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UK NHS circumcision rate

1047 Views 13 Replies 7 Participants Last post by  TigerTail
I've been "told" that the NHS does 30,000 circumcisions per year, presumably medically necessary.
Any tips on how to research the real figure?

Jessica
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That is depressing. I suspect most are by religious folk, wink wink nudge nudge, for 'phimosis'. The UK has a long way to go.

Where the heck is Revamp? He'd probably know. Or Christopher.

(OT Speaking of intactivists I haven't seen here lately, does anyone know how Gabysmom is doing? I haven't seen her ANYWHERE & I am a little worried.)
2
But does that figure include Religious Circumcisions??

Trends in paediatric circumcision and its complications in England between 1997 and 2003


It's possible I suppose...
:

I mean for example, when my Godson went to have his Testicles sown back down the Surgeon did say "We can Circ him at the same time, if u want us too...."
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http://bmj.bmjjournals.com/cgi/conte...l/321/7264/792

"If the most recent overall circumcision rate (about 12 200 procedures annually) remained unchanged, 3.8% of English boys would be circumcised by their 15th birthday. Among boys resident in the ********* and Sefton health districts the proportion would be 1.5%. "

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I've had that 30,000 figure thrown at me before, it's in one of the NHS statistical docs, BUT it isn't circumcision, it's "Operations on the prepuce" which includes all the non-circ interventions as well.

This is the post I wrote to counteract it:

No one said foreskins in Europe never develop any problems at all, only that they are not common and dealt with on a "medical needs" basis, rather than amputation of all at birth. The vast majority of men have no trouble with their penises at all. Those 30,000 procedures on the prepuce were not circumcisions btw, removal of the named part in that list is "excision". Many of them would have been treatments like a dorsal slit, or epi/hypospadius repairs. They were also across all age groups.

To get that into perspective:

There were
B27 Total excision of breast 17,161
B28 Other excision of breast 37,056
C71 Extracapsular extraction of lens 306,083
C75 Prothesis of lens 301,319
C12 Extirpation of lesion of eyelid 29,966
D15 Drainage of middle ear 47,666
E03 Operations on septum of nose 26,878
E04 Operations on turbinate of nose 22,201
E20 Operations on adenoid 24,047
E49 Diagnostic fibreoptic endoscopic examination of lower
respiratory tract 44,718
F09 Surgical removal of tooth 76,072
F10 Simple extraction of tooth 71,186
F34 Excision of tonsil 52,785
H01 Emergency excision of appendix 35,350
H20 Endoscopic extirpation of lesion of colon 31,627
J18 Excision of gall bladder 50,300
K49 Transluminal balloon angioplasty of coronary artery 49,495
L85 Ligation of varicose vein of leg 32,296
L87 Other operations on varicose vein of leg 59,904
L91 Other vein related operations 77,311
M42 Endoscopic extirpation of lesion of bladder 37,909
M45 Diagnostic endoscopic examination of bladder 255,207
M47 Urethral catheterisation of bladder 123,503
M49 Other operations on bladder 37,104
M70 Other operations on outlet of male prostate 26,296
P05 Excision of vulva 7,133 (!!)
P09 Other operations on vulva 7,073
P13 Other operations on female perineum 3,446
P23 Other repair of prolapse of vagina 23,686
Q07 Abdominal excision of uterus 32,528
Q08 Vaginal excision of uterus 14,081
Q22 Bilateral excision of adnexa of uterus 26,095
S70 Other operations on nail 3,544
V54 Other operations on spine 33,253
W37 Total prosthetic replacement of hip joint using cement 38,833
W40 Total prosthetic replacement of knee joint using
cement 45,500

It goes on and on, but you probably get the point. A foreskin is no more problematic than any other part of the body, and using your theory (cut it off before it can cause problems) then all newborns ought to have their adenoids, tonsils, appendixes, gall bladders, breasts, eyelids, colons, external leg veins removed at birth, and their hip and knee joints replaced while they can't remember it. When they come through their teeth ought to be removed. Oh and looking at the figures too, all women ought to have a hysterectomy if not at birth then after the last child has been born since so many have to have it done anyway. Looks like nails are dodgy things to have too. There seem to be a lot of problems with eyes there, especially lenses - what would you propose to do to prevent them? See anything wrong with this reasoning?

In fact if you read down the list, there are far more operations listed on womens parts than there are on male, and yet I'm sure you wouldn't want to cut off anything from your daughters.

http://bmj.bmjjournals.com/cgi/conte...l/321/7264/792
"..balanitis xerotica obliterans.4 This problem, the only absolute indication for circumcision, affects some 0.6% of boys,..."

