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MOMS & DADS TALK: Circumcision Gets Controversial

Is this only a personal choice for parents?

I recently caught wind of a on the Lutherville-Timonium Patch. It began with the story of a mother who opted not to circumcise her two boys, only to be plagued by issues, which required their youngest to have the procedure performed as a toddler.

When my husband and I asked our obstetrician and pediatrician about circumcision, neither offered a definitive medical recommendation. While they provided pros and cons, they ultimately declared it “a personal choice.”

Both sides of the case seem to have merit—perhaps because there is no right answer? As a parent, we love our children and want to do what is best for them on all accounts. When we make a decision, we tend to stand firm and hold our ground.  But I wonder, if there were a clear medical answer, instead of just research and recommendations, would it be such a highly debated issue?

What do you think? Why is circumcision so controversial? Is this only "a personal choice" for parents?

Jakew March 05, 2011 at 09:22 PM
People have to make decisions based upon incomplete data all the time. Very few things in life are certain. We just use the best information available to us.
Craig Ginsberg March 05, 2011 at 09:27 PM
referring to my references above The foreskin, like the eyelid, also serves an important protective and hygienic function. The foreskin protects the delicate glans of the penis and puts the urethra at a distance form its environment protecting it from foreign contaminants of all kinds. While simultaneously shielding the penis from injury.It is a double fold of skin which offers two layers of protection. Natural secretions of oil are achieved by sebaceous glands which are abound in the foreskins inner lining, these are not present in the glans. [1] They are also present in the eye lid and perform the same function in both places. They secrete the oils necessary to keep the glans surface soft, moist, warm, sensitive, and with a healthy red or purple color. This moisturizer keeps the surface of the glans glistening, smooth, soft, maintained PH balance, and optimal cleanliness. This is required to keep the surface of the glans healthy and clean via the cleaning effects of mucous secretions. This function is analogous to the eye lid. The glans are meant to be an internal organ covered and protected from the outside world.
Craig Ginsberg March 05, 2011 at 09:27 PM
In the genitally intact penis the urine stream flushes out the urethra and foreskin of foreign microbes. In healthy individuals, urine is sterile and has a disinfectant quality. Researchers have demonstrated that the swirling action of urine as it rushes through the foreskin flushes it out effortlessly and naturally. [2] Though urine passes through the foreskin every day, the inner foreskin is remarkably free of urea-a by-product of liver metabolism that is secreted in urine. Studies demonstrate that washings from the foreskin are rich in fructose, acid phosphatase, and mucin, but never urea. It appears that the secretions of seminal vesicles, prostate, and urethral mucous glands, collectively or individually, keep the foreskin clear and clean as well. [3] At birth, the foreskin is usually attached to the glans(head) of the penis, akin to how a fingernail is attached to a finger. [4] At infancy the foreskins tubular neck(prepucial orifice) is often long and narrow while the sphincter muscle in the tip of the foreskin keeps its opening closed. This acts as an extension of the urethra. [5] [6] Together these property's prevent the entry of contaminants. The idea that the foreskin is "dirty" or "unclean" is a scientifically unfounded superstition.The intact penis is naturally clean and maintains a level of hygiene that is optimal when compared to a penis that has been altered by circumcision.
Craig Ginsberg March 05, 2011 at 09:31 PM
correcting my sentence In infancy, simple sugars in breast milk, like antibacterial oligosaccharides, are acquired from the mothers milk and excreted in urine. University studies have shown that these substances cling to the mucosal lining of the inner foreskin and protect against urinary tract infections [18] , as well as infections in other parts of the body [19]
Craig Ginsberg March 05, 2011 at 09:36 PM
"Apocrine glands are a type of sweat gland, and neither sweat nor sebaceous glands are present." try checking the references i actually used.
Jakew March 05, 2011 at 09:39 PM
"The foreskin, like the eyelid, also serves an important protective and hygienic function. The foreskin protects the delicate glans of the penis and puts the urethra at a distance form its environment protecting it from foreign contaminants of all kinds." -- more to the point, it holds contaminants in a warm, moist sac in close proximity to the urethral meatus. "Natural secretions of oil are achieved by sebaceous glands which are abound in the foreskins inner lining," -- as I pointed out above, these don't exist. You did read my reply, didn't you? "In the genitally intact penis the urine stream flushes out the urethra and foreskin of foreign microbes" -- if that were so, studies that sampled the urethra and glans would consistently find fewer pathogenic bacteria in the uncircumcised male. But the opposite is true (see refs below). "At birth, the foreskin is usually attached to the glans(head) of the penis, akin to how a fingernail is attached to a finger." -- another claim that we've already discussed. (continued)
