The Circumcision Discussion

Specialties Ob/Gyn

Published

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 :)

Specializes in ABMT.
In any case, it doesn't work, and I doubt we need double blind studies to prove THAT. Speaking of being 'blind' . . . I wonder if circumcision leads to decreased incidents of sudden onset adolescent blindness?

~faith,

Timothy.

HAR! You make me laugh. You are funny. Ha ha.

I believe the adolescent blindness epidemic will only be rivaled in our time by the hairy palm epidemic. Sad, really...

Seriously, thanks for bringing this article to our attention, Timothy. And as a side note,

"lack of male circumcision has also been associated with sexually transmitted genital ulcer disease, infant unrinary tract infections, penile cancer, and cervical cancer in female partners of uncircumcised men. (emphasis mine) The latter two infections are related to human papillomavirus (HPV) infection. Transmission of this virus is also associated with lack of male circumcision."

from CDC HIV/AIDS science facts "Male Circumcision and Risk for HIV Transmission: Implications for the United States, December 2006.

http://www.cdc.gov/hiv/resources/factsheets/pdf/circumcision.pdf

Cervical cancer has been referred to as "a developing epidemic" with high rates in sub-Saharan Africa. http://www.paho.org/English/DD/PIN/pr041220.htm

Naturally, the HPV vaccination will most likely bring those rates down the most dramatically in developing nations. However, this news about circumcision is very promising--a relatively simple procedure that can potentially reduce HIV rates and oh yeah by the way reduce cervical cancer rates is exciting.

Again, thanks, Timothy,

Rebecca

Specializes in Critical Care.
Unofficial Anecdotal Poll of my 17 yr old son:

"You're discussing THAT online? . . . Mine, specifically????"

Followed (after a few faces of disgust) with a sheepish: "I don't care, I'm just glad I don't remember it."

I'll take that as validation of BOTH my right as a parent to make an informed decision AND the timing of said decision.

~faith,

Timothy.

I have to laugh at this post Timothy. One of my sons had almost the same reaction!!!

My 20 year old just clammed up and said, "Mom, you shouldn't be talking about my thing online."

My 22 year old said he didn't care who talked about it or where. He was proud of his.

They both aren't circumcised and feel that it didn't matter one way or the other.

tvccrn

There is so much sickness in Africa, and I don't just mean the diseases that are being passed around. There is poverty, government corruption, corruption amongst the people, promiscuity and rape occurring daily. It is a "sick" place and they desperately need help, because this illness runs deep.

Thank you for quoting me. Let me clarify my statement. I replied yesterday and lost the entire post in cyber-space! Here it goes again...

When I said, sick, I purposely put it in quotation marks, because I didn't mean it in a derogatory way. I was trying to say that the problem is not just a physical one, but runs much deeper than that. It is an emotional and spiritual illness (not speaking religiously here, but more about the human spirit). Meaning, we can't just treat the physical ailments, because there is much more involved than just the AIDS epidemic. I feel we need to have much compassion and sympathy for them, and I always have.

As far as lumping all of Africa into one group, I don't feel anyone here has done that. Obviously, it's a vast and diverse group of countries, but this thread was directed at those places (Sub-Saharan) where HIV/AIDS has reached epidemic proportions. I guess I just assumed that everyone posting knows this is the Africa we are all referring to. I don't claim to be the definitive authority on Africa, but I know enough about it to know that the things I mentioned in the above quote are all parts of the problem.

Teenage girls are targeted sexually, because they are seen as virgins and therefore free of HIV. In some places, for every teenage boy five times the amount of girls are infected. Also places like Uganda, where they have seen a decrease in the spread of HIV it is due to education, changes in sexual behaviors and condom usage. I think there is still a lot of mystery surrounding why it has become such an epidemic so quickly.

I think your assessment of me was unfair, but maybe I should have used different terminology or explained further. I'm probably more interested, concerned and compassionate about those suffering in Africa, than most people I know. I have always had the desire to go there and help out. School, marriage and kids seems to have ruled it out, but maybe in the future.

My personal thoughts is I would never circumcise my son. It is also part of my boyfriend's culture to NOT circumcize.

That being said, for those in high risk areas/groups for HIV, this is something that should be included in the education about prevention for HIV.

I am rather uneducated about it all now, but one of my goals in life is to work in PREVENTITIVE health and I want to educate people about HIV and other issues. And not only educate on direct prevention, but in other ways as reading and writing and helping them too to have the resources to change the way their country/community is living.

see the problem I have with this is the idea that advocating an invasive surgical procedure in a continent notorious for the inavailability of properly sterilized instruments. Has anyone looked into the prevalence of aids transmission through this?

