The Circumcision Discussion

[jmspeach]

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 :)

[L&D.RN]

I'm of the opinion that it is a good thing, both medically and socially. I also don't want to debate personal opinions, but after lots of research, I had both of my boys circumsized and watched the procedures. They hated being held down and screamed more about that IMO than pain because they were "numbed" prior. I also watched circs without meds, and the crying was about the same.

[memphispanda, RN]

Both of my boys were circumcized. Had the second one been the first done, I wouldn't have had it done to the other.

My first was done with the plasti-bell. It didn't swell, turn red, etc. There were no problems later.

My second was done with the gomco and it looked horrible afterwards. He was miserable and so was I. His member was red and swollen and it stayed that way for several days. They left a good deal of skin there as well (which is better than taking off too much which does happen). The skin kept readhering to the corona during his first couple of years and it would itch and cause problems. It seems to have stopped doing that for the last couple of years.

As far as numbing/anesthesia/etc....they don't use anything here. I have heard that some places use EMLA but that it really doesn't help much--it's not a deep enough numbing. Not to mention that even if it did numb it, there would still be pain afterwards.

Anyway, do your research. Do a google search. There are numerous stories about babies who were circumcized and had problems from the circumcision. There are numerous stories about babies that were not circumcized and had problems with their foreskin later.

[ktwlpn, LPN]

foreskin.com....lots of reliable info.(I had our son done primarily because his dad is)

[Goldenearring1]

There is a great article that was just published on www.medscape.com. The article contains a wealth of info and it's easy to read. Ultimately the decision is yours. Good Luck!

Type in circumcision in the search engine.

Melissa

Goldenearring1

[love4neos]

As a neonatal nurse, I have assisted with every type of circumcision possible. It would be a good question to ask the ped, what type of circ he/she uses. There are MANY different types. You can also request a pain agent, many may prescribe a little tylenol, it really helps, others also use a cream that numbs the area, it should be applied 30-40 minutes before the circ. They may also do a shot of lidocaine, I have seen that work great, without a cry, when the ped injected it under the skin of the member. Hope I help. PM me if you have more ??s.

[Gator,SN]

I had both my sons circ'd. Not for any religious reasons just because my husband expected it (cuz he is without the forskin himself,) and so it just seemed logical.......

I also saw this done in clinical and had an instructor who was totally against it and so, I'm glad that I didn't think too much about it at the time.

I think that it is a personal choice, so I wish you and the baby well.

Gator

PS. stay away from the room when they do it and have them bring you the baby right away afterward. It will do both of you a world of good and baby settles down pretty quickly after......and then sleeps pretty soundly for a while. Lots of time to cuddle!

[Anagray, BSN]

Hi, I am not a nurse yet, but since u were wondering about this subject, I'd like to offer you some info.

I came from a country where boys aren't circumcised and I had my son in the US. When i was pregnant, I questioned some of the traditional values I grew up with, so naturally I looked into the circumcision subject.

To make the long story short, I did not circumcise my son and the research I started at that time continued for the last 4 years, just because I found this to be so controvercial.

I have read tons of articles, looked at a LOT of medical research and after it was all said and done I am very glad I didn't perform this surgery.

American Academy of Pediatrics released a statement where they stress POTENTIAL benefits of circumcision. Looking at the statistics, it will take 200 circumcisions to prevent 1 UTI. As far as penile cancer goes, the stats for that are also very low and it is well known that penile cancer is caused not by having a foreskin, but by HPV infection. As with any STD, it is the sexual lifestyle that contributes to the risk. If it makes a difference, I have HPV and I became infected from a circumcised american parentner, not from my previous experiences at home. There is a condition called phimosis, where the foreskin does not become freely movable in adulthood and can cause problems, but it is also rare. Chances of your son having that condition or the infections are the same or less as for your daughter to have fused labia at birth and chances of a little girl having recurrent UTIs are much higher than any boy.

Another aspect that worries me is that I feel the patients aren't adequately informed about the risks of circumcision. Yes, the risk is low, but if you ask any of the mothers who ever had to deal with those complications, i'm pretty sure they feel remorseful.

Removing foreskin causes decrease in sexual sensation ( which some people consider not to be a big deal or do not believe that at all.) foreskin is made of the same errogenous tissue women's labia is composed of. Glans, which are normally convered by skin, become keratinized when the skin is gone. Instead of mucus membrane with time appears simple squamous epithelium similar to skin on other parts of body. u get the picture.

