GunnerJ

Please. I only did that once.

Boro Nut

I offer the following as a more obvious study of HIV distribution within circumcised and uncircumcised African populations without actually incurring the expense or risk of travelling in questionable aircraft piloted by persons who's sole qualifications comprise being someone else's nephew and having an attraction to glowing buttons.

Case Study 1 - Circumcised Goatherder :
"Well of course I'm worried about AIDS. Do you think I would have walked 15 miles in this sun in my bare feet to have part of my knob chopped off with a rusty tin opener if I wasn't? Do you think I like having my bell end covered in bluebottles or something? Well OK, it is curiously pleasant, but I'll certainly be trying my best not to contract HIV in future."

Case Study 2 - Uncircumcised Goatherder :
"What's AIDS?"

Boro Nut

PS - Do you think I could get some funding for this sort of thing? I'm sure I could write it up much more quickly and significantly cheaper than the larger universities do.

tronvillain

Oolon: So you wouldn't might having a similar curvature yourself? I'm afraid that your second paragraph doesn't stand, at least from my perspective

Anunnaki

Has anyone seen the HBO America Undercover special about the Army of God and other anti abortion freaks who openly admit they will do whatever it takes to stop doctors from performing abortions?

Well anyway, one of the Army of God freaks HBO interviewed was a guy who found Jesus while in prison. He claims that God told him to circumcise HIMSELF while in his cell with a piece of a razor blade. The guy actually did it and said that "God steadied my hand" while he sliced it off!!!! <img src="graemlins/banghead.gif" border="0" alt="[Bang Head]" />

[ February 15, 2002: Message edited by: Anunnaki ]</p>

Baloo

Tronvillian, Frogsmoocher, et al, please tell me who on this board is arguing FOR circumcision without anesthesia? Because whoever that person is, you are really kicking his/her ass. Way to go! <img src="graemlins/notworthy.gif" border="0" alt="[Not Worthy]" />
(I mean, seriously, when people make pro-abortion arguments, is it reasonable to assume by default they are arguing for back-alley procedures involving clothes hangars, and argue against abortion by pointing out the barbaric nature of such conditions? If you were considering an appendectomy for a daughter, would you stop to factor in how much it would hurt if she were not anesthetized? Would you factor in pictures, sound clips, and videos demonstrating how excruciating it would be, without anesthesia? )

I mean, it really seems to me that many people here are letting appeals to emotion rule a debate. And honestly, on the "Science and Skepticism" thread of a freethought discussion board, you really hurt your own case more than anything.

In a similar vein, there is another issue which is really interfering here: the notion that the decision for circumcision is the right of the child. In a nutshell, it is always the responsibility and right of the parent (or legal guardian) to make the final medical decisions on behalf of their children. And if a parent makes an informed decision that, statistically, the benefits of a medical procedure are likely to exceed the detriments, then they have every right to decide to have their child undergo that procedure.


Anyway, if you remove the emotionally biased fluff, it looks like the decision for ANESTHETIZED circumcision is not nearly so black and white as some would have us think. In a nutshell, we're talking about subjecting an infant to a minor surgical operation (with complications occuring between 0.2 and 0.6% of the time, and the majority of these "complications" being very mild occurances of bleeding, bruising, or swelling) in order to
1) Greatly reduce the risk (by a magnitude of 10 - 20 times) of the extremely uncomfortable, often painful, experience of getting a first-year UTI; an experience that usually requires a hospital visit, an intrusive examination, and medications that may cause further complications, and possibly even death.
2) Slightly reduce the risk of certain potentially deadly cancers.

Do these medical benefits outweigh the trauma of minor surgery? Hard to say, as I yet to see any numbers which reflect any sort of long-term detriments due to modern anesthetized circumcisions. But it appears that the "trauma" of this operation is: a little crying during the set-up (not much different than the nervous crying during the first diaper-changing); a little prick of a needle, nervous fidgetting during the operation; and probably a day of slight soreness afterwards.