Jakew March 05, 2011 at 09:39 PM
Serour F, et al. Comparative periurethral bacteriology of uncircumcised and circumcised males. Genitourin Med. 1997 Aug; 73(4): 288-90 Fussell EN, et al. Adherence of bacteria to human foreskins. J Urol. 1988 Nov; 140(5): 997-1001 Wiswell TE, et al. Effect of circumcision status on periurethral bacterial flora during the first year of life. J Pediatr. 1988 Sep; 113(3): 442-6 Glennon J, et al. Circumcision and periurethral carriage of Proteus mirabilis in boys. Arch Dis Child. 1988 May; 63(5): 556-7 Neubert U, Lentze I. The bacterial flora of preputial space. Hautarzt. 1979 Mar;30(3):149-53 Cascio S, et al. Bacterial colonization of the prepuce in boys with vesicoureteral reflux who receive antibiotic prophylaxis. J Pediatr. 2001 Jul; 139(1): 160-2 Savas C, et al. Comparison of preputial sac and urine cultures in healthy children. Int Urol Nephrol. 2000; 32(1): 85-7 Wijesinha SS, et al. Does circumcision alter the periurethral bacterial flora? Pediatr Surg Int. 1998 Mar; 13(2-3): 146-8 Gunsar C, et al. The effect of circumcision status on periurethral and glanular bacterial flora. Urol Int. 2004; 72(3): 212-5. Bhargava RK, Thin RN. Subpreputial carriage of aerobic micro-organisms and balanitis. Br J Vener Dis. 1983 Apr; 59(2): 131-3 Jackson DH, et al. Carriage and transmission of group B streptococci among STD clinic patients. Br J Vener Dis. 1982 Oct; 58(5): 334-7
Stan Barnes March 05, 2011 at 09:47 PM
There are effective, non-invasive methods for treating UTIs in both boys and girls. I find it astonishing that in 2011 some people still try to justify cutting off a normal, healthy part of a child's genitals when there is no compelling reason to do so.
Craig Ginsberg March 05, 2011 at 09:51 PM
how many UTi's do you think one botched circ is worth?
Jakew March 05, 2011 at 09:52 PM
""Apocrine glands are a type of sweat gland, and neither sweat nor sebaceous glands are present." try checking the references i actually used." -- your ref 9 is a case report of problematic apocrine glands affecting the prepuce. It does not indicate whether they were on the inner or outer layer. Ref 10 is unclear, but the abstract does appear to imply that the presence of these glands has at least been claimed. Now, do you have a response to the evidence I cited?
Jakew March 05, 2011 at 09:55 PM
"how many UTi's do you think one botched circ is worth?" -- I think it would depend on the severity of the UTIs and the degree of botching. Are we talking about a severe UTI causing major kidney damage and subsequent problems? Or are we talking about a minor UTI? Are we talking about a circumcision so badly botched that the penis is lost? Or are we talking about a crooked scarline?
Craig Ginsberg March 05, 2011 at 10:10 PM
How did wiswell get his sample? where the babies breast feed? where they pre-mature? Wiswell TE, et al. Effect of circumcision status on periurethral bacterial flora during the first year of life. J Pediatr. 1988 Sep; 113(3): 442-6
Craig Ginsberg March 05, 2011 at 10:16 PM
people dident know study section bias was a co founding factor until the effect of breast milk was studied 19. ↑ Coppa GV, Gabrielli O, Giorgi P, Catassi C, Montanari MP, Veraldo PE, Nichols BL. Preliminary study of breast feeding and bacterial adhesion to uroepithelial cells. Lemcet 1990 Mar 10;335(8689):569-71.
Jakew March 05, 2011 at 10:23 PM
"in 1988 the only intact children in the hospital where premature and un-breast feed Glennon J, et al. Circumcision and periurethral carriage of Proteus mirabilis in boys. Arch Dis Child. 1988 May; 63(5): 556-7" -- in Ireland? Are you serious? "Ectopic sebaceous glands concentrated near the frenulum produce smegma" -- Craig, instead of making the same claims over and over again I really think you ought to address the studies I've already presented, which clearly state that there are no glands in the subpreputial space.
Craig Ginsberg March 05, 2011 at 10:45 PM
we should do rigours studys on weather cutting off noses and ears are "beneficial". We should do study's on how beneficial preemptive breast amputation is. Where are these study's? Why don't they exist? I NEED TO KNOW IN ORDER TO MAKE THE BEST DECISIONS FOR MY CHILD.
Craig Ginsberg March 05, 2011 at 11:25 PM
GreaT! They measured bacterial rates in dead, amputated, chemically treated prepuces inoculated with virulent strains of pathogenic bacteria--conditions that represent no known biological or behavioural reality. That must make fussells findings, good right? Fussell EN, et al. Adherence of bacteria to human foreskins. J Urol. 1988 Nov; 140(5): 997-1001
Craig Ginsberg March 05, 2011 at 11:33 PM
