The Circumcision Discussion - page 57

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... Read More

  1. by   ElvishDNP
    Quote from natania
    True, the rates of circumcision are amongst the highest in the world, but the rates of circumcision are falling in the US. Perhaps it is merely coincidence that the rise in STD rates coincide with the falling circumcision rates?
    I think what KYCNM was pointing out was that we have the highest circumcision rates in the world along with a very high incidence of STDs. So it kind of takes the wind out of the 'circumcision-stops-STDs' argument. I think that's what she's arguing. Please correct me if I'm wrong, KYCNM.

    Edited to add: natania, I see that you are a nursing student. Have you done your OB rotation yet? Have you seen a circumcision?
  2. by   ElvishDNP
    Quote from mvanz9999
    It also leaves the owner with some say in the matter!:spin:
    This is a very valid point, mvanz. My son's foreskin is HIS, not mine. If it is not diseased, there is no reason to get rid of it, just as I wouldn't have his appendix removed 'just in case.' Especially not while he is a newborn!
  3. by   vashtee
    Quote from Arwen_U
    I think what KYCNM was pointing out was that we have the highest circumcision rates in the world along with a very high incidence of STDs. So it kind of takes the wind out of the 'circumcision-stops-STDs' argument. I think that's what she's arguing. Please correct me if I'm wrong, KYCNM.

    Edited to add: natania, I see that you are a nursing student. Have you done your OB rotation yet? Have you seen a circumcision?
    Yes, I saw his/her point, but my point is that the circumcision rates in the US (while still high) are FALLING and the STD rates are RISING. Anyway, I'm not sure who was arguing that circumcision STOPS STDs...

    And yes, I am in Peds/OB now. I've seen several circumcisions, but they were all done by a moyel. To be honest, I was expecting it to be brutal the first time around, but it wasn't nearly as bad as I was expecting. One baby even slept through it. Of course, these moyels were also physicians, so the babies had local anesthesia beforehand. Based on what I am reading on this thread, I guess that isn't necessarily the case in the hospital. (The hospital I am working in does not do circumcisions on newborns.)
    Last edit by vashtee on Nov 14, '07
  4. by   Spidey's mom
    Quote from danissa
    Arwen no, my boy neither notices nor cares that hes different from his Father. then again, he's fifteen, so doesn't discuss his anatomy with me one bit at the moment!! When he was younger though, never bothered, and I'm sure it wont matter to him in the future, as long as his bits are healthy and happy! If, like my brother, he finds he needs it when hes older, then its his choice.

    the vaseline wrap thing babe, wow, thats a bit scary protection wise isnt it. From the point of covering raw skin...when the wee guys pee, surely it falls off! poor wee guys!

    We go in asap after the doc leaves and REMOVE that gauze - the RN's and CNA's hate it because it sticks to the raw head of the penis. We simply slather the penis in petroleum jelly and usually there isn't a problem.

    NO GAUZE.

    steph
  5. by   danissa
    Quote from stevielynn
    We go in asap after the doc leaves and REMOVE that gauze - the RN's and CNA's hate it because it sticks to the raw head of the penis. We simply slather the penis in petroleum jelly and usually there isn't a problem.

    NO GAUZE.

    steph
    Steph, what do the wee guys have for pain relief following procedure?
    And are they not screaming when they pee? Just interested, have no fixed opinion here
    Last edit by danissa on Nov 14, '07 : Reason: forgetful mind!
  6. by   rnin02
    No gauze? We slather gauze with vaseline (I really, really pile it out) and put that gauze on. I would think that would do a better job of keeping the poop away somewhat...no gauze seems to be asking for trouble. And the majority of babies I have seen scream like the devil when they pee on a fresh circ, they really scare their parents sometimes. Especially the brand new parents who are already freaked out by the way a baby cries when you change a diaper anyway, poor parents. Our babies get sweet-ease before and during the circ, lidocaine block before the circ (or rarely emla cream) and then a one time dose of tylenol after the circ.
  7. by   danissa
    [QUOTE=rnin02;2496549]And the majority of babies I have seen scream like the devil when they pee on a fresh circ, they really scare their parents sometimes. Especially the brand new parents who are already freaked out by the way a baby cries when you change a diaper anyway, poor parents.

