The Circumcision Discussion - page 130

by jmspeach 187,153 Views | 1299 Comments

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... Read More


  1. 0
    Quote from consult2
    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.
  2. 0
    Quote from 2curlygirls
    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. 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.
  3. 0
    Quote from BabyLady
    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/bios.../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.
  4. 2
    Quote from BabyLady
    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 penises 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 PENISES 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)
    Smurfette752 and Elvish like this.
  5. 2
    Quote from BabyLady
    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...............................<0.1

    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.................... .<17%.......................30%

    France.....................0.4................... ....<1%.......................<1%

    Netherlands............0.3....................... <1%.......................<1%

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

    Germany.................0.1...................... .<1%.......................<1%

    Sweden..............0.1......................... <1%.......................<1%

    Norway.......... ....0.1..........................<1%............. ..........<1%

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

    Finland..........01...........................<1 %....................<1%

    Japan..........<0.1......................... <1%........................<1%

    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
    CFitzRN and Smurfette752 like this.
  6. 4
    "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?
    Smurfette752, dnp2004, 2curlygirls, and 1 other like this.
  7. 1
    Quote from BabyLady
    I listed SEVERAL sources of DIFFERENT studies that were done.

    None of them were done in Africa.

    You are posting that as if all of the research is based on a single study done in Africa...and there is simply, no truth to that whatsoever.
    Hate to be the one to point this out to you, but I am quoting directly from the links you posted.
    http://www.cdc.gov/hiv/resources/fac...rcumcision.htm
    In these studies, men who had been randomly assigned to the circumcision group had a 60% (South Africa), 53% (Kenya), and 51% (Uganda) lower incidence of HIV infection compared with men assigned to the wait-list group to be circumcised at the end of the study.
    The Uganda study investigators are also examining the following in an ongoing study
    In an earlier study of couples in Uganda in which the male partner was HIV infected and the female partner was initially HIV-seronegative, the infection rates of the female partners differed by the circumcision status and viral load of the male partners.
    A number of important differences from sub- Saharan African settings where the three male circumcision trials were conducted must be considered in determining the possible role for male circumcision in HIV prevention in the United States. Notably, the overall risk of HIV infection is considerably lower in the United States, changing risk-benefit and cost-effectiveness considerations. Also, studies to date have demonstrated efficacy only for penile-vaginal sex, the predominant mode of HIV transmission in Africa, whereas the predominant mode of sexual HIV transmission in the United States is by penile-anal sex among MSM.
    Lastly, whether the effect of male circumcision differs by HIV-1 subtype, predominately subtype B in the United States and subtypes A, C, and D in circulation at the three clinical trial sites in Africa, is also unknown
    individual men may wish to consider circumcision as an additional HIV prevention measure, but they must recognize that circumcision 1) does carry risks and costs that must be considered in addition to potential benefits; 2) has only proven effective in reducing the risk of infection through insertive vaginal sex; and 3) confers only partial protection and should be considered only in conjunction with other proven prevention measures (abstinence, mutual monogamy, reduced number of sex partners, and correct and consistent condom use).
    Your research sites were located in Africa, and this research is far from conclusive in saying that circumcision is the only way to reduce HIV transmission.
    Smurfette752 likes this.
  8. 0
    Link #2 posted:
    http://www.cnn.com/2009/HEALTH/03/26...pes/index.html

    In the new study, a research team at the Rakai Health Sciences Program in Uganda -- in collaboration with researchers from the Johns Hopkins University Bloomberg School of Public Health in Baltimore, Maryland, and Makerere University in Uganda -- conducted two clinical trials involving 3,393 uncircumcised men ages 15 to 49. All the men were negative for HIV and genital herpes (also known as herpes simplex virus type 2); a subgroup of men also tested negative for HPV.
    They also note, however, that male circumcision is not completely effective in preventing sexually transmitted infections. Safe sex practices, including consistent condom use, are still necessary to provide the best protection.
    In Uganda.

    They also point out that roughly 3/4 of US adults have already had at least one HPV infection....already. That in a country that still circumcises the majority of baby boys. Hmmmm.

    And link #3:
    http://www.fsneo.org/JourClub/3-023.htm
    Does not say where the study was done. Furthermore, the two sample pools (circ vs intact men) were not even remotely close in size. 292 circed men, vs. 847 intact men. Got to have similar sample pools if the research is going to be considered valid.

    Still, I especially like the MD's comment at the very bottom - that he fully expects for us to start doing mastectomies on newborn girls, because it will prevent cancer in the future, should be able to be done w/ local anesthesia, and they won't remember it anyway.
  9. 0
    I am very proud of the fact that I base my teaching on facts, backed up by research that I can prove, rather than thinking that the CDC and WHO is involved in some conspiracy theory to con the world into circumcisions.
    Last edit by Elvish on Aug 6, '09 : Reason: TOS
  10. 5
    Takes off regular member hat, puts on moderator hat.

    Name-calling on either side (i.e., ignorant, wearing blinders) is not cool.

    Feel free to disagree with each other - and just 'cause I moderate this forum doesn't mean you can't disagree with me - but name calling won't be tolerated. A few posts will be edited/deleted to reflect that.

    And, I'm closing this temporarily so everybody (including me) can take a break from it.
    Last edit by Elvish on Aug 6, '09
    canigraduate, dianabay, AirforceRN, and 2 others like this.


Top