Complications from surgery include: sepsis, adhesions, circumcision performed too tight can casue painful erections, in very rare cases it can cause disfigurement and necrosis. There is also material out there conserning deaths related to male circumcision.

The true numbers about circ. complications are not known, because there is only 1 research ( i found it on AMA website i believe) where some numbers are given. however, those numbers come from data on complications collected at the Washington hospital, immediately after the child is circed. Long term complication after discharge are not included in the research.

If after your research you will still decide to circ, please do demand pain relief for your baby. AAP also states that pain relief must be used. I saw this surgery performed at the hospital, the baby was in pain. Also, please be sure to find a doctor who is highly skilled and knows what he or she is doing.

My personal conviction is that if my son decides to get circumcised, it will be his choice, his decision, his body.

As of now, he is a perfectly healthy, clean little boy.

Good luck with your research.

[Rustyhammer]

I know this Dr. who does free circumcisions....

...he only takes tips.

-Russell

[NancyRN]

I agree with sanakruz. It's not your body. If he wants a circ later, he can have one. There are no good reasons for genital mutilation on boys or girls. Isn't it insulting to assume that a male is not capable of keeping himself clean?

[AHarri66, BSN, RN]

My oldest son (13) is circ'ed, my youngest (4) is not. I think it's ******** that infants don't "remember" the pain. For the entire time my oldest son was in diapers, he would scream bloody murder at each and every change, curling into a fetal position. Of course he doesn't remember now, but for almost 3 years it was h*ll.

Also, after watching a couple of botched circs in school (ugly messes they are!), I decided there was no way I was risking that happening to my youngest's body.

The MD who performed one of the circs I observed told us that the practice of circumcision came about during WWI, when it was erroneously thought that the foreskin made a man more likely to contract VD. The advent of antibiotics shot that out of the water.

A point to consider (according to statistics): fewer babies are being circumcized nowadays, so that the curve is actually greater against. For those of us (like myself with my oldest son) who want baby to look "like Daddy," young boys are more likely to be exposed around their peers (locker rooms, school bathrooms), so if they are circ'ed, they will soon be the "different" ones.

I realize I'm going a bit "off" here, but if I were to have a cause, this would be it. I also realize it is a matter of individual decision...I just think it should be left up to the individual with the member. To expand upon Browneyedgirl's comment: we look at infundibulation/female circumcision as "mutilation," why do we not look at this the same way? There is little evidence (less than 1% chance, I believe) that foreskins pose a "health risk." That would be like performing a mastectomy because breast cancer is a risk!

Okay, okay...I'll shut up now. :imbar

[dawngloves, BSN, RN]

Originally posted by Rustyhammer

I know this Dr. who does free circumcisions....

...he only takes tips.

-Russell

GROAN!!!!!!!

[ShandyLynnRN, BSN, RN]

I have had numerous patients ask me the same questions. I tell them this: It is more common for boys in *my* area to be circ'd. Certain cultures around here do it less often, mostly hispanic. It is purely a personal choice. There are pro's and con's to both. I don't care what anyone says, I have seen little (or big) old men with foreskin infected, or a caregiver forget to pull it back down after cleaning and it became swollen, or (I think this is the term, cant remember) phimosis, where the opening becomes too small to retract it properly thus increasing the risk for infection, etc...

There is also the body image thing to be addressed. I always tell them to consider whether dad or brothers are circ'd. Not that it is a BIG deal, but there would be questions like "why does mine look different than daddy's", or "the boys in the locker room were teasing me" (my ex-husband told me that that was never an issue when he or his friends, circ'd, were in there with someone un-circ'd.

Then there is the fact that IF there is a mistake, the boy will be scarred for life. I have also seen many circ's, and although I had my son circ'd, as a nurse now I'm not sure that I would have another boy of mine circ'd if I had to make that decision.

Also, about the medication. The doc's I work with use lidocaine for all circ's. The last hospital I worked at, there were two that didn't use anesthetic. They said their reasoning was that the procedure takes 5 minutes or less, and the only time there is pain is the small cut, which is usually only about 30 seconds or so. The lidocaine burns, and hurts the baby anyway, and the burning lasts for 30 seconds to a minute.