The Circumcision Discussion - page 17

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   onehusbandsevenkids
    Quote from tvccrn
    As a Mom-to-be, I am still on the fence about this. Yes, my other two sons are uncircumcized and one wishes he had been. Everytime I read things like this it goes further toward no circumcision. I was interested in seeing the pictures so I know what kinds of things to look for if, and that's a big if, I decide to go this way. but, the pictures wouldn't come up, it said page not found. Is there a way you can provide a link to the blog for reference?

    shoot! let me look for it!
  2. by   onehusbandsevenkids
    Quote from tvccrn
    As a Mom-to-be, I am still on the fence about this. Yes, my other two sons are uncircumcized and one wishes he had been. Everytime I read things like this it goes further toward no circumcision. I was interested in seeing the pictures so I know what kinds of things to look for if, and that's a big if, I decide to go this way. but, the pictures wouldn't come up, it said page not found. Is there a way you can provide a link to the blog for reference?

    VERY graphic and disturbing

    lets see if this one works...
    Last edit by onehusbandsevenkids on Dec 20, '06
  3. by   onehusbandsevenkids
    one more and then I'll leave it alone because the entire issue raises by BP.

    "I think this child has an infected penis after neonatal circumcision;" Fournier's gangrene.

    6 day old baby with infection from circ and the horrifying consequences

    very graphic.

    OB nurses also tell me that these types of problems happen much more frequently than the public is aware of.

    complications of circumcisions
    Circumcision Complications

    Okay, also here is a teen forum where teen males are discussing being circumcised or not, yes there are some post with the same ole misconceptions and myths & some who are claim they are glad they are circed, BUT there are many who aren't circed and GLAD they werent and there are some that are circed and WISH THEY HADN'T BEEN. Just thought it was interesting to hear from totally anonymous population of teen males
    Student Center Forums, forums, teen forums, teen boards, Puberty, Circumcise (Males Only)
    I like what one guy wrote at the bottom of his post on the bottom of the first page:
    Finally, an educated post. Circumcised men feel the need to circumcise their sons because they were circumcised. Thank God my dad is a doctor, he knew better.
    Last edit by onehusbandsevenkids on Dec 20, '06
  4. by   ICURN_NC
    We are really mixing up to issues here: routine infant circumcision in our culture and whether circumcision can help stop HIV infx in Africa.

    If circumcision can really help (and I have serious issues with this study), why not let the men make an informed decision when they are old enough to be sexually active? Why do they HAVE to circumcise infants? Circ can be presented as another way to protect themselves (IF it's true), like condoms. I think it's flying off the handle a little to start routinely circing infants in Africa to someday keep them from spreading HIV.

    I didn't circ my son, and I'm glad I didn't. But if he grows up and decides to have it done, then I'd respect that decision.
  5. by   ElvishDNP
    Very interesting, the teenage boys' forum. Mine is only 2yo and I guess he would say the advantage to being uncut right now is that it gives him a game to play in the bath: "On/Off." You figure it out.
  6. by   tvccrn
    Those worked. And they are very, very disturbing.

    Thank you.

  7. by   RN mom of 2
    i understand what you mean about having your bp go up! i can't even bring myself to watch time was enough for me. for those who have never seen one, please watch it. i think it's so important for everyone to know what can and does happen to these babies.

    also, to the mom sitting on the fence unsure what to do. i understand how you feel. i was in your shoes with my first pg. i literally agonized over what to do, mainly, because it is so ingrained in our culture that it's the right thing to do, and that your child will have all kinds of horrible infections if you leave them intact. i actually had some elderly friends of my aunt's say, "why would she do that?" they thought i was crazy not to circ. the problem is, there is so much misinformation out there about the care of the intact penis. many things a doc tells parents to do actually cause more problems.

    my son is 4 and has never had a problem. i never retracted it and let him do it himself. retracting it before it's ready causes all kinds of tiny tears, which later get infected. we are so obsessed in this culture with being clean. just like the self cleaning vagina (you wash the outside, but don't go up in the canal) the penis is the same way. it is self cleaning. once the foreskin is ready to retract easily, then it can be cleaned inside. ironically, docs who are not "intact friendly" and who don't understand how to properly care for the uncirc'd penis, tell parent to retract and clean them. when infections set in the myth of intact boys = problems/infections sets in, and the parents feel they did the wrong thing. it is a vicious cycle.

    i'm not sure if you're worried, because your son may feel different from the one who is circ'd? but i use this as an opportunity to tell my son it's more than ok to be different. we should always be teaching this to our kids, and this is just another way to do it. the other day my son wanted to know what was inside the foreskin. i told him it's the top of you penis, and that is the foreskin and it protects your penis. i told him not every boy has that covering, but we wanted you to keep yours. he just said, "ok."

    there is a wonderful site that has great info on the child's intact penis and how to care for it. if you have trouble reading it, click on the little magnifying glass above and it will zoom in to the print. i have to tell you, i am so glad i left my boys intact. i just know i did the right thing for them. if you want to chat about it, i guess there is a pm feature here? i'm sorry, i'm not really sure. i haven't been here that long.

    national organization of circumcision information resource centers
  8. by   onehusbandsevenkids
    wow. this thread got quiet real quick!
  9. by   TiffyRN
    I just didn't know where to go with it when I found out there was a secret circumcision industry sneaking around stealing foreskins to put in skin cream.
  10. by   RN mom of 2
    Quote from tiffyrn
    i just didn't know where to go with it when i found out there was a secret circumcision industry sneaking around stealing foreskins to put in skin cream.
    it's not a secret. they are not stealing them, but rather, purchasing them.

    i wish i could say i compiled all this, but someone already did all the hard work! - used for testing cosmetics, very nice for animals, not so hot for little boys.

    there are at least 3 types of cell cultures derived from foreskin. keratinocytes, melanocytes, and fibroblasts.
    there are 5590 hits for "melanocyte, foreskin" on google.
    at this website you can buy foreskin-derived melanocytes.
    that same website's melanocyte info sheet. a quote:
    "nhem [melanocytes] are isolated neonatal foreskin tissue resulting from routine circumcision..."
    another site's info on melanocytes. quote:
    "human epidermal melanocytes (hem) are primary cells isolated from normal human neonatal foreskin."
    page on melanocyte preparation.
    more melanocyte foreskins for sale here.

    about fibroblasts.
    a google search produces 21,300 hits for fibroblast foreskin.
    "fibroblast cultures derived from neonatal foreskin explants have been an important model for understanding the basic mechanisms of fibroblast function and activity. neonatal foreskin has been routinely usedfor establishing such fibroblast cultures in vitro."

    "we found that outgrowth and propagation of viable fibroblasts in vitro occurred with foreskin samples obtained within 24 days after surgical harvesting."


    watch for the words keratinocyte, melanocyte, fibroblast. if mentioned, ask from what the cells are derived.

    to find the products on the cascade biologics site, you can do a search for "foreskin" and the products will come up. or you can follow the menus across from "products" on the menu bar. it's a bit awkward.

    6xt25 flasks of proliferating cells are $495 !!
    (that's keratinocytes)
    (neonatal endothelial cells)

    there are more types of cells for sale, but i'm sure you get the picture.


    according to this article:

    tns recovery complex is engineered from human foreskins--"dr. wexler also mentioned a new product that boosts collagen production and can rejuvenate skin called tns recovery complex. tns is comprised from six natural human growth factors found in normal healthy skin. dr. wexler told us the factors are engineered from human foreskin!"

    according to this site, which is the main site of the tns complex:

    the priniciple ingredient is nouricel-md

    and according to this site:

    " nouricel-md is a unique product that consists of a concentration of naturally occuring human growth factors derived from bio-engineered tissue cultures. these growth factors help to promote collagen production, new blood vessel growth,thickening of the epidermis, and to decrease inflammation. "
    "the product (tns recovery complex with nouricel-md) contains a concentrated formulation of the nutrient solution
    derived from manufacture of bioengineered human tissue using neonatal fibroblasts. "

    "tns recovery complex with nouricel-md is a product of skinmedica, carlsbad, calif. the enriched tissue nutrient solution used in its manufacture is obtained from advanced tissue sciences. dr. fitzpatrick is founder and chairman of the board of skinmedica."

    looks like skinmedica took over ats in 2003.


    other sites of interest (gleaned from john hopkins center altweb it's a huge site, and i don't have time to search it all, but there is a huge amount of work going on using neonatal foreskin in in order to save animals from being used in testing):
    "alternatives to skin irritation/corrosion testing in animals"

    go to "search abstracts"

    and put in "neonatal foreskin"

    5 results, all research papers using cells derived from neonatal foreskins.
    "a model of the human epidermis, epiderm , cultured from neonatal foreskin-derived normal human epidermal keratinocytes (nhek) was introduced by mattek corporation in april 1993. using highly controlled tissue culture techniques, weekly batches of epiderm are produced and shipped domestically and internationally for dermal irritancy testing, percutaneous absorption studies, and basic skin research, amongst other uses."
    "the u.s. department of transportation now requires companies to assess the skin corrosivity of raw materials and products in order to insure their safe transport. the united nations has issued guidelines and assigned packaging groups to materials based on how quickly corrosion of skin occurs in animal studies: i: less than 3 minutes, ii: 3 minutes to 1 hour, iii: 1 hour to 4 hours, and non-corrosive: greater than 4 hours. it was anticipated that epiderm , a model of the epidermis cultured from neonatal foreskin-derived normal human epidermal keratinocytes would be useful in predicting skin corrosivity since the barrier properties of epiderm have been shown to closely approximate those of normal skin."


    altbib - bibliography on alternatives to animal testing:
    in the search field i put in "neonatal foreskin" 5 results:

    unfortunately, the search results are only held in a temp file, so they don't work when the search expires. i've given the information on how to get there, and i hope it will be possible for other people to easily pull the abstracts up.

    1. "characterization of an immortalized human cell line derived from neonatal foreskin diploid fibroblasts
    authors: chiang lc chiang w chang sf chen hy yu hs
    source: jdermatol 1992;19(1):1-11
    a new human skin cell line, designated as ccfs-1/kmc, immortalized from human neonatal foreskin diploid fibroblast cells, has been subcultured successfully in vitro for more than 500 passages. this anchorage-dependent cell line possesses many common features of transformation such as morphological and cytoskeletal changes, hypotriploidy, infinite lifespan, increasing plating efficiency and saturation density, and decreasing serum requirement and population doubling time. human papillomavirus (hpv) type 18 dna was detected in the cell line before and after immortalization by the polymerase chain reaction (pcr) method. tumorigenicity, however, was not demonstrated in vivo. the authors report that these immortalized human fibroblasts derived from neonatal hpv-18-dna-contained diploid fibroblasts possess double minute chromosomes (dms), a karyotypic aberration usually found in cancer cells."

    interesting that one, some babies appear to have already got hpv??? it's contaminated the cell line, it would be interesting to know if it manages to get into the end products.

    2. "safety evaluation of human living skin equivalents.
    authors: nemecek gm dayan ad

    source: toxicol pathol 1999;27(1):101-3.
    ..the resulting product has the appearance and handling characteristics of human skin. safety evaluation of lses begins with insuring that foreskins are obtained only from healthy infants whose mothers are negative for a panel of adventitious agents."

    i wonder if the mothers realise what is going on here, they're being checked out to make sure their babies are suitable before harvest....

    3. "use of fluorescent redox indicators to evaluate cell proliferation and viability. authors: rasmussen e

    source: in vitro mol toxicol 1999;12(1):47-58.

    ...cultures of human neonatal foreskin fibroblasts were exposed