Anyway, medical benefits aside, it appears that there is no expected decrease in sexual activity, and actually an expected increase in the richness of sex life (i.e. increased variety of sexual acts). I have seen nothing that convinces me that circumsized males enjoy sex more than their counterparts (or vice versa); granted, it appears women prefer sex with uncircumcized males. There is plenty of anecdotal evidence to support the statement that circumcized men struggle with knowing that a part of them is missing; there is plenty of anecdotal evidence to support the statement that uncircumsized boys struggle with being anatomically different than their peers and/or father.

Let me summarize by saying that I think the arguments against circumcision are a little stronger than those for it, but not nearly enough to think of it in the black-and-white terms some of the people here seem to use. Regardless of my ultimate decision (which is still years away) I resent the attitude displayed by some which seems to favor a kneejerk appeal to emotion over a calm analysis of all available data.

Corwin

Increase the risk of UTI's during the first year of life by a factor of even 20 and it's STILL miniscule.

We've posted a fair number of links to not only anecdotal evidence but established studies linking circumcision to a marked decrease in sexual sensitivity, as well as a number of potential complications. (The .2 to .6% number is for serious complications... malformities, such as a severe bend due to an improperly done circ generally aren't factored into this. They aren't considered 'complications' in spite of the fact that if you'd just leave things as they were it wouldn't happen...)

I will restate... whether or not the procedure uses anesthesia is irrelevant. Would you support a right for a parent to surgically remove their baby's outer ears with no medical justification? How about preemptive masectomies? How about preemptive castration? After all... people did it regularly thousands of years ago... (eunuchs had pretty much gauranteed employment... it was a good thing...) and you don't really NEED testicles. There will be enough people who don't get the procedure done to keep the species going... and testicular cancer is frequently fatal.

This is nothing at all like an appendicitis. That's something that's done to deal with a life threatening infection, not a perfectly normal and functional body part. The right of parental choice in medical procedures is NOT absolute. We had a few members of an odd christian sect in Oregon some years ago that discovered this the hard way.... (they made the choice to heal their daughter through prayer, and refuse conventional medical treatment.) They're in jail now.... because their daughter died as a result of their choice. Welcome to life. A parent is expected to make choices for their childs welfare, but not all choices are allowable by society. In addition parents are expected to make informed, rational choices for their children. The information most parents get about circumcision is so heavily biased and frequently completely untrue that they can hardly be expected to make an informed choice. (And there have been some reports of children just being circumcised. The doctor just assumed that the parents would want it done... personally in my opinion any such doctor should lose his license and face stiff penalties...) There are still parents making this decision based on the 'studies' that seemed to show a lower rate of cervical cancer with uncircumcised men... (of course they never mention numbers.... nor do they mention how questionable the procedures of this study were...) As well... decisions are frequently based on principles that if it were the parent talking about any other procedure on themselves the doctor would ask 'Are you INSANE?' and refuse to perform the procedure. (See the cutting the ears off argument...)

We aren't making the 'back alley abortion' argument here. Quite the opposite in fact... complications occur regardless of the conditions that the procedure is performed in, and when it comes down to it the desired effect of circumcision is something most of us would consider to be a severe complication. (Keratinization of the glans, lessened sensitivity, decreased sexual response, etc.) When it comes down to it, you must ask 'why do this?' Several reasons have been suggested, every one except 'because I fucking well feel like having it done' have been shot down. Which of course would be all well and good....

If it were your penis.

Undercurrent

People don't typically do abortions without anaesthetic. Children are often circumcised without anaesthetic. Granted that using anaesthetic makes circumcision a less vicious procedure.

Now whose being emotional. The incedence of UTI in boys in the first ten years is about 1% and is usually treated by antibotics (ironically, the risk is greater amoung girls.) The risk of complications and death due to a UTI is at least as negligable as the chance of complications from circumcision, yet your writing makes it seem like uncircumcised children are dying en masse from fatal UTIs. cite: <a href="http://my.webmd.com/content/article/1680.52727" target="_blank">webMD</a>

Sure circumcision "greatly reduces" the incedence of this problem, but it "greatly reduces" from less than 1% to much less than 1%.

Reposting the same quote that you missed earlier in this thread:

If you don't want your child to get penile cancer, make sure they don't smoke, it's a much greater risk factor.