Specializes in Emergency & Trauma/Adult ICU.
have you even seen a circ performed?

i have, and this baby passed out from the pain with a local. the doctors are known for not using enough, or not waiting long enough for it take effect. time is money, you know. i asked the nurses if this was a common practice and if other babies pass out, and they all said, yes.

frankly, until we can remember what it's like to be a newborn and experience the pain, it's really not fair for us to assume it's not unbelievably painful. from what i witnessed...it is. personally, i think all parents should witness one before they decide to send their own child in. i can pretty much assure you the rates would drop.

pain free, or not, it still should not be our right to take a way a perfectly healthy part of a male's body.

for this discussion among medical professionals, can you clarify what you mean by "passed out"? do you mean the infant became unresponsive? what measures were initiated to revive the child? what evidence do you have that this troubling episode of unresponsiveness in a neonate was connected to the procedure?

are there any nicu nurses reading this discussion who could comment from experience on unresponsiveness in neonates undergoing procedures?

there will not come a time when we "remember" infant experiences with the clarity that we can recall some events from early childhood on. i don't have a text handy, but pull out any psych 101 text and refer to a chapter on memory.

Specializes in Emergency & Trauma/Adult ICU.

this is one of my favorite quotes on the subject of circumcision:

"nature is a possessive mistress, and whatever mistakes she makes about the structure of the less essential organs such as the brain ans stomach, in which she is not much interested, you can be sure that she knows best of the genital organs." sir james spence

if any one is interested there is an organization called nurses for the rights of the child. www.cirp.org/nrc/

any psych nurses reading this? i'm at a loss to properly dx this all-encompassing focus on genitalia. i have no idea who james spence is/was ... but after reading his view that "nature" considers the brain and stomach to be "less essential" organs ... i don't feel the need to supplement my knowledge of him.

mvans ... i hope you have sought appropriate treatment. i am familiar with a large number of amputees who are less conflicted about losing one or more limbs, w/life-altering consequences, as adults, than you seem to be about the removal of foreskin as an infant.

Specializes in Accepted...Master's Entry Program, 2008!.
Any psych nurses reading this? I'm at a loss to properly dx this all-encompassing focus on genitalia. I have no idea who James Spence is/was ... but after reading his view that "Nature" considers the brain and stomach to be "less essential" organs ... I don't feel the need to supplement my knowledge of him.

mvans ... I hope you have sought appropriate treatment. I am familiar with a large number of amputees who are less conflicted about losing one or more limbs, w/life-altering consequences, as adults, than you seem to be about the removal of foreskin as an infant.

Who wants to volunteer for a Clitoridotomy? Perhaps we should circumcise all females as well?

I see. But I suspect your adult amputees would feel differently if they had an arm or leg removed for aesthetic purposes rather than a medical reason. Would your adult amputees be so resolute if someone had removed a limb for cosmetic purposes? So maybe they looked just like their dad? I think NOT.

You can speak further about the mater after you have been circumcised yourself.

Specializes in Emergency & Trauma/Adult ICU.
see the problem I have with this is the idea that advocating an invasive surgical procedure in a continent notorious for the inavailability of properly sterilized instruments. Has anyone looked into the prevalence of aids transmission through this?

As you will remember from microbiology, HIV does not live on surfaces. If there is a lack of properly sterilized instruments being used in surgical procedures, this is certainly a huge problem in and of itself as there are a multitude of other organisms which could be transmitted ... but it has no bearing on transmission of HIV.

Specializes in Community, OB, Nursery.

I have seen many babies "shut down" after circs and refuse to breastfeed (or bottlefeed, for that matter) for 12-24 hours...leading to dehydration and jaundice and heelsticks and bilibeds etc. That in and of itself is enough to make me not want to have any of my boys circd.

Specializes in PERI OPERATIVE.

I've seen many circs done while working in OB. I've NEVER seen a baby pass out, nor have I ever heard of it.

I'll keep my personal opinions to myself...

Pain causes an extreme amount of stress to the neonate.

According to Marenstein (2006) it can cause (among others):

- Increased need for oxygenation, which may result in respiratory and alkalosis and tissue hypoxia.

- increased ICP, increasing the risk for intraventricular hemorrhage.

- increased serum gluscose levels and decrease of insulin production.

- catabolic stress.

- Aversion to feeding.

- weight loss.

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