CDC rec to counsel all males about benefits of circumcision

allnurses Guide · Dec 6, 2014

Are there studies showing that in the United States we will see a significant decrease in STIs? I have never seen such a study.

You can look them up too. I think many of the studies have biases. I do know that the CDC, ACOG, WHO, and AAP all agree that there is enough compelling evidence to state that routine male circumcision health benefits outweigh the risks.

"Circumcision and non-ulcerative STI

In a prospective multicenter USA study, there was evidence

for an increased incidence of gonorrheal infection in uncircumcised

men (odds ratio 1.5), but no difference with

respect to chlamydial infection.68 In a South African trial,

Chlamydia trachomatis infections decreased among circumcised

men with a borderline statistical significance.69 A

randomized trial, which investigated the prevalence of Neisseria

gonorrhoeae amongst South African men, showed that

circumcised and uncircumcised men showed similar prevalence

rates,70 which was supported by a Kenyan randomized

trial.71 Furthermore, no link between circumcision and

gonococcal or chlamydial urethritis was detected in a

meta-analysis."

http://www.ncbi.nlm.nih.gov/pubmed/23573952

I had to pull the article up with my school account so you won't be able to see what I quoted unless you can get the full article.

caroladybelle, BSN, RN · Dec 6, 2014

Are those against circumcision for infant boys also against ear piercing for infant girls? I'm just curious.

I am.

caroladybelle, BSN, RN · Dec 6, 2014

As a mom to an intact male, the majority of this thread makes me smile. Thankful for nurses who realize that the foreskin isn't a meaningless useless flap of skin, it is a functioning organ. We do not remove breasts because they might get cancer. We do not remove the appendix, because it might rupture. There is preventative medicine and then there are unnecessary medical procedures.

A point of error.

For those of us with significant family histories, we may undergo genetic testing for BRCA 1 and 2. During the required genetic counseling, one of things discussed is how the patient will use the information and what options for reducing risk if positive are discussed. One of those options includes prophylactic bilateral mastectomy and removal of both ovaries. Note, that option does not eliminate risk, it merely reduces the risk. In addition, not all women positive for the gene will get breast or ovarian cancer. Thus, they may be getting the procedures done, despite perhaps possibly never getting the disease at all.

Red Kryptonite · Dec 6, 2014

A point of error.
For those of us with significant family histories, we may undergo genetic testing for BRCA 1 and 2. During the required genetic counseling, one of things discussed is how the patient will use the information and what options for reducing risk if positive are discussed. One of those options includes prophylactic bilateral mastectomy and removal of both ovaries. Note, that option does not eliminate risk, it merely reduces the risk. In addition, not all women positive for the gene will get breast or ovarian cancer. Thus, they may be getting the procedures done, despite perhaps possibly never getting the disease at all.

But you're not going to test baby girls and then remove their breast buds, right? We're talking about adult women making decisions about their own bodies.

Red Kryptonite · Dec 6, 2014

I am.

Me too. None of my children of either sex had ears pierced until they we're old enough to ask to have it done, and had the maturity to understand that there was guaranteed pain and some risk of infection, which would mean more pain and probable loss of the piercing. Ear piercing is WAY below circumcision when it comes to tissue damage, pain, and affecting functionality and wholeness, so I thought it appropriate to allow them to choose it even as minors, once they understood the risks.

caroladybelle, BSN, RN · Dec 7, 2014

The poster that I quoted, posted that breasts are not removed to remove risk of disease. I merely pointed out that was incorrect. In addition,most genetic testing, including for BRCA 1/2 advises and in many cases REQUIRES counseling of someone reasonably capable of making a competent decision and those decisions for treatment of underage pts be limited. That would exempt children from having extensive testing or surgery unless there was very sound reasoning. As there is no mass epidemic of BRCA positive children dying with breast cancer, there would be no reason to be removing "breast buds", now would there be?

I have no desire to have unnecessary surgery forced on anyone underage, including piercing and tattoos. I do not see where I advocated removing baby breast buds or any other "bulldust" as you are suggesting. Please use someone else's words for posting your hyperbolic statements.

guest64485 · Dec 7, 2014

I am sorry that you do not know how to use pubmed to look up research studies, but here is the abstract to the one I mentioned earlier.
Effects of circumcision on male sexual functions: a systematic revi... - PubMed - NCBI
Common sense would state that if you are going to debate a medical/physiological point then you provide research literature to support your point. You have failed to do this, and the only thing that you can come up with is poor designed study from an anti-circumcision site. It isn't me that is lacking in showing evidence it is you.
P.S. I have the equipment, so I am not the one confused.

Here's a quote from your study

There were no significant differences in sexual desire (odds ratio (OR): 0.99; 95% confidence interval (CI): 0.92-1.06), dyspareunia (OR: 1.12; 95% CI: 0.52-2.44), premature ejaculation (OR: 1.13; 95% CI: 0.83-1.54), ejaculation latency time (OR: 1.33; 95% CI: 0.69-1.97), erectile dysfunctions (OR: 0.90; 95% CI: 0.65-1.25) and orgasm difficulties (OR: 0.97; 95% CI: 0.83-1.13).

As I expected, and as this study shows, you continue to argue a point I've never been talking about. 90% of what you are writing has no application to the point I've tried to clarify over and over. We continue to talk past each other. I don't know how to make myself any more clear.

Good night.

allnurses Guide · Dec 7, 2014

But you're not going to test baby girls and then remove their breast buds, right? We're talking about adult women making decisions about their own bodies.

There really is no comparison. Male circumcision has the most medical and public health benefits when done as an infant.

