Quick! Where did the thread about the "proven medical benefits" go??

[leila1213]

My cousin's wife is a nurse and doesn't know the sex of her baby due in a month. I sent her the Marilyn Milos essay and she said that's not how it's done these days. They do use anesthetic now... and that there have been proven medical benefits to circ (UTIs, STDs, etc). Help! That thread would have helped me immensely!

Also, she says the ped told her that 90% of American boys are circed. Maybe he is talking about existing kids, but I thought the current incidence of circ was closer to 50%.

Aack! I'm totally new at this and not prepared. TIA!

[Fellow Traveler]

This one?

http://www.mothering.com/discussions...d.php?t=913922

Also the % will depend on the area. Some parts of the US are more progressive than other parts.

[glongley]

The bottom line:

1) No medical organization in the world recommends routine neonatal circumcision based on any potential medical benefits.

2) Even if medical benefits exist, neonatal circumcision is not ethically justifiable since the benefits do not outweigh the risks, there are other reasonable ways to obtain the hoped for benefits, and the hoped for benefits are not essential to the well-being of the child.

See the following brochure for a summary of excerpts from medical organization position statements (with urls to the full statements for her to read herself), and a summary of the ethical issues in re: medical justifications for circumcision.

http://www.coloradonocirc.org/files/...Statements.pdf

HTH

Gillian

[perspective]

Originally Posted by leila1213

I thought the current incidence of circ was closer to 50%.

Your right, the current national average % for newborn boys circed is something like 55%. 90's% is WAY OFF!

Also there is this comprehensive list that debunks many of the reasons people think circ is good (backed up with sources)
http://www.mothering.com/discussions...d.php?t=913922


This is a very extensive and well reseached study that shows men with foreskins have little difference in their rate of STI infection.
http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract

Here is a link to a post from the forum that links to the new report that sheds a lot of doubt on many of the "spotlighted" studies in the media that say circumcision is a way reduce AIDS infection.
http://www.mothering.com/discussions...4#post11157324


Finally here is a article from the site "Doctors Opposing Circumcision" that talks about the higher risks circed boys face for catching super bugs.
http://www.doctorsopposingcircumcisi.../DOC/mrsa.html

[leila1213]

Thanks!

[Claire and Boys]

Some links I collected

http://www.cirp.org/news/doctorsguid...tch2006-08-17/
Study of African countries in 2003-2005 shows HIV infection rates not necessarily lower in areas where circumcision is prevalent.

"HIV prevalence was markedly lower among circumcised than uncircumcised men only in Kenya (11.5% among uncircumcised men vs. 3.1% among circumcised men). A small protective effect of male circumcision was also seen in Burkina Faso (2.9% vs. 1.7%, respectively) and Uganda (5.5% vs. 3.7%).

In the other countries, there was either no difference in HIV rates between circumcised and uncircumcised men or circumcised men were more likely to be HIV-positive than uncircumcised men. For example, in Lesotho, HIV was seen in 23.4% of circumcised men compared to 15.4% of uncircumcised men.

"If anything, the correlation [between circumcision and HIV infection] goes the other way," in most of the countries studied, Dr. Mishra said during his presentation on August 15th."

http://www.cirp.org/news/iht2007-03-06/
Procedure may put women at a higher risk of infection.

"Among 70 men with HIV who underwent circumcision, 11 of their female partners became infected with the virus in the month after the surgery. In contrast, only four partners of 54 uncircumcised men with HIV in the control group caught the virus — nearly half the rate, early results showed."

http://www.sciencedaily.com/releases...0620085239.htm
Links prostitution with HIV infection, not circumcision

http://www.ncbi.nlm.nih.gov/sites/en..._uids=17334373
Langerhans cells a natural barrier to HIV transmission

http://www.nature.com/nm/journal/v13/n3/abs/nm1541.html
Langerin found in Langerhans cells is a natural barrier to HIV transmission

http://www.ias-2005.org/planner/abstracts.aspx?aid=3138
Study shows lower risk of HIV in circumcised females. Does that mean it's ok to circ them too?




Sexual Function

http://www.medicalnewstoday.com/articles/69318.php
"This study suggests that adult circumcision adversely affects sexual function in a significant number of men, and the authors suggest that it may be due to loss of nerve endings in the removed skin."

