Frequency of adult male circumcisions? - Mothering Forums

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#1 of 29 Old 01-29-2011, 04:12 PM - Thread Starter
 
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#2 of 29 Old 01-29-2011, 05:40 PM
 
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Many Dr will make up a "need" in order to get insurance to pay for an elective circ.  Adult men may wish to be circ for a variety of reasons.  

 

The other reason would be that many medical reasons for circ could be be treated with less drastic measures, but Dr don't bother to try those first.  A circ is a very quick and easy relatively low risk procedure, which is quite profitable.  For example, phimosis is easily treated with a steroid cream, similar to what get prescribed for eczema.

 

We don't do any other surgical procedure at birth just b/c it might be necessary when the baby is an adult.  I'm sure your mom sees at least twice as many appendectomies being billed for, but no one suggest doing an appendectomy at birth just to prevent it later.


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#3 of 29 Old 01-29-2011, 05:48 PM
 
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We don't do any other surgical procedure at birth just b/c it might be necessary when the baby is an adult.  I'm sure your mom sees at least twice as many appendectomies being billed for, but no one suggest doing an appendectomy at birth just to prevent it later.


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In Canada one in nine women will develop breast cancer in their life time. That is a MUCH higher number than men who will have medical issues requiring circumcision, and yet we don't remove baby girls' breasts!

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#4 of 29 Old 01-29-2011, 06:02 PM
 
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It's difficult to comment on the situation because we can't independently verify her assertion. However, consider that circumcision is rare in most other parts of the world and ask yourself if there are so many problems, why isn't it done everywhere? The answer is there aren't really near that many problems and those that happen can be easily treated by knowlegable parents and doctors without it. It's simply that in the US, doctors only learn to cut it off and nothing else. Plus there are probably a lot of people looking for a way to get their insurance to pay for it too.

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#5 of 29 Old 01-29-2011, 06:02 PM
 
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Many Dr will make up a "need" in order to get insurance to pay for an elective circ.  Adult men may wish to be circ for a variety of reasons.  



 



The other reason would be that many medical reasons for circ could be be treated with less drastic measures, but Dr don't bother to try those first.  A circ is a very quick and easy relatively low risk procedure, which is quite profitable.  For example, phimosis is easily treated with a steroid cream, similar to what get prescribed for eczema.



 



We don't do any other surgical procedure at birth just b/c it might be necessary when the baby is an adult.  I'm sure your mom sees at least twice as many appendectomies being billed for, but no one suggest doing an appendectomy at birth just to prevent it later.




 



yeahthat.gif to the bolded. Phimosis isnt a reason to circ, UTI is not a reason to circ. But that is what the Dr. here in the USA do. Phimosis should be treated in an adult with steroid cream and stretching and if that fails a small slit can be made in the tip to allow for retraction while keeping the foreskin relatively intact. UTI has absolutely nothing to do with having a foreskin or not so any Dr. saying it does is not up to date on the research.

So basically the circ rate for teens/men isnt accurate for medical reasons due to the fact what Dr. call medical reasons are not actual reasons just the ignorance of the Dr. While some men do choose to be circed for personal reasons I doubt if the number is very high at all.

 
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#6 of 29 Old 01-29-2011, 06:25 PM
 
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Reasons it's preferable to be circ'd as an adult rather than a baby:

 

(1) At birth, the foreskin is fused to the penis. It usually separates by puberty. Forcefully retracting the foreskin on a baby or young boy is excruciatingly painful (also unhealthy) even if you don't cut it off. A grown man/teen is usually already fully retractable, so the doctor doesn't need to prematurely rip the foreskin off in order to remove it.

 

(2) Doctors have no way of looking at a baby's penis and knowing how big it will be when he's an adult; many men circ'd as babies have painful erections because they don't have enough skin. If a man is circ'd after his penis is fully grown, he can avoid this problem. (Nowadays many doctors are performing "loose" circumcisions on babies to try to avoid this, but that comes with other problems associated with having half a foreskin.)

 

(3) Babies usually eliminate in diapers, so their circumcision wound will be stewing in urine and feces, which is both painful and unhealthy. Grown men and teens usually don't wear diapers.

