When circ's go bad... - page 6

Has anyone seen a circ go really bad? I saw one today where the doc took too much foreskin off and the skin on the shaft ended up "degloving" from the fascia underneath. A urologist had to come in... Read More

  1. by   Ross1
    Quote from jwk
    You're a medical professional (to be) - quote your sources, otherwise it's called hearsay. You say you're not a "radical anti-circumcision activist", but that kind of statistic is straight out of their playbook.
    Excerpts From the American Association of Pediatrics 1999 Policy statement:

    CHICAGO - After analysis of almost 40 years of available medical research on circumcision, the American Academy of Pediatrics (AAP) issued new recommendations today stating that the benefits are not significant enough for the AAP to recommend circumcision as a routine procedure. The new policy statement was published in this month's issue of Pediatrics, the journal of the AAP..........................

    Studies conclude that the risk of an uncircumcised man developing penile cancer is more than three-fold that of a circumcised man. However, the AAP policy notes that in the United States only 9 to 10 cases of this rare disease are diagnosed per year per 1 million men, indicating that while the risk is higher for uncircumcised men, their overall risk is extremely low.


    I don't need to quote statistics or citations to form my opinion. Circumcision is a surgery and ALL surgery has risks. Clearly a certain percentage of circumcisions do go wrong as evidenced by the postings on this list. Why would anyone impose a surgical procedure on a healthy patient for which there is no medical reason for that surgery? .....especially on something as sensitive and important as a male's sexual organs?

    If anything is radical, it is circumcision. All a male requires is basic hygiene and he will have no problems with his foreskin. I know this firsthand experience.......not from what others tell me...and not from anti-circumicsion web sites....but from my own actual experience as a male (with a foreskin.....which is probably more then most of the posters in this discussion can say!)

    It is true that circumcision does promote penile hygiene, but so does soap and water. I'm sure that the men out there who have had botched circumcisions, and there are many, would much rather have a life of soap and water then their botched circumcision. Even if the complication rate of circumcision is only 1%, that is still a lot of people given the numbers of male babies born each year in the USA.
  2. by   jwk
    Quote from Ross1
    Studies conclude that the risk of an uncircumcised man developing penile cancer is more than three-fold that of a circumcised man. However, the AAP policy notes that in the United States only 9 to 10 cases of this rare disease are diagnosed per year per 1 million men, indicating that while the risk is higher for uncircumcised men, their overall risk is extremely low.
    Close but no cigar - your original stat was regarding the mortality rate from infant circs compared to penile cancer. This statement from the AAP doesn't address that.

    Quote from Ross1
    Why would anyone impose a surgical procedure on a healthy patient for which there is no medical reason for that surgery?
    That would leave out about 98% of the work that plastic surgeons do every day.

    I think the main point is that it's up to the parents to decide what is or is not appropriate in this situation - not you, not the RN in the nursery, not me. Whether you agree with it or not, it's a perfectly legal procedure nationwide, and I'd guess you'd have a hard time restricting it.

    Quote from gompers
    I might add that this particular hospital had a policy of putting EMLA cream on the babies an hour before the procedure...if they had insurance. If they didn't, NO ANALGESIA was used. NONE. :angryfire
    And this is amazingly unethical. The standard of care is the same, insurance or no insurance. Did you (if you worked here) or anyone else at that hospital have the cojones to report this? It's called advocating for your patient. By being silent, you're complicit in the act.
  3. by   Spidey's mom
    Interesting perspectives from the guys - thanks.

    I do remember arguing with my husband at the time regarding the cleanliness issue . .. "you know, it is very difficult to keep little kids ears clean and they get those darn ear infections all the time so why don't we just lop off our son's ears while we are at it?". He didn't think that was very funny. He still insisted that our boys be circumcised.

    I still say that the majority of the time it is the man who advocates for circumcision, not the women.

    I still feel awful that I had to sign the consent since I was the one who gave birth. I really wanted it to be my husband but it had to be me. And I didn't want it done.

    steph
  4. by   Ross1
    I guess this discussion may be somewhat futile because minds are made up. But let's not forget what originally started the discussion. A new graduates observation of a severely botched circumcision. And it is that little boy and future man who is going to have to live with the physical, psychological, and sexual implications of having a deformed penis. Not you, not I, not the RN, and not the MD. This trauma was completely preventable.

    I do agree with you on one point though. You comment about cosmetic surgery is correct, however, most cosmetic procedures are performed on patients who can consent to the operation, or as is sometimes the case, on minors who may be disfigured and the surgery is "reconstructive" as well as cosmetic. I believe in such cases, the pros far outweigh the risks and the parent does have the legal and moral right to make that decision on behalf of the child. Circumcision just doesn't meet that standard. Having a natural intact penis is not a disease or a deformity that requires surgical intervention so I disagree that it is the parent's right to make this decision.
    What if the parent decided to cut the child's ear lobe off? Would that be okay?





    Quote from jwk
    Close but no cigar - your original stat was regarding the mortality rate from infant circs compared to penile cancer. This statement from the AAP doesn't address that.


    That would leave out about 98% of the work that plastic surgeons do every day.

    I think the main point is that it's up to the parents to decide what is or is not appropriate in this situation - not you, not the RN in the nursery, not me. Whether you agree with it or not, it's a perfectly legal procedure nationwide, and I'd guess you'd have a hard time restricting it.


    And this is amazingly unethical. The standard of care is the same, insurance or no insurance. Did you (if you worked here) or anyone else at that hospital have the cojones to report this? It's called advocating for your patient. By being silent, you're complicit in the act.
  5. by   Fiona59
    OK, Ross, we get it you are attached to your foreskin. So are my husband and sons. But it is not my place as a nurse to try and get a family to change their ways.