Study shows circed penis is less sensitive
http://www.urotoday.com/58/browse_ca...ult_penis.html

Risks

Infection
http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum
http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum


Circ may cause UTI
http://www.ncbi.nlm.nih.gov/sites/en...t=AbstractPlus

HPV
http://www.ncbi.nlm.nih.gov/sites/en...RVAbstractPlus

Penile Cancer on circumcision scar
http://www.ncbi.nlm.nih.gov/sites/en...t_uids=3944860
http://www.ajsp.com/pt/re/ajsp/abstr...195629!8091!-1


STDs

No link found with circumcision and prevention of STDs.
http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract
http://highwire.stanford.edu/cgi/medline/pmid;16925903
http://www.cirp.org/library/general/dave1/

[Fellow Traveler]

You might want to point out that there is nothing lost leaving a boy intact, if he wishes to be circumcised it can be done later though most intact guys would never choose it.

[DocsNemesis]

I wanted to add that YES IT IS STILL DONE THIS WAY!!! Doctors will straight up LIE to the parents and not use any anesthesia. Most of the time parents dont go with the baby to watch it done so they have no way of knowing. But even when they are there, yeah....my friend was there for her sons and was told he gave them *oral anesthesia.* When I told her that was crap, she checked their records and they were given TYLENOL. Yeah, real great anesthesia....

I've also seen a few and they've never used pain meds. I mean, that makes it take longer right, so why bother? Not like the patient is going to tell on them (ie the baby). Regardless, the real pain meds hurt just as bad to administer and once it wears off, they still have all that pain. They also dont know if it works or not before they do it-just like in some adults, it wont numb at all or wont numb it completely. How about letting HIM decide...ugh, I hate some people...:endrant

[leila1213]

She sent me this link saying it "provides evidence based research without bias or emotional involvement": http://www.emedicine.com/ped/TOPIC1791.HTM

It is going to be really hard for me to read/dissect this with my heart pounding in my ears.

She said she attended one circ in nursing school and the baby didn't "even" cry. I am assuming she means "at all", and not "cried a little and passed out". She thought it odd. They had been prepared for crying and pain. Anesthetic wasn't used at all, and they used the plastibell method.

...How could you see this done in person and not feel one way or another on having it done to your child!? She says her and her husband have not discussed it or thought about it much at all. I don't get it.

She said pediatricians now use local anesthetic now, so I am sending her an email stating what DocsNemesis said about still not using pain meds. But isn't it mostly OBs performing the procedure?

I also added the comment about leaving him intact to decide for himself whether he wants it done. I said that this almost never happens, and in fact, most boys are usually horrified when they find out the details later on. Is this a good point to make? Should I say this counts for a lot of circ'ed men as well?

I am also hesitating to use the term "cut". I fear that it will "expose" me as being part of the whole extremist intactivist (biased) circle. Is this crazy to think?

Wow, this is difficult. I'm working up a sweat. I need to go check out the website now.

[Claire and Boys]

Well, I just read it. It says at the very end:

The most relevant ethical questions regarding circumcision refer to the decision by parents to allow or request an operation that only has marginal proven health benefits and results in permanent physical alteration of the child at a time when the child has no input in the decision-making process.

That really says it all. MARGINAL.

Then you've got the list of risks.

Several complications are associated with neonatal circumcision.
Complications can be minimized if an experienced practitioner performs the circumcision.

Bleeding is the most common early complication and usually is adequately controlled with local hemostatic measures, such as pressure dressings. On occasion, the patient must be taken back to the operating room for surgical hemostasis and hematoma evacuation.

Infection is the second most common early postoperative complication, but usually is minor and easily managed with oral and topical antibiotics.

The most common long-term complication seen after circumcision is meatal stenosis.

Other complications described in isolated case reports include the following:
Recurrent phimosis

Wound separation

Penile torsion

Concealed penis

Unsatisfactory cosmesis

Skin bridges

Urinary retention

Meatitis

Skin chordee (due to removal of excessive skin)

Inclusion cysts

Retained Plastibell devices

Other case reports have mentioned rare events such as scalded skin syndrome, necrotizing fasciitis, sepsis, meningitis, urethral fistula, penile necrosis, and amputation of a portion of the glans penis.

Worth it, for marginal health benefits?

[Fellow Traveler]

Originally Posted by leila1213

She sent me this link saying it "provides evidence based research without bias or emotional involvement": http://www.emedicine.com/ped/TOPIC1791.HTM

It is going to be really hard for me to read/dissect this with my heart pounding in my ears.

Send her this:
http://www.racp.edu.au/download.cfm?...36DF59A1BAF527

The Australian's were nice enough to break it down pretty well.

http://www.abc.net.au/news/stories/2...09/2113665.htm

[SleeplessMommy]

An acquaintance circed twin boys about 7 years ago. They were given sugar water, which the doctor claimed was an anesthetic.

I would emphasize:
1) risk of MRSA type infection
2) risk of maternal regret - newborn is a precious, delicate, perfect creature. Why do cosmetic surgery at 3 days old?