 

(4) To some extent it can be unsafe to use anesthesia on a newborn. Many doctors (and/or insurance companies) don't even bother giving babies pain medicine since they won't clearly remember the painful event. A baby can't even tell you if his circumcision wound hurts after the operation. Not only do they usually give grown men better pain killers during the operation, but he can take pain pills afterward of his own accord.

 

(5) Performing a medically unnecessary surgery on the genitals of an infant is a human rights violation--and "it might get infected someday" is not a medical necessity. A grown man will be able to give informed consent. It's arguable whether a teenager would be mature enough to give informed consent, but it's definitely better than a baby. Even if the operation doesn't have any complications, regardless of when the man has the operation performed, there are major downsides to not having a foreskin. It's not like getting your ears pierced where it's just a couple almost-invisible holes in your earlobes. A man has the right to make this decision for himself.

 

The lack of a foreskin is a problem in itself. I don't know how frequently men need to be circumcised, but I know it's far fewer than 100% of men. However, if you circ him as a baby, you are giving him a 100% chance of having this problem. I'm not seeing an "up" side. 

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#7 of 29 Old 01-29-2011, 07:51 PM
 
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Many doctors in the US do not know how to deal with a foreskin problem should it arise. All they know how to do is remove the foreskin. Like previous posters said, a foreskin has nothing to do with causing UTIs and that belief is way outdated. True Phimosis is rare and can be treated with a a steroid cream.

 

Women get all sorts of infections (yeast infections, vaginosis, UTIs) yet no doctor recommends labia removal.

 

A lot of men that get recurring infections of the foreskin get them from over cleaning! The use of too much soap upsets the natural PH balance of the glands and foreskin. It's the same for women. If we scrub up in our vaginas with soap, hello yeast infections! Unfortunately, most of the time it's doctors telling men to incorrectly scrub the heck out of their penises! So it's the doctors causing the problems. :(


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#8 of 29 Old 01-30-2011, 05:11 AM - Thread Starter
 
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#9 of 29 Old 01-30-2011, 07:04 AM
 
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I saw it stated that in Sweden, a country that does not practice infant circumcision, that only one in 160,000 men would die without his foreskin.  This came from Edward Wallerstein's book, Circumcision, a health fallacy, I think it was called.   This contrasts sharply with what we know takes place in the U.S.  Why?  The biggest reason is that in the U.S. doctors have not been taught anything about the form and function of a foreskin. All they know is to cut it off.  Coupled to the fact that for decades they have been advising parents of intact infants to forceably retract their baby's foreskins to clean them causing all kinds of issues ranging from scarring (causing phimosis) to infections (caused by upsetting the natural balance).  So the bottom line is that most "required" circumcisions in the U.S. were either caused by the doctors themselves or else could have been remedied by far less invasive means.  It has been said that the only valid symtoms for circumcision are gangrene, frostbite or severe injury.  All extremely rare.

 

In my life I have only known of  four "later" circumcisions.  One was elective (I do not know the reason), one for a paraphimosis (which does not require circumcision, the foreskin just needs to be manipulated forward again) and the other two were due to phimosis (caused by injury from forced retraction as a baby) but in both cases No other option such as steroid cream or even preputioplasty were suggested or offered.

 

All I can say is that your gut feeling is right on, and there is no reason for you to change your mind - after all how could millions of years of evolution be wrong!!

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#10 of 29 Old 01-30-2011, 09:44 AM
 
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 I've been a nurse for almost 20 years (I was a LVN for a few years and then became an RN). In my whole career of nursing, I've never known of any foreskin problem for anyone young or old needing a circ. I live/work in Texas, a fairly circ happy state. Sure, there are adult men who choose to get a circ for cosmetic reasons (and trust me, the doctor will code it as a "medical" reason for insurance reimbursement) but despite reading about adult circs online, I've never known one to occur in real life. I spent about 4 years working primarily surgical nursing and never encountered adult circs. In all my years of OB nursing, I worked night shift. I had to read the surgical schedule each night to see how many post-op OB/Gyn patients we'd get the next day. So I read all the surgical schedule. I never saw a circ. on the schedule. Heck, I even worked in medical records before I was a nurse and I can't remember reading about adult circs then either ( I could have and maybe it didn't register, that was before I paid any attention to circ issues). Another possibility may be that her hospital is the one where all the good urologist do their surgeries, so maybe that's why they have so many each week (maybe the other smaller and larger hospitals always send their uro-genital surgeries to your mom's workplace).