    See, thats horrible!
  8. by   rnin02
    [quote=danissa;2496559]
    Quote from rnin02
    And the majority of babies I have seen scream like the devil when they pee on a fresh circ, they really scare their parents sometimes. Especially the brand new parents who are already freaked out by the way a baby cries when you change a diaper anyway, poor parents.

    See, thats horrible!
    yeah, i agree, it makes the babies a little unhappy and not themselves for at least a day. my husband is not circ'd, and has not had any issues ever...should we ever have a little boy, he will not be circ'd.
  9. by   danissa
    so, would these babies be given even paracetamol as a follow up pain relief?
  10. by   KYCNM
    OK. Yes, the circumcision rates have been falling since 1987. However, the rate of circumcision in the US is still above 50%. An online article (Declining Rates in Male Circumcision amidst Increasing Evidence of its Public Health Benefit) found increased rates of STIs in uncircumcised males, but their study was flawed because only males visiting an STI clinic were included. They didn't go out on the street and examine guys there to see if they had an STI or were circumcised, so the findings cannot be generalized to the population.

    Further, the major decline has been over the past decade, and I hardly think 10 year olds are contributing to the major increase over the past year.
    Last edit by KYCNM on Nov 15, '07
  11. by   Spidey's mom
    Quote from danissa
    Steph, what do the wee guys have for pain relief following procedure?
    And are they not screaming when they pee? Just interested, have no fixed opinion here
    Nothing for pain after - they just get the lidocaine prior and the procedure takes about 10 minutes.

    We've not noticed any screaming with peeing.

    What has happened is the gauze that the doc places gets stuck, even with petroleum jelly. And trying to pull that off does cause pain for the baby and sometimes bleeding. So, we take it off before it gets stuck. And slather on petroleum jelly.

    steph
  12. by   ElvishDNP
    Quote from natania
    Based on what I am reading on this thread, I guess that isn't necessarily the case in the hospital. (The hospital I am working in does not do circumcisions on newborns.)
    The hospital I work at gives Tylenol beforehand - a big loading dose, more than what you'd give for a fever. They also get local anesthesia. They also get sucrose before, during, and after prn. And they still scream. The scream of a circumcision is different than the scream of hunger or a wet diaper.

    The bottom line for me is that there are other ways to prevent STD transmission that do not involve irreversibly messing with the genitalia of baby boys. The foreskin is a NORMAL body part.

    But if you want to follow that line of reasoning, maybe we ought to just do penectomies. Bet that would REALLY cut HIV transmission.
  13. by   crissrn27
    The hospital I left a few months ago did sweet ease immediately prior. Thats it. I did notice screaming during and after (especially with pee). No Tylenol, no nothing. Wait, we did have one doc that did EMLA 1 hour pre.

    We did jelly gauze until 1st diaper change, then jelly in diaper only. I did notice that the gauze would sometimes stick, so I tried to get to the gauze before the doc, and really load it up for them, and that seemed to work better. Think it is too little jelly that causes the sticking.

    I always have to say (and have gotten in trouble for this) that the AAP no longer recommends routine circs, when asking if they want a circ. That is all I say, cause I catch enough grief even for this, but most of the docs do NO teaching. They ask if they want it, then they put the $$ in their pockets, do the circ and walk away. I would love for a doc to do actual teaching and see if that would change pts minds.

    At my old hospital it was $200 out of pocket. I work with Arwen now. How much is where we are Arwen? I can't remember what I was told, something like $600-700. Medicaid and lots of insurances are not covering this now. Docs don't want circs to go away, they are making big money on this. All that cash for a 5-10 min (hopefully) procedure.

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