That is why there needs to be an unbiased discussion with parents about the benefits and risks of circumcision, preferably during prenatal care that way parents have time to think about the decision.

allnurses Guide · Dec 7, 2014

Me too. None of my children of either sex had ears pierced until they we're old enough to ask to have it done, and had the maturity to understand that there was guaranteed pain and some risk of infection, which would mean more pain and probable loss of the piercing. Ear piercing is WAY below circumcision when it comes to tissue damage, pain, and affecting functionality and wholeness, so I thought it appropriate to allow them to choose it even as minors, once they understood the risks.

Complication rates are actually higher with ear piercing than male circumcision.

macawake, MSN · Dec 7, 2014

Are those against circumcision for infant boys also against ear piercing for infant girls? I'm just curious.

I definitely am. Pierced ears aren't a medical necessity, the child can decide when she or he gets old enough if they want pierced ears. I'm also against parents who have their children tattooed (yes, I have seen that) or have any other invasive and or permanent procedures performed that aren't medically necessary. It bothers me when parents view their children as an extension of themselves rather than autonomous individuals with an inalienable right to physical integrity.

I've mentioned it before, but I can't stress it enough. The widespread acceptance of circumcision of male infants in the US is heavily influenced by culture. I've noticed that it upsets some posters when male circumcision is compared to the female version. However to many people, myself included, both procedures are a violation of a child's autonomy. While I certainly agree that the procedure for females is much more drastic, the principle is the same. It involves adults deciding to surgically alter the body of a healthy child. I simply don't believe that a person should have that power over another human being.

If an adult male chooses to be circumcised, that's in my opinion a completely different issue. It's his body and he has the right to decide.

The following article authored by several European Pediatricians describe very well why I'm against circumcision of male infants. Among many other things it discusses criteria for preventive medicine. There should 1) exist strong evidence for effectiveness and 2) no other more effective and less intrusive means to achieve the same goal are available.

I think that this is a good and informative article but I doubt that it will sway anyone who's firmly in the circumcision support camp. I feel that the strongly held cultural or religious beliefs and also the emotional component invested by someone who themself is circumcised or has decided to have their child circumcised, makes it hard to view this topic in a dispassionate way.

http://pediatrics.aappublications.org/content/131/4/796.full.pdf

allnurses Guide · Dec 7, 2014

Here's a quote from your study
As I expected, and as this study shows, you continue to argue a point I've never been talking about. 90% of what you are writing has no application to the point I've tried to clarify over and over. We continue to talk past each other. I don't know how to make myself any more clear.
Good night.

It helps if you actually know how the author's define the things they are studying and not just draw your own conclusions. It also helps if you read the whole study and not just the abstracts.

Most sexual surveys on sexual function are going to include some kind of question on masturbation.

I really hope you aren't basing an argument against male circumcision based on the possibility of circumcised male occasionally needing lube...

"The representative National Health and Social Life Survey of 1,410 U.S. men aged 18–59 years found that sexual dysfunctions were more common among uncircumcised men [40]. This was slight at younger ages, but became more frequent later in life (Table 3). Similarly, a large telephone survey of men aged 16–64 in Australia found that circumcised men reported fewer sexual difficulties for a month or more during the previous year [27]. Problems were reported most often among men over 50 years of age (27% for uncircumcised and 15% for circumcised men) [27]. The difference became not statistically significant (P = 0.09) in a later survey of half of the subjects [39]. The latter study found that circumcised men were somewhat less likely to have worried during sex about whether their bodies looked unattractive (OR 0.77, 95% CI 0.61–0.99; P = 0.04). Masturbation was more common in the circumcised men (OR 1.2, 95% CI 1.03–1.40; P = 0.02), consistent with the U.S. study [40]."

It really appears that circumcised guys are having sexual problems and masturbating.

allnurses Guide · Dec 7, 2014

I definitely am. Pierced ears aren't a medical necessity, the child can decide when she or he gets old enough if they want pierced ears. I'm also against parents who have their children tattooed (yes, I have seen that) or have any other invasive and or permanent procedures performed that aren't medically necessary. It bothers me when parents view their children as an extension of themselves rather than autonomous individuals with an inalienable right to physical integrity.
I've mentioned it before, but I can't stress it enough. The widespread acceptance of circumcision of male infants in the US is heavily influenced by culture. I've noticed that it upsets some posters when male circumcision is compared to the female version. However to many people, myself included, both procedures are a violation of a child's autonomy. While I certainly agree that the procedure for females is much more drastic, the principle is the same. It involves adults deciding to surgically alter the body of a healthy child. I simply don't believe that a person should have that power over another human being.
If an adult male chooses to be circumcised, that's in my opinion a completely different issue. It's his body and he has the right to decide.
The following article authored by several European Pediatricians describe very well why I'm against circumcision of male infants. Among many other things it discusses criteria for preventive medicine. There should 1) exist strong evidence for effectiveness and 2) no other more effective and less intrusive means to achieve the same goal are available.
I think that this is a good and informative article but I doubt that it will sway anyone who's firmly in the circumcision support camp. I feel that the strongly held cultural or religious beliefs and also the emotional component invested by someone who themself is circumcised or has decided to have their child circumcised, makes it hard to view this topic in a dispassionate way.
http://pediatrics.aappublications.org/content/131/4/796.full.pdf

When there is a medical and public health benefit with no decrease in function from female circumcision then it will be appropriate comparison to male circumcision until then there is no appropriate comparison in what should be discussion on the medical and public health benefits of male circumcision.

It might also be helpful to read the commentary from the AAP before making a one-sided decision on male circumcision. The original author "cherry-picked" his articles to support his/her view on circumcision, which is obvious since there is no methods section in the article telling the readers how the author systematically chose these articles.

Cultural Bias and Circumcision: The AAP Task Force on Circumcision Responds