 

I agree w/ PP - maybe some adult circs happen due to UTI's or tightness when other non-surgical methods weren't previously tried (antibiotics or steroid creams). Unfortunately, I've also read online where some men get circed because their wife/gf wanted it done (or the guy thought the girl wanted done). I would hope that's not the case but I guess it's a possibility.


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#11 of 29 Old 01-30-2011, 09:57 AM
 
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I just cannot imagine a hospital doing 130 adult male circs a year.  I agree with everyone else, cosmetic circs can be deemed 'medical' for insurance reasons, but I know a lot of intact men and they are certainly not lining up to get it done.  2 to 3 a week is an awfully high number.


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#12 of 29 Old 01-30-2011, 02:10 PM
 
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Can I just say how much the idea of doctors telling my son when he's grown that he needs a circ for __insert medical problem___ worries me.  It's kind of alarming to me that my son has a body part that most doctors don't know anything about!  Not that that would be a good reason to amputate it, but I guess it does emphasize the importance of teaching DS about the foreskin so that, as an adult, he doesn't leave a dr's appt thinking "great, now I have to have it cut off.  I wish mom had just let them do it to me as a baby."


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#13 of 29 Old 01-30-2011, 02:35 PM
 
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Can I just say how much the idea of doctors telling my son when he's grown that he needs a circ for __insert medical problem___ worries me.  It's kind of alarming to me that my son has a body part that most doctors don't know anything about!  Not that that would be a good reason to amputate it, but I guess it does emphasize the importance of teaching DS about the foreskin so that, as an adult, he doesn't leave a dr's appt thinking "great, now I have to have it cut off.  I wish mom had just let them do it to me as a baby."


 

I think we need to teach all our children to be careful medical consumers who think for themselves and aren't afraid to get a second opinion.


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#14 of 29 Old 01-30-2011, 03:54 PM
 
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OK, I am so done with this thread.  I came here to find possible reasons why the number is so high - not to hear people assume my mom's a liar.  She deals with all their medical records, and ever since I told her I was thinking of not circ'ing the next boy, she'll tell me on the phone "Oh, we had another adult circumcision today."  This happens 2-3 times a week.  She's not making it up.  I am pretty disgusted that some of you would instantly assume she's stretching the truth rather than try to figure out why she's seeing that number.  Thanks to those of you who suggested real reasons, like men overscrubbing or being forcibly retracted as babies or doctors not knowing any other solutions.
 

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I just cannot imagine a hospital doing 130 adult male circs a year.  I agree with everyone else, cosmetic circs can be deemed 'medical' for insurance reasons, but I know a lot of intact men and they are certainly not lining up to get it done.  2 to 3 a week is an awfully high number.



I could see it in a large hospital, but a bit of exaggeration on the part of the OP's mom also wouldn't surprise me.  Remember that includes purely cosmetic circs, circs due to converting, circs b/c his Dr didn't realize that a yeast infection could be treated with OTC monistat, and very rarely b/c the man who actually needed his foreskin amputated b/c it had become gangrenous from his poorly managed diabetes.


 


OP, honestly, if I were you I would tell my mom "thank you for your concern, I'm looking at all the information I can.  I will make the best decision for any future sons that I can.  Can we please drop the subject?"  I essentially told my mom the same thing, only A LOT more forcefully (she was being pretty forceful with me).  When I told her my decision, she very angrily said, "WELL I THINK YOU'RE MAKING A BIG MISTAKE!"  And I replied, "Well the good news is that in this case it doesn't really matter what you think, because I'm the mom and you're not."  My mom and I have a good enough relationship that arguments like that aren't permanently damaging, so it's worked out okay.

 

Basically, my point is that I think you have a right to decide not to have your sons circ'd without getting constant grief for your decision.