Of all of the supposed medical benefits I've heard expounded, the UTI one is by far the best, and I don't know about you, but it strikes me as being at best on par with the risks of circumcision complication. And for any other proposed operation, if the risk of the operation is not greatly exceeded by the benefits, we don't do it (or we be honest and call it cosmetic surgery.)

m.

tronvillain

Baloo, you cannot compare circumcision without anaesthesia to abortion with a coathanger or an appendectomy without anaesthesia, for the simple fact that it is commonly done and they are not. I am not opposed to circumcision because it is often performed without anaesthetic - I was simply irritated by your dismissal of the fact.

While it is true that it is the responsibility and right of the parent (or legal guardian) to make medical decisions on behalf of their children, they are limited in those decisions. After all, parents do not have the right to decide to have the genitals of their daughters mutilated. Why they should be permitted that right when it comes to the genitals of their sons when the justificaitons for it are so flimsy is beyond me.

Decreased incidence of urinary tract infections and penile cancers were reasons put forward to justify a practice that was already taking place.

<a href="http://www.cirp.org/library/disease/UTI/" target="_blank">Circumcision and urinary tract infection</a>

<a href="http://circquotes.tilted.com/utireport.html" target="_blank">UTI Report</a>

<a href="http://www.cirp.org/library/disease/cancer/" target="_blank">Penile cancer, cervical cancer, and circumcision</a>

<a href="http://www.fathermag.com/health/circ/acs/" target="_blank">Letter From the American Cancer Society</a>

<a href="http://www.circumstitions.com/Cancer.html" target="_blank">Circumcision and Cancer</a>

<a href="http://dmoz.org/Health/Child_Health/Circumcision/Articles/Medical_Journals/" target="_blank">Circumcision Articles</a>

You mentioned this study earlier:
What you didn't address is the explanation for this difference: circumsized men do not experience the same level of stimulation that uncircumsized men do. Masturbation, oral sex, and anal sex provide increased levels of pressure and friction over vaginal sex, so circumsized men seek them out more often to compensate for being desensitized - this is not "increased richness of sex life" as you described it.

It's pathetic that this discussion is still going on.

[ February 15, 2002: Message edited by: tronvillain ]</p>

Dr Rick

NEJM Volume 342:921-929 March 30, 2000 Number 13
Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1
Thomas C. Quinn, M.D., Maria J. Wawer, M.D., Nelson Sewankambo, M.B., David Serwadda, M.B., Chuanjun Li, M.D., Fred Wabwire-Mangen, Ph.D., Mary O. Meehan, B.S., Thomas Lutalo, M.A., Ronald H. Gray, M.D., for The Rakai Project Study Group

"...In a community-based study of 15,127 persons in a rural district of Uganda, we identified 415 couples in which one partner was HIV-1–positive and one was initially HIV-1–negative and followed them prospectively for up to 30 months...The incidence of seroconversion was...16.7 per 100 person-years among 137 uncircumcised male partners, whereas there were no seroconversions among the 50 circumcised male partners (P&lt;0.001). emphasis added"

[ February 15, 2002: Message edited by: rbochnermd ]</p>

Dr Rick

NEJM Volume 336:1244-1245 April 24, 1997 Number 17 Editorial
Circumcision Circumspection Thomas E. Wiswell, M.D. Thomas Jefferson University
Philadelphia, PA 19107

"...At least 1.2 million to 1.8 million newborn boys (60 to 90 percent) are circumcised annually in the United States. Until the mid-1980s, it was believed that the procedure had few, if any, health-related merits.

Subsequently, however, numerous studies delineating medical advantages of circumcision have appeared.

Specifically, there is substantial evidence of the following benefits. Pathologic phimosis (in contrast to the normal state in infancy, when the prepuce is nonretractile) and paraphimosis cannot occur unless there is a foreskin. Inflammation of the glans penis (balanitis) and prepuce (posthitis) are extremely painful, and they primarily affect uncircumcised males. Chronic or recurrent balanoposthitis may result in scarring and secondary phimosis.

