had a lower risk of cervical cancer than women whose partners were uncircumcised (adjusted odds ratio, 0.42)...
:
J Indian Med Assoc 2000 Epidemiology of cancer of the cervix: global and national perspective. Shanta V, Krishnamurthi S, Gajalakshmi CK, Swaminathan R, Ravichandran K. Cancer Institute (WIA), Chennai.


Cancer of the uterine cervix is one of the leading causes of cancer death among women worldwide...Aetiologic association and possible risk factors...are: Sexual and reproductive factors, socio-economic factors (education and income), viruses e.g., herpes simplex virus (HSV), human papillomavirus (HPV), human immunodeficiency virus (HIV) in cervical carcinogenesis and other factors like smoking, diet, oral contraceptives, hormones, etc...ritual circumcision can undoubtedly reduce cervical cancer incidence.
------------------------------------------------------------------------


From Uganda, evidence that circumcision protects against HIV aquisition:
AIDS 2000 Male circumcision and HIV acquisition and transmission: cohort studies in Rakai, Uganda. Rakai Project Team. Gray RH, Kiwanuka N, Quinn TC, Sewankambo NK, Serwadda D, Mangen FW, Lutalo T, Nalugoda F, Kelly R, Meehan M, Chen MZ, Li C, Wawer MJ. Johns Hopkins University, School of Hygiene and Public Health, Department of Population and Family Health Sciences.



...Prepubertal circumcision significantly reduced HIV acquisition (RR 0.49, CI 0.26-0.82), but postpubertal circumcision did not. In discordant couples with HIV-negative men, no serconversions occurred in 50 circumcised men, whereas HIV acquisition was 16.7 per 100 py in uncircumcised men (P = 0.004). In couples with HIV-positive men, HIV transmission was significantly reduced in circumcised men with HIV viral loads less than 50000 copies/ml (P = 0.02)...
Pediatr Nephrol 2001 Circumcision for the prevention of significant bacteriuria in boys. Nayir A. Department of Pediatrics, Pediatric Nephrology Division, Istanbul Faculty of Medicine, University of Istanbul, Tarik Zafer Tunaya sok 2/6, Gumussuyu-Istanbul, 80040 Turkey.

...Among the uncircumcised patients, symptomatic UTI was observed in 6 cases..., whereas after circumcision no patient had symptomatic UTI. No complication due to circumcision occurred in any patient...The present study indicated that circumcision in boys decreases the rate of positive urine cultures. Therefore circumcision could be considered as a part of UTI therapy.


Sex Transm Infect 2001 Risk factors for active syphilis and TPHA seroconversion in a rural African population. Todd J, Munguti K, Grosskurth H, Mngara J, Changalucha J, Mayaud P, Mosha F, Gavyole A, Mabey D, Hayes R. National Institute for Medical Research, Mwanza, Tanzania.


...Among men, prevalence was associated with lack of circumcision (OR=1.89)...

Sex Transm Infect 2000 Circumcision and STD in the United States: cross sectional and cohort analyses. Diseker RA 3rd, Peterman TA, Kamb ML, Kent C, Zenilman JM, Douglas JM Jr, Rhodes F, Iatesta M. Kaiser Permanente Research Department, Nine Piedmont Center, 3495 Piedmont Road, NE, Atlanta, GA 30305-1736, USA.

...Uncircumcised men were significantly more likely than circumcised men to have gonorrhoea in the multivariate analyses (odds ratio 1.3) and in the cohort analysis (OR, 1.6).


Sex Transm Infect 1998 Oct;74(5):368-73
Male circumcision: assessment of health benefits and risks.
Moses S, Bailey RC, Ronald AR.
Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.
OBJECTIVES: Globally approximately 25% of men are circumcised for religious, cultural, medical, or parental choice reasons...There is substantial evidence that circumcision protects males from HIV infection, penile carcinoma, urinary tract infections, and ulcerative sexually transmitted diseases. We could find little scientific evidence of adverse effects on sexual, psychological, or emotional health. Surgical risks associated with circumcision, particularly bleeding, penile injury, and local infection, as well as the consequences of the pain experienced with neonatal circumcision, are valid concerns that require appropriate responses.

Urol Clin North Am 1995 Feb;22(1):57-65

Neonatal circumcision.
Niku SD, Stock JA, Kaplan GW.
Division of Urology, University of California, San Diego Medical Center.
Circumcision remains the most common operation performed in males in the United States. When performed by an experienced operator, circumcision is usually a safe and simple operation. The medical benefits of circumcision appear to exceed the risks of the procedure.

Pediatrics 1999 Mar;103(3):686-93
Circumcision policy statement. American Academy of Pediatrics. Task Force on Circumcision.

Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided.
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Old 03-14-2003, 07:02 PM   #18
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Default Medical vs ethical

I find medical arguments that appear to advocate removal of natural healthy tissue to be entirely irrelevant, for the simple fact that we don't put any other body part under this kind of intense scrutiny.

So, a few questions. Why does the foreskin get this special attention? Why do we need to find "medical" excuses to cut it off, when we would never consider for a moment cutting off any other natural functional tissue, when we are disgusted by the idea of cutting something off a baby girl's genitals just because it might reduce the chance she'll get a rare cancer when she's 60 years old, or an easily treatable urinary tract infection?

Is it okay to trade the special sensitivity and important functions of the foreskin for minor perceived benefits when the owner of the foreskin never consented? Do males without a foreskin consider its value when they consent to having their sons circumcised (how could they know? do they look for information so that their decision is an informed one?). Do they understand how it entirely changes the "engineering" of the penis during sex?
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Old 03-14-2003, 07:40 PM   #19
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you know in these days of frivolous lawsuits,it wouldn't surprise me at all,if some circumsised man happened to sue his parents for millions of $$,for emotional suffering etc for having done this to him as a baby.than people might think twice before considering circumsising their boys.
hey now there's an idea
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Old 03-14-2003, 07:59 PM   #20
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Not to mention suing their doctors for performing damaging cosmetic surgery without their consent.
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