 

And as for adults needing circumcision... 1) I honestly believe that it has more to do with American docs not really knowing what to do with intact foreskins than anything else and 2) I'm sure that dentists fill more than 2-3 cavities a week in their office, but you don't see any dentists recommending that we pull children's adult teeth as soon as they come in.  Basically, I don't understand how anyone can suggest that amputation is rational prevention


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#15 of 29 Old 01-30-2011, 04:44 PM
 
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I wonder if the majority are with the same doctor? There are doctors out there who um, cater to men wanting circumcisions. There are also doctors out there who think its their job to convince every intact male to get circumcised, whether they actually need it or not. Or it could be less insidious, perhaps a prominent urologist works at the hospital and naturally he gets referrals for more complex cases. I think the circ rate at one hospital is not necessarily indicative of the usual rate. I mean, if a doctor who specializes in brain surgery works at one hospital, and thus that hospital has a few brain surgeries a week, you might assume quite a lot of people need brain surgery. When the reality is, people needing brain surgery simply tend to go to that particular hospital.
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#16 of 29 Old 01-30-2011, 05:18 PM
 
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Let's assume 100 men per week choose or need to get cut at this hospital.  So what?

 

I just don't know how that's relevant to anyone else's situation.  What we know is that not one national medical association on earth endorses routine circumcision.  The most recently revised national policies (Holland's and Austraila's) condemn it.  From the Dutch KNMG web site: "Doctors,.. actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications." 

 

There is no reason at all not to let it be an adult who undergoes the procedure if he's determined to have it done.  Up to 40% of adult men in affluent cultures will choose vasectomy.  They handle the pain meds for the procedure and recovery just fine - better than an infant, who can't tolerate as much medicine or tell you where it hurts.  And the adult genitals are just much easier to do precise cosmetic surgery on.  WHO KNOWS how big a baby penis would grow, how turgid it is during the procedure (puffed up from handling or shrivelled from the cold room), or how much slack he'd prefer to keep? 

 

But I think the main reason to leave him intact is that it's HIS specialized pleasure-receptive tissue to decide about. 

 

And just for argument's sake assuming someone's circumcision is inevitable, at least if he's cut as an adult and the procedure goes terribly wrong, he'll have someone NOT long dead to sue and/or retaliate against. 


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#17 of 29 Old 01-30-2011, 05:21 PM
 
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OP If you are still reading, I thought you might find this interesting:

http://www.caringforkids.cps.ca/pregnancybabies/Circumcision.htm

According to the Canadian Pediatric Society, the number of intact males who end up getting circed later in life is the same as the number of circed males who end up getting recirced later in life.  So the circed males end up going through the painful, risky procedure TWICE.  Seems like pretty simple math to me.

 

Good luck to you!


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#18 of 29 Old 01-30-2011, 05:39 PM
 
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It's difficult to comment on the situation because we can't independently verify her assertion.

 

Um... yeah, I don't think my mom is lying to me, thanks.  I believe her that her hospital circs 2-3 adult men a week; I'm only trying to figure out why.

 

 

You are misunderstanding what I am saying here. I am not calling her a liar but the fact is we can't verify the assertion that these are two or three medically needed circumcisions per week that are occurring at her hospital. By verification we are talking about finding out what kind of conditions lead to the circumcisions she's talking about not that they necessarily actually occurred. The reasons there seem to be so many at a US hospital is because  quite frankly medical professionals in the US are taught little if anything about the foreskin except how to cut one off. So any one who comes in with just about anything and who is not circumcised is going to get a recommendation for circumcision.

 

Foreskin a little tight, circumcise. Foreskin a little inflamed, circumcise. Got a UTI, circumcise. Got a diabetes diagnoses, circumcise. Foreskin a little long, circumcise. Have a cold, circumcise. Got insurance, circumcise. As others have said, most of these go back to knowledge about proper care as a youth and the availability of better treatments. The next time your mother calls you with thing news, do some digging. Ask here: What was the diagnosis? What were the possible alternatives? Were they offered to the patient? What were the results? For example, if she says:someone presents with a tight foreskin and had to be circumcised. Ask were they offered steroid creme? What was the result or why wasn't it offered? Were they offered prepuceplasti? What was the result, why wasn't it offered?