Ectopic sebaceous glands concentrated near the frenulum produce smegma Taylor failed to identify them. http://www.cirp.org/library/disease/STD/fleiss3/ # Delbanco E. Über das gehäufte Aufreten von Talgdrusen an der Innerflähe des Präputium. Monatshefte für praktishe Dermatologie 1904; 38:536-8. # Hyman AB, Brownstein MD. Tyson's "glands," sebaceous glands and papillomatosis penis. Arch Dermatol 1969;99:31-7. # Piccinno R, Carrel C-F, Menni S. et al. sebacous glands mimicking molluscum contagiosum Acta Derm Venerol1990;70:344-5. # Krompecher St. Die Histologie der Absonderung fur Smegma Praeputi. Anatomischer Anzeiger 1932; 75:170-176.
Craig Ginsberg March 05, 2011 at 11:54 PM
here it is "adhesions (25.6%),"(1) (1)Van Howe RS. Variability in penile appearance and penile findings: a prospective study. Br J Urol 1997; 80: 776-782.http://www.cirp.org/library/complications/vanhowe/
Craig Ginsberg March 06, 2011 at 12:04 AM
altho p was not less then 0.05 skin disease that were twice those of uncircumcized males http://www.cirp.org/library/complications/enzenauer1/
Jenny March 06, 2011 at 12:18 AM
Can you shut up Jake, this is a human rights issue and you look so dumb defending baby cutting.
Craig Ginsberg March 06, 2011 at 01:17 AM
in this one(1) The circumcised boys where older and we all know that UTI rate decreases with age in men. they also said "this hardly seems justifiable Bering in mind that the operation is not with out risk." i wonder what the results would be if the stuck the swab in the urethra of circumcised boys. (1)Glennon J, et al. Circumcision and periurethral carriage of Proteus mirabilis in boys. Arch Dis Child. 1988 May; 63(5): 556-7
Hugh7 March 06, 2011 at 01:31 AM
To your original question,- why is there no absolute medical recommendation? - because infant circumcision is not a real medical procedure. There is no other normal, healthy, functional, non-renewable part of the human anatomy that is removed at parental whim with no diagnosis other than "live birth (male)". The medical "reasons" were all found - actually invented - after circumcision was customary. You can see the kind of medical sophistry at work when Jakew starts defending circumcising healthy babies by reference to that small subset of UTIs (already rare at ~1 in 100 boy babies - commner in girls - and treatable) so severe they cause kidney damage, which must be phenomenally rare (and accompanied by neglect). The other thing indicating that circumcision is not just a medical procedure to prevent medical conditions is the VAST number of unconnected and often contradictory reasons for doing it. (See http://www.circumstitions.com/Stitions&refs.html) It is no coincidence that circumcision is a prehistoric modification of the sexual orgains, though many of the reasons now given have ostensibly no connection to sex. Circumcision is a memeplex (a cluster of units of culture, transmitted by imitation). See http://www.circumstitions.com/meme.html But that is only part of the story. The full reason it has such a hold on human culture has yet to be fully explained.
Cyn March 06, 2011 at 01:51 AM
Emily - many people who read his posts don't know where Jake's really coming from. He passes himself off as a valid source for information on this subject and unsuspecting people are clueless as to his underlying motivations - those motivations have *everything* to do with his presence on this page. Readers should be aware of this when they see his comments.
Cyn March 06, 2011 at 01:53 AM
@Jenny - Jake is here for the reasons I've mentioned above.
Cyn March 06, 2011 at 01:55 AM
@Jenny - you are correct, the AAP does NOT recommend routine infant circumcision.
Cyn March 06, 2011 at 01:59 AM
Thanks, Lori. And you're correct - Jake's close association with other circumfetishists and circumfetish groups such as CircList and Gilgal are not 'accusations', they are based on what is already widely known about him.
Cyn March 06, 2011 at 02:00 AM
"This is MY personal choice." It's not YOUR penis. It's not a choice that morally belongs to you.
Cyn March 06, 2011 at 02:02 AM
@psandz - obviously Britain is much smarter than America is on this issue.
Cyn March 06, 2011 at 02:26 AM
Circumcision does not prevent HIV. The claims that it does are often based on the highly flawed African studies. Further info: http://www.doctorsopposingcircumcision.org/info/HIVStatement.html http://www.cirp.org/library/disease/HIV/vanhowe2005a/ http://www.cirp.org/library/disease/HIV/ http://www.circumstitions.com/HIV.html http://findarticles.com/p/articles/mi_6869/is_10_98/ai_n32398719/?tag=content;col1
Cyn March 06, 2011 at 02:32 AM
Complications of circumcision: http://www.circumstitions.com/Complic.html How to identify circumcision damage in the adult male: http://www.noharmm.org/IDcirc.htm Circumcision and psychological harm: http://www.norm-uk.org/circumcision_psychological_effects.html Male genital mutilation in America (warning - graphic video of infants being assaulted): http://www.youtube.com/watch?v=MDuDhkiDdns http://www.youtube.com/watch?v=bXVFFI76ff0 The tragic story of David Reimer: http://www.youtube.com/watch?v=vFMfrBWM7_A

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