    It's a personal choice that a family makes for religious or cultural ideals. We as nurses are not there to judge their practices only make sure the child is adequately cared for. I often wonder how many "accidents" that the religious practioners have or is it just a problem for doctors.

    I mean, when I gave birth, I had male doctors who decided that a forceps delivery was "best" for me. I didn't get a lot of input into that. End results, torn cerevix, and within five years corrective surgery. Trust me it wasn't pretty. I was kind of attached to my original parts to..
  6. by   Mimi2RN
    We only have one ped does circs in the hospital, and most parents don't ask about it. As we have at least 50% hispanic population, I don't think even 40% of the babies are circed.

    Anyone remember the story from at least 30 or 40 years ago about twins being circed, the doc was using something new to cauterize, and bungled the job on one baby. I think the doc severed the end of his penis. To make matter worse, the parents were talked into castrating the baby and raising him as a girl.

    As an adult, the boy decided he was really male, and later wrote a book.
  7. by   Ross1
    Quote from Mimi2RN
    We only have one ped does circs in the hospital, and most parents don't ask about it. As we have at least 50% hispanic population, I don't think even 40% of the babies are circed.

    Anyone remember the story from at least 30 or 40 years ago about twins being circed, the doc was using something new to cauterize, and bungled the job on one baby. I think the doc severed the end of his penis. To make matter worse, the parents were talked into castrating the baby and raising him as a girl.

    As an adult, the boy decided he was really male, and later wrote a book.
    That was just in the news last year. Sadly, the victim committed suicide last year. Source:
    http://www.cbc.ca/news/background/reimer/
  8. by   Spidey's mom
    Quote from Mimi2RN
    We only have one ped does circs in the hospital, and most parents don't ask about it. As we have at least 50% hispanic population, I don't think even 40% of the babies are circed.

    Anyone remember the story from at least 30 or 40 years ago about twins being circed, the doc was using something new to cauterize, and bungled the job on one baby. I think the doc severed the end of his penis. To make matter worse, the parents were talked into castrating the baby and raising him as a girl.

    As an adult, the boy decided he was really male, and later wrote a book.


    I read that book. Sadly, as noted, both he and his brother killed themselves. If you read the book, the doctor who took care of their psychological needs was and is a very sick man. The man who ended up being raised as a girl ended up very angry at the doctor who made he and his brother do very weird things during their sessions with him. Dr. Money should be removed from his positon at John's Hopkins and thoroughly discredited - but there he sits. :angryfire

    I've read the book over a couple of times . .. he forgave his parents in the end but it would have been better if he had been raised the sex he was.

    It is a good book but very sad.

    steph
    Last edit by Spidey's mom on Feb 21, '05
  9. by   Mimi2RN
    Steph, do you remember the title of the book? I haven't read it yet, and I could add it to my stack to read while I'm off sick.

    Mimi
  10. by   Spidey's mom
    Quote from Mimi2RN
    Steph, do you remember the title of the book? I haven't read it yet, and I could add it to my stack to read while I'm off sick.

    Mimi
    Yeah, it is sitting right here . .. "As Nature Made Him: The Boy Who Was Raised As A Girl" by John Colapinto.

    steph
  11. by   Gompers
    Quote from jwk
    And this is amazingly unethical. The standard of care is the same, insurance or no insurance. Did you (if you worked here) or anyone else at that hospital have the cojones to report this? It's called advocating for your patient. By being silent, you're complicit in the act.
    Jeez, give me a break here, I was just telling the story of a circ gone bad!!! I was doing my very first rotation as a junior nursing student, it was the second day of clinical, and I was petrified. We hadn't yet learned about circumcision in class yet, and all I was doing was helping soothe the baby during the procedure. I had no clue what was normal! Only when I commented about the baby being in pain as they examined him did the docs informed me that he had no insurance so they didn't use EMLA on him. I did point it out to my instructor that I thought it was totally wrong to provide pain relief to some infants but not others, so yes I did report it to someone. It was an absolute pit of a hospital, and I haven't set a foot in there since my clinicals ended.
  12. by   jwk
    Quote from Gompers
    Jeez, give me a break here, I was just telling the story of a circ gone bad!!! I was doing my very first rotation as a junior nursing student, it was the second day of clinical, and I was petrified. We hadn't yet learned about circumcision in class yet, and all I was doing was helping soothe the baby during the procedure. I had no clue what was normal! Only when I commented about the baby being in pain as they examined him did the docs informed me that he had no insurance so they didn't use EMLA on him. I did point it out to my instructor that I thought it was totally wrong to provide pain relief to some infants but not others, so yes I did report it to someone. It was an absolute pit of a hospital, and I haven't set a foot in there since my clinicals ended.
    Lighten up - you did the right thing! You spoke up!. The surgeon is the one who was unethical, not you. Hopefully someone further up the line took notice. Funny that a nursing student on their 2nd day of clinical notices the problem that everyone else is ignoring.
  13. by   DidiRN
    JWK, are you a nurse?



    Quote from jwk
    Close but no cigar - your original stat was regarding the mortality rate from infant circs compared to penile cancer. This statement from the AAP doesn't address that.


    That would leave out about 98% of the work that plastic surgeons do every day.

    I think the main point is that it's up to the parents to decide what is or is not appropriate in this situation - not you, not the RN in the nursery, not me. Whether you agree with it or not, it's a perfectly legal procedure nationwide, and I'd guess you'd have a hard time restricting it.


    And this is amazingly unethical. The standard of care is the same, insurance or no insurance. Did you (if you worked here) or anyone else at that hospital have the cojones to report this? It's called advocating for your patient. By being silent, you're complicit in the act.

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