 

You don't even have to go that far you can ask why, and then ask us what we think happened, what the alternatives were, and what questions you can ask.
 

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Quote:
Originally Posted by calngavinsmom View Post

OP If you are still reading, I thought you might find this interesting:

http://www.caringforkids.cps.ca/pregnancybabies/Circumcision.htm

According to the Canadian Pediatric Society, the number of intact males who end up getting circed later in life is the same as the number of circed males who end up getting recirced later in life.  So the circed males end up going through the painful, risky procedure TWICE.  Seems like pretty simple math to me.

 

Good luck to you!

 

I wanted to expand on this with a little more detail that might have more impact on the readers:

 

The Canadian Paediatric Society lists on their site (http://www.caringforkids.cps.ca/pregnancybabies/circumcision.htm) -

 

"Of every 1,000 boys who are circumcised:

  • About 10 babies may need to have the circumcision done again because of a poor result.

 

Of every 1,000 boys who are not circumcised:

  • 10 will have a circumcision later in life for medical reasons"

 

So as the previous poster  said, there is an equal chance of circumcised and uncircumcised needing to be done later in life...although in reality, only a small 1% chance. And as was also pointed out, the circumcised kid gets the 'fun' of two surgeries. 

 


 

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#20 of 29 Old 02-01-2011, 06:56 AM
 
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April Dawn- I'm sorry that you felt your mother was being called a liar. I think Fellow Traveller summed it up well.  It's not that what she says she's seeing that is in question- it's what she makes of what she's seeing that is being discussed. I think part of your own situation is that you don't know how to approch this information your mother is presenti ng... do you thank her, do you let it frighten you, do you tell your friends what she told you, do you circumcise your baby??  Obviously you love and respect your mom, you value her opinion and experience and you are confused.  I think in this situation the best "answer" is a question.  Put your mom on an assignment to use her position inside the medical field to get some more information for BOTH of you.

 

One issue is that in a foreskin-phobic culture- foreskin problems are attributed to a "lack of circumcision" and circumcision problems are attributed to "the inherent issues of being male".  If she was able to see circumcision problems for what they are- would circumcision still seem so risk free?  If she is only in the OR where adult issues are being sorted out- she may not be witnessing the earlier issues that are dealt with in the office of a pediatric urologist... recircumcision, adhesions, skin bridges and meatal stenosis. How many circumcision revisions does the local pediatric urologist see a week?  How about erectile dysfunction? What is going on with adult men who don't need surgery but who are having sexual problems.  What about female sexual problems later in life?  How many women are assuming the "blame" for their sexual problems because their bodies can no longer compensate for the harsh sex that circumcision imposes on a couple?  

 

Do non-circumcising countries experience the same rate of "needed" circumcisions in their major hospitals as she sees in this hospital?  You would assume that with more intact men in the population there would be more people to have problems... is this the case?  I bet not. Can you ask her to contact the urology department of a hospital in another country- like Sweden or Denmark?  I bet that foreskin problems are managed conservatively and circumcision is viewed only as a last resort, but here in the USA, because circumcision may still be considered optimal socially (especially by a circumcised doctor who is treating the intact patient) the problem is seen as a great opportunity to finally circumcise. I am sure that  many elective (cosmetic social) circumcisions in the USA are coded as medical for insurance purposes.

 

Last you have to consider that intact adult males may be suffering from problems caused by faulty care in their childhood- that many of the problems were caused by forced retraction and overzealous hygiene routines imposed on their young bodies. Your own baby should not be lumped into that same risk category because you would not make those mistakes.

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#21 of 29 Old 02-01-2011, 06:46 PM
 
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#22 of 29 Old 02-01-2011, 07:04 PM
 
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Well that should be the case certainly but I know from multiple posts here that a consult with a urolgist is given right away even when there isnt really a problem like yeast.

With my own ds the ped saw him last year when he was 5 took one look at his penis and said his foreskin was to long I should take him to a urolgist for a circ consult hammer.gif

My dh knows a guy who went to his Dr. for a tight foreskin and he was circed the next month without any other measures being tried or offered. The guy ended up with to much skin removed and had to have skin grafted from his bumm to fix it.