[Fellow Traveler]

A few things you might want to point out in your next discussion or email rather. First thing is first. I agree with Clair. I think it is important to point her to the following in her piece:

The most relevant ethical questions regarding circumcision refer to the decision by parents to allow or request an operation that only has marginal proven health benefits and results in permanent physical alteration of the child at a time when the child has no input in the decision-making process.

And that is really the crux of the issue. Presented anyway you like but if you think she can handle it you might want to ask something along the lines of would she have a part of her body surgically removed to prevent a problem that was very rare or easily avoidable and if it did occur was easily treatable anyway?

For example, her paper makes a big deal of the UTI. Compare that with what the RACP has to say. Why would one choose a surgical operation (and all the possible complications that go with it) on the off chance it might prevent a UTI that can be treated? As an adult, when presented with two possible treatment options does she go for the most or least invasive?

Also the cancer/HPV thing is irrelevant for two reasons first it is exceedingly rare and second we can vaccinate for that now too. (Though I know some of you don't vaccinate). It's the same deal if the doctor sat me down at 11 or 12 or 13 and said:

We'd like to increase your resistance from HPV would you like the vaccine or the circumcision?

That would be a no brainier for me. (I know that some would choose neither but I am just illustrating the point of choosing the least invasive means.)

STDs are a similar thing if your friend want to read the latest she can go here: http://www.cirp.org/library/disease/STD/dickson2008/

Also, I would back of the pain of the operation. While I think it is a compelling reason not to do it I don't think it is the best argument. Managing the pain doesn't make it an ethical practice.

[tennisdude23]

Here is some common sense. If it would be so beneficial, I think much of the rest of the world would do it. But they don't. This tells you something. 90% does not correspond to any known statistic. Even the total population in the US of circumcised males is not 90%, more like 75% perhaps, if not lower. The current rate is about 55%, give or take. In any case, the rates have fallen dramatically over the past 30 years. I and quite a few of my friends are not cut (late 80s generation). Most importantly, nobody should choose useless life altering procedures for anyone without their consent. I think this is the most important point, which you have to keep underlining. Make sure you ask, why would you cut off a part of somebody's penis? The thought in itself just sounds wrong!

[leila1213]

The ped did say that 90% of the world is intact, and she took notice of that. We'll see what she says after reading my links! Thanks everyone.

[leila1213]

OMG! I just found out that another cousin's wife is pregnant (same family as this one). She is an L&D nurse and had a scheduled C/S with her 2 yo who they circ'ed! She is due in October and they also don't find out the sex of the baby before it is born!! I don't know if I can take any more of this. I am going to need counseling...

[tennisdude23]

Originally Posted by leila1213

The ped did say that 90% of the world is intact, and she took notice of that. We'll see what she says after reading my links! Thanks everyone.

Ok, 90% for the world is just a little high. In any case, the ped. should look up the statistics better.

[DocsNemesis]

OB's do do the majority of circ's, but I've also talked to peds and seen circ's performed by them with no pain meds. And I've seen the sugar water thing too.

I think she's full of it tbh. Unless the baby had some serious issue to begin with, there is just no way that it wouldnt react at all. I mean, its the most sensitive part of the body-I bet she'd be crying if they cut off part of her labia or her foreskin. Even the one time I saw it done WITH a real anesthetic (which is done with a needle into the base of his penis....ow??) he still screamed his head off. That crap stings!!! Anyway...

I can tell you right now, my intact 8 year old son has NEVER had a UTI, while my dd has. And if he got one, we'd treat it the same way as I treated my dd, with antibiotics, cranberry juice, and lots of water. And I can also tell you that if you asked my son if he'd want to be circ'd, even at 8, he'd think you were nuts. My intact brother in laws feel the same way-they are quite happy they were left as is and also, have never had a UTI. My circ'd dh has had numerous though, so yeah, that argument goes out the window for me right there!

I'd tell her if she wants to get her son circ'd so bad, she should go in and have it done too. I mean, in other countries, the same benefits we state for boys are made for girls.

[leila1213]

Originally Posted by DocsNemesis

I'd tell her if she wants to get her son circ'd so bad, she should go in and have it done too. I mean, in other countries, the same benefits we state for boys are made for girls.

Ooh, do you have any links? That would be great if I could say, "see, the same benefits would apply to circ for girls, so you can go ahead and schedule the surgery and either way (boy or girl), you will be covered!"

[PuppyFluffer]

I have not read the whole thread...but I will tell you that I have a friend who is a nurse who hates circ. She said that even when injectable anesthetic is used, the doctors say "let's get this over with" and start cutting and probing WITHOUT waiting for the anesthetic to take effect. Nice- get the pain of the anesthetic injection and the medication (lidocaine stings like hell at first!) then get no benefit of it! It's horrendous!