...Another benefit is a reduction in urinary tract infections. A meta-analysis of nine published reports showed that the risk of such infection is 12 times as high among uncircumcised male infants as among circumcised infants.6 A high proportion of infants with urinary tract infections have concomitant bacteremia, and renal scarring and its sequelae are not uncommon...Female partners of uncircumcised men are more likely to contract cervical cancer. Human papillomaviruses are implicated in the pathogenesis of both cancers. Lastly, virtually every sexually transmitted disease is more common in uncircumcised men, and the risk of human immunodeficiency virus infection is greater.[emphasis added]...It has been suggested that lifelong hygiene of the uncircumcised penis will prevent many of the above-mentioned disorders. To date, however, there is no evidence that optimal attention to genital cleansing confers such protection[emphasis added].

Clinical and neurologic testing has not detected differences in penile sensitivity between men who were circumcised and those who were not.

...For an experienced operator, the circumcision of a neonate is a low-risk procedure.2,5 The most common complications are easily treatable local infections and bleeding, which both occur after 0.1 to 1 percent of procedures. Most complications of circumcision can be traced to poor technique or inexperience."

</strong>

"Furthermore, circumcision reduces the risk of penile cancer. In uncircumcised men, the lifetime risk of this cancer is about 1 in 500, as compared with a risk of 1 in 50,000 to 1 in 12 million in circumcised men....Over the past 45 years, four deaths of neonates have been attributed to circumcision. During the same period, more than 11,000 uncircumcised men died from penile cancer. [emphasis added]

Despite the increasing evidence linking circumcision with health-related benefits, opposition to the procedure persists.10 (At least part of the opposition is based on the supposition that physicians do not think the procedure causes pain and do not use analgesia.) The extent to which parents are affected by what they hear about the medical aspects of the procedure is uncertain, because most parents make the decision about circumcising their sons for nonmedical reasons. However the decision is made, physicians need to be cognizant of the current scientific literature on the topic so that they can counsel parents objectively."

1. Taddio A, Stevens B, Craig K, et al. Efficacy and safety of lidocaine-prilocaine cream for pain during circumcision. N Engl J Med 1997;336:1197-1201.
2. Wiswell TE. Neonatal circumcision: a current appraisal. Focus Opin Pediatr 1995;1:93-9.
3. Fontaine P, Toffler WL. Dorsal penile nerve block for newborn circumcision. Am Fam Physician 1991;43:1327-1333.
4. Anand KJS, Hickey PR. Pain and its effects in the human neonate and fetus. N Engl J Med 1987;317:1321-1329.[Medline]
5. Report of the Task Force on Circumcision. Pediatrics 1989;84:388-391. [Erratum, Pediatrics 1989;84:761.][Abstract]
6. Wiswell TE, Hachey WE. Urinary tract infections and the uncircumcised state: an update. Clin Pediatr (Bologna) 1993;32:130-134.
7. Schoen EJ. The relationship between circumcision and cancer of the penis. CA Cancer J Clin 1991;41:306-309.[Medline]
8. Cook LS, Koutsky LA, Holmes KK. Circumcision and sexually transmitted diseases. Am J Public Health 1994;84:197-201.[Abstract]
9. Moses S, Plummer FA, Bradley JE, Ndinya-Achola JO, Nagelkerke NJ, Ronald AR. The association between lack of male circumcision and risk for HIV infection: a review of the epidemiological data. Sex Transm Dis 1994;21:201-210.[Medline]
10. Ciesielski-Carlucci C, Milliken N, Cohen NH. Determinants of de-cision making for circumcision. Camb Q Healthc Ethics 1996;5:228-236.[Medline]

This article has been cited by other articles:

* Schoen, E. J., Oehrli, M., Machin, G. (2000). The Highly Protective Effect of Newborn Circumcision Against Invasive Penile Cancer. Pediatrics 105: 36e-36  
* Schoen, E. J., Colby, C. J., Ray, G. T. (2000). Newborn Circumcision Decreases Incidence and Costs of Urinary Tract Infections During the First Year of Life. Pediatrics 105: 789-793

[ February 15, 2002: Message edited by: rbochnermd ]</p>