 
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#23 of 29 Old 02-01-2011, 08:44 PM
 
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My brother wasn't retractable at 6 years old.  No infection problems or anything.  Just the fact that he wasn't retractable and they told my parents he needed a circ.  This was before the time of the internet.  So they trusted the doctor and had him circed.  No consultation with a urologist or anything.  I wouldn't be surprised at all an adult would just go with the doctors suggestion. It can be an embarrassing issue and they just want to fix it and get on with their lives.


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#24 of 29 Old 02-02-2011, 05:05 AM
 
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I had a friend who chose to get circumcised as an adult due to phimosis. I was talking to him before the procedure and asked him, "Aren't there any other treatment options?" This was before I was an intactivist, but surgery sounded drastic to me when creams and stretching could work (I was actually going through the same thing myself due to vulvar vestibulitis at the time). He replied, "There are, but circumcision is the easiest and most common." I thought, "Easiest for who?" but I didn't say anything else, as the conversation was already pushing boundaries of acceptable conversation. I have always wondered how the procedure went  for him and whether he regretted it afterwards (although I'm guessing he wouldn't if phimosis was causing him pain before) but he started a new relationship around that time and we've grown apart so I think it would be inappropriate for me to bring up again several years later.


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#25 of 29 Old 02-02-2011, 07:02 AM
 
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The surgery definitely sounds drastic. Perhaps the doctor made it seem as if other measures would be way too complicated and tough so your friend just decided to go for the surgery instead.

I am amazed at what can be done with stretching when it comes to foreskin restoration. If men can essentially recreate a foreskin in a couple years by stretching, I can't imagine it would be too tough to loosen a tight foreskin by stretching methods and/or creams.
 

Quote:
Originally Posted by NSmomtobe View Post

I had a friend who chose to get circumcised as an adult due to phimosis. I was talking to him before the procedure and asked him, "Aren't there any other treatment options?" This was before I was an intactivist, but surgery sounded drastic to me when creams and stretching could work (I was actually going through the same thing myself due to vulvar vestibulitis at the time). He replied, "There are, but circumcision is the easiest and most common." I thought, "Easiest for who?" but I didn't say anything else, as the conversation was already pushing boundaries of acceptable conversation. I have always wondered how the procedure went  for him and whether he regretted it afterwards (although I'm guessing he wouldn't if phimosis was causing him pain before) but he started a new relationship around that time and we've grown apart so I think it would be inappropriate for me to bring up again several years later.




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#26 of 29 Old 02-02-2011, 07:51 AM
 
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I just want to remind everyone to avoid castin suspicion. Thank you!

 
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#27 of 29 Old 02-04-2011, 01:21 PM
 
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Originally Posted by Coral123 View Post

I'm also a nurse, and am interested in the issue of circumcision.  I don't think there is very much data on who gets circ'd as an adult, and why.

 

I will say that I have to disagree with the assertion that doctors are recommending circs when other more conservative measures can be utilized.  For one, most men will see their primary care doctor first.  A referral to a urologist would not even be made unless the issue is chronic, or severe. 


You are correct that most, if not all will see their primary care doctor first, but nearly all will then be referred on to a urologist. This is where the problems start because many urologists do not bother to offer more conservative measures (If they are even aware of them) and recommend a circumcision right off the bat.

 

It would be very interesting to see the stats of adult circs done in the U.S. versus, say Scandinavia.
 

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#28 of 29 Old 02-06-2011, 03:23 PM
 
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I found a link that says the rate of adult circ in the US is 1 in 10,000 men. It also states that approximately 71% of the adult male population is circumcised, so that comes out to 1in 2900, if circumcised males are included in the 10,000 and it sounds like they are.

 

http://www.icgi.org/information/us-adult-circ-rate/


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#29 of 29 Old 02-12-2011, 09:18 PM
 
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This is just the thread I needed--thank you!  Lots of great information and links on here.


Mama to Nell (11/15/06) and Maggie (10/9/10) . AFTER 2.5 YEARS, I AM AN AUNTIE!!! joy.gifHOORAY TEAR78 and welcome Anika and Brand New Baby Boy!!!!  Circumcision: the more you know, the worse it is; please leave the decision up to your son!

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