The Circumcision Discussion

Specialties Ob/Gyn

Published

I know this can be a HUGE debate, and I'm not looking to start any arguments. I was just wondering as you are OB nurses. I'm expecting a boy in July and not sure if we should circ. or not. My husband says yes, it's better medically in the long run. My gpa who just turned 70 had to have a circ. due to endless complications lately.

As nurses in this area, is the medication that they use good? And what are some questions to ask my Dr. about it. I already know that my hospital i'll be at uses a med. when they perform it, I"m just wondering what you all think.

Thanks

Jen :)

I say phooey on medical reasons....you are already probably pretty educated on those. You will have 6 of one opinion, half a dozen for the other side. At the end of the day, follow your heart:heartbeat Best of luck with your decision:wink2:

The OPINIONS may be equal, but the facts and evidence are not--try following your brains. And the end of the day, WHY do something that has no proven benefit and proven harm? Which direction does one's brains lead?

Being a bit lazy are we?:D

yup, and i was getting ready for my massage appointment.....then to bed to work 3rd shift.....lol.....thanks again

Since this is an anonymous international forum, I am wondering how many practitioners on this forum would be okay with removing what they might consider "nonessential" tissue from a female infant, with lidocaine/xylocaine of course?

Specializes in NICU.
You are comparing apples to oranges.

I cannot control what parent hears or how they interpret the information. All I can do is present it to them, assess their level of understanding, and ask if they have any questions. Once they leave the hospital, it's up to them, not me, to raise and parent that child.

I don't care what they teach or the circ rate or HPV, STD rate or anything else in the UK, etc....I don't live in those countries...I live and practice healthcare in the USA. I don't live in a geographical area with a transient population.

Therefore, my job as a nurse is to practice objectively and non-judgmentally on FACT-BASED PRACTICE. The literature at our hospital that we provide to parents supports what I teach.

An circumcision...is done with a lidocaine, does not cut into muscle, does not cut through a protective membrane that would expose major organs to possible infection and has minimal blood loss. It is considered a minor surgical procedure.

An appendectomy, is considered major surgery. It is done through general anesthesia and all of the risks of intubation, cutting through major muscles of the abdominal cavity, thus, placing the body at risk for adhesions, major infection, stitches, etc.

I cannot believe any intelligent healthcare worker could think the two are even remotely related.

Well, in some ways you're right. Appendectomy is ONLY done when it's needed. When there is a medical indication. Very much unlike a circ. BUt if you think that circ's don't place infants at risk for infection, stitches, adhesions, you are sorely mistaken Not to mention that we don't pack an appendectomy site with poop (as a open, healing circ is repeatedly exposed to urine and feces, yum!)

I do have very strong opinions on the matter. I, think the facts speak for themselves. I encourage parents to be to do research. Nine times out of ten, they go the non circ route. So many parents just think it's SOP and don't give it any more thought. THAT is the saddest part.

Our neonatologists don't recommend them.

And in my area, circ'ed boys are the odd ones out so that argument becomes completely irrelevant.:yeah: The rates will get lower and lower. In the words of one of our hospital's pediatricians "I can't believe we're still doing these!"

Specializes in Community, OB, Nursery.
And in my area, circ'ed boys are the odd ones out so that argument becomes completely irrelevant.:yeah: The rates will get lower and lower. In the words of one of our hospital's pediatricians "I can't believe we're still doing these!"

Can I come work where you are??:up:

Specializes in NICU, Post-partum.
.

In SCIENCE, all it takes is ONE valid exception to make a theory invalid--you got them in Scand. and Japan--and the other rates for various countries are valid ENOUGH to complete the picture.

You need to go back and take a class in experimental research because there is no truth to this statement whatsoever.

Specializes in NICU, Post-partum.
And it is just as prevalent in areas that DO circumcise and those that don't --something does not compute logically.

Not according to the CDC, WHO and Unicef.

Once again, these are internationally recognized authorities on disease prevention and education.

Specializes in NICU, Post-partum.
Well, in some ways you're right. Appendectomy is ONLY done when it's needed. When there is a medical indication. Very much unlike a circ. BUt if you think that circ's don't place infants at risk for infection, stitches, adhesions, you are sorely mistaken Not to mention that we don't pack an appendectomy site with poop (as a open, healing circ is repeatedly exposed to urine and feces, yum!)

I do have very strong opinions on the matter. I, think the facts speak for themselves. I encourage parents to be to do research. Nine times out of ten, they go the non circ route. So many parents just think it's SOP and don't give it any more thought. THAT is the saddest part.

Our neonatologists don't recommend them.