I don't understand why boys or men shouldn't be offered treatments to cure a valid medical problem, if one develops, rather than amputation for all at birth when most of them won't ever have a problem with it (the same as most of them won't get appendicitis, or gall bladder problems etc.). Why the obsession with cutting off a part of their body that is no more likely to cause a problem than any other part?

I'll try to find out where the original paper is.
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Thank you, wow, that's exactly what I was looking for... its an, I'm sure it is a bogus number, but if I can't come back with a solid rebuttal, I can't say anything.

Thanks, I hope I have time to wade through this tomorrow.

Jessica
P05 Excision of vulva 7,133 (!!)
P09 Other operations on vulva 7,073
P13 Other operations on female perineum 3,446
P23 Other repair of prolapse of vagina 23,686

CAn we make any comparisons of these.... prolapse of vagina is usually in elderly populations right? I"d probably exclude that, but the other 3 leave 17,000 vaginal surgeries....

I doubt the number of religous circs makes up the difference, but I should be able to look at pop. % to figure out a guess.

Editing to add that , by my very rough math it may be reasonable to estimate about 12,700 boys born that are Jewish or Muslim (thus considerations for a religous circumcisions) a year. But then how likely is it that the religious circumcision would be done medically and not by a mohel for Jews, and where would a Muslim go for the procedure?? Would most Muslims have a hospital/clinic circumcision? Maybe some Jews, but obviously not all.

Jessica

Uuugh, I'm going to attempt some math....

Ok according to http://en.wikipedia.org/wiki/Demogra...United_Kingdom
Jewish .5%
Muslim 2.7% Total 3.2%

UK Total Population: 60,209,500
Males age 0-14 5,560,489 = 397,000 in each age group I'm dividing by 14 to get an approxiamentation of those in each age group (ie 0-1 year olds, 12-13 year olds, etc. )
3.2% of 397,000 age group approx

12,700 Jews/Muslims* of circumcision age in the UK each year
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Don't quote Wikipedia anywhere if you want to be taken seriously.

UK Population:
http://www.statistics.gov.uk/cci/nugget.asp?id=6

Ethnicity and Religion:
http://www.statistics.gov.uk/cci/nugget.asp?id=395

************************************************** *********

I've found the NHS operation stats lists. They've changed the URL and the format (and some of the categories!) since last year.
The summaries are here:
http://www.hesonline.org.uk/Ease/ser...categoryID=204

But what I have found is this for 2004/5, the broken down figures for the Operations on the prepuce:
http://www.hesonline.org.uk/Ease/ser....pdf&u_id=5403

N30.3Operations on prepuce, Circumcision 24,313 99%100%2%95%111881.612744%43%9%5%77%8,420 lol, that's not too helpful is it? The information is at the bottom of page 163. It shows that 44% were carried out on children aged 0-14 which corresponds to the earlier paper from 2000, of about 12,000 children a year being circ'd, the rest are spread out over all age groups. The broken down figures show that the number of childrens circs is, in fact around the 10,500 mark (44% of 24,000)

2005-6 figures (Excel format)
http://www.hesonline.org.uk/Ease/ser....xls&u_id=7557

N30.3 Operations on prepuce, Circumcision25,224 (total) ;10,684 (aged 0-14);11,112(aged 15-59); 2,121 (aged 16-74); 1,271 (aged 75+)

I don't think there's any arguing with that really.

The incidence of circumcision here is very low. (And yes, those would include Muslim circs - they do it in hospitals in places like Bradford and Leicester to cater for the local populations, and charge cost price for it).
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Another rebuttal someone else calculated for that 30,000 figure,

"The "operations on prepuce" that you are referring to.. Has a total of operations for the 2004-2005 year of 30,719 cases.

The 14,000 cases in 0-14 year olds - I think it's pretty safe to assume that the majority are newborn circumcisions. If you compare this # to the # of deliveries for the year (522,000) and assume that 51% of all deliveries are BOYS (since that's typical) then you assume that out of 266,000 newborn boys - about 12,000 - 14,000 were circumsized - that = 5% of newborns being circumsized in Europe - and the reasons could easily be religious - since it's a small percentage.

I think the most you could allow yourself to suppose as "problems with the prepuce that ended up with surgery" are maybe 10% of the 0-14 age operations and almost all of the 15yo and above operations.

Still at that # - you have 11,000 operations in 15 - 59yos for the year. That's a gap of 44 years so each year of births - it's a minimal amount.

And, let's put this into perspective... In that same year there were 10,400 operations to repair prolapse in the vagina - in the same 15yo - 59yo age group...
22,500 operations to the vans deferens in that same 15you - 59yo age group....

So, is your point that all of 5% of newborn boys in Europe are still being circumsized, as opposed to 40% of all newborn boys in the U.S. still being circumsized?

Or that the small % of men that do wind up having an operation on their prepuce could be avoided by making all 100% of boys get that operation, even though 99% of them don't actually need it.. Is there an operation that we should be giving to all of our baby girls - to pre-empt that prolapse in the vagina repair they will have to undergo at the same rate of operation of the prepuce - during the same 15yo - 59yo age period?

If you're going to quote statistics - at least be forthcoming about what they ACTUALLY represent & put them into perspective with related stats!!!

If there's one thing that bothers me the most, it's people taking statistics out of context & using them to pretend to back up their side, when it actually supports the opposite! UGH!" (source funlovingorlovingfun ).

Go, seek and destroy.
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I don't think we have to get all defensively nationalistic in the sense of "my country is better than yours." No question, the UK is way better than the US both culturally and from a medical profession perspective in terms of not having the huge number of RICs each year. Same for Germany and other European countries.

But the fact remains that there are still a very large number of unnecessary circumcisions each year in the UK, and that this number should come down. The fact remains that many boys are still unnecessarily circumcised for phimosis, etc., and that at the end of the day, circumcision is still seen as a treatment of first resort, not last, by many doctors.

E.g, http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

Quote:
CONCLUSION: Circumcision rates in England continued to fall up until 2000, particularly in those aged under 5 years, in whom pathological phimosis is rare. The circumcision rate remains five times higher than the reported incidence of Phimosis.
When it comes right down to it, the BMA has not come out and said outright that circumcision should not be a parental choice. If parents are willing to pay for it, they can find a doctor to do it, for any reason or no reason.

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_DocSum

Quote:
This article offers a critique of the recently revised BMA guidance on routine neonatal male circumcision and seeks to challenge the assumptions underpinning the guidance which construe this procedure as a matter of parental choice. Our aim is to problematise continued professional willingness to tolerate the non-therapeutic, non-consensual excision of healthy tissue, arguing that in this context both professional guidance and law are uncharacteristically tolerant of risks inflicted on young children, given the absence of clear medical benefits. By interrogating historical medical explanations for this practice, which continue to surface in contemporary justifications of non-consensual male circumcision, we demonstrate how circumcision has long existed as a procedure in need of a justification. We conclude that it is ethically inappropriate to subject children-male or female-to the acknowledged risks of circumcision and contend that there is no compelling legal authority for the common view that male circumcision is lawful.
The UK has certainly come much, much further than the US, but it still has a long way to go to get to a place where the male prepuce is valued and protected as much as the female prepuce.
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Quote:

Originally Posted by Quirky View Post
I don't think we have to get all defensively nationalistic in the sense of "my country is better than yours."
:

I only provided a set of stats and links to the original documents....which were requested by someone else so they could respond to a specific attack, probably by the same person that attacked me from the sounds of it....

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fyi

http://www.ingentaconnect.com/search...ize=20&index=1

Quote:
Paediatric preputial pathology: are we circumcising enough?

Authors: Yardley, I.E.1; Cosgrove, C.1; Lambert, A.W.1

Source: Annals of The Royal College of Surgeons of England, Volume 89, Number 1, January 2007, pp. 62-65(4)

Publisher: The Royal College of Surgeons of England
...
RESULTS: A total of 422 boys were referred, median age 6 years 2 months (range, 3 months to 16 years). Over half the boys referred simply required re-assurance that all was normal with their penis. However, 186 boys (44.1%) were listed for surgical procedures - 148 circumcision, 33 preputial adhesiolysis, and 5 frenuloplasty. There were histological abnormalities in 110 specimens (84.8%); chronic inflammation (n = 69; 46.6%), BXO (n = 51; 34.5%), and fibrosis (n = 4; 2.7%). Nineteen (12.8%) specimens were reported as histologically normal. The overall prevalence of BXO in the boys referred was 12.1%.
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Quote:
I suspect most are by religious folk, wink wink nudge nudge, for 'phimosis'.
Doubtful since in some parts of England the NHS willingly pays for it for that reason.

If a foreskin isn't retracted by 5 and they notice, it's generally suggested to get rid
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Great, looks like they're attacking here too...
btw, I meant the NHS was paying for some for religious folks, claiming it was for medical, not that it was in any way a religious circ. Like 'we know these immigrants are going to do it anyway so we'll do it more safely in hospital'.

thought I'd read of that happening, although obviously it would be anecdotal, the NHS physicians aren't going to boldly admit they are defrauding the taxpayers.
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