And in my area, circ'ed boys are the odd ones out so that argument becomes completely irrelevant.:yeah: The rates will get lower and lower. In the words of one of our hospital's pediatricians "I can't believe we're still doing these!"

You cannot let the "facts speak for themselves" because I posted hard-core statistics and you have posted NOTHING to back up what you are saying.

The point of this entire discussion is being severely missed.

The point is that if you work as a healthcare worker, your JOB IS TO BE OBJECTIVE.

If you are only presenting the risks and none of the BENEFITS THAT IS SUPPORTED BY RESEARCH, then you are misleading parents, and to me, that borderlines malpractice.

You need to go back and take a class in experimental research because there is no truth to this statement whatsoever.

Really, perhaps you missed this in scienice 101? Note the last paragraph...

http://www.uic.edu/classes/bios/bios100/labs/scimethod.htm

The Principles of Science

As this is a science class, it would be beneficial to start out with a discussion on just what is "science." Science is a methodical process which seeks to determine the secrets of the natural world by using the scientific method.

The Scientific Method The scientific method is a process scientists must follow in determining the workings of the universe. There are five basic components to the scientific method:

1. From observations of the natural world, determine the nature of the phenomenon that is interesting to you (i.e. ask a question or identify a problem).

2. Develop one or more hypotheses, or educated guesses, to explain this phenomenon. The hypotheses should be predictive - given a set of circumstances, the hypothesis should predict an outcome.

3. Devise experiments to test the hypotheses.

All valid scientific hypotheses must be testable.

4. Analyze the experimental results and determine to what degree do the results fit the predictions of the hypothesis.

5. Further modify and repeat the experiments.

It is impossible to prove something to be true (this dips deeply into philosophy, but Truth is an ever-elusive principle.) One can create a theory with an overwhelming amount of support, but one valid piece of contrary evidence can strike it down. As such, science and scientific theories are an ever-evolving as new ideas and technologies allow us to create and test hypotheses in new and exciting ways.

Specializes in NICU.
You cannot let the "facts speak for themselves" because I posted hard-core statistics and you have posted NOTHING to back up what you are saying.

The point of this entire discussion is being severely missed.

The point is that if you work as a healthcare worker, your JOB IS TO BE OBJECTIVE.

If you are only presenting the risks and none of the BENEFITS THAT IS SUPPORTED BY RESEARCH, then you are misleading parents, and to me, that borderlines malpractice.

Malpractice??? That's a good one. I could say the same thing for those who fervently advocate for this unnecessary practice.

I think you missed the fact that I just don't discuss it with our NICU parents. Most of them don't do it anyway so it's really a non issue. I don't need supporting evidence for that. I also don't need to back up the statement that an open wound in a diaper full of poo is a bad idea. Or the fact that a baby boy will most definitely have a much higher chance of morbidity with a circ than without one (intact memberes don't take days to heal) That's just common sense. Nor, do i need supporting evidence that the majority of the intact, developed world, DOES NOT HAVE ANY SIGNIFICANT HEALTH ISSUES ASSOCIATED WITH THE STATUS OF THEIR memberES and that they think we are nuts for routinely circumcising our boys (that's not scientific I admit, but it comes from my numerous British family members)

Not according to the CDC, WHO and Unicef.

Once again, these are internationally recognized authorities on disease prevention and education.

Really?

The US has the 6th highest HIV rates in the industrialized countries

HIV cases % UNAIDS (2003)

Circumcising countries:

Zimbabwe........................24.6

Congo................................4.9

Malawi..............................14.2

Kenya.................................6.7

Chad..................................4.8

USA...................................0.6

Eithiopia............................4.4

Non-circumcising countries:

Japan...............................

Finland...............................0.1

Norway..............................0.1

Sweden.............................0.1

Germany...........................0.1

UN data from 2003 show the following AIDS rates for that year:

Nation AIDS cases% Cirk rates/1995* Cirk rates/1975**

USA.........................0.6........................60%.......................85%

Australia...................0.1..........................8%.......................55%

Canada....................0.3........................

France.....................0.4..........................

Netherlands............0.3..........................

UK...........................0.1.............................1%.........................1%

Germany.................0.1..........................

Sweden.................0.1............................

Norway............. ....0.1.............................

New Zealand........0.1...............................5%......................10(?)

Finland................01...........................

Japan................

Eithiopia...............4.4..............................100%......................100%

So taking the estimated cirk rates of 20 years ago we find an amazing POSITIVE correlation between the cirk rates and the HIV rates

"If you are only presenting the risks and none of the BENEFITS THAT IS SUPPORTED BY RESEARCH, then you are misleading parents, and to me, that borderlines malpractice."

Ok, I'll bite, what are these alleged "benefits" that are supported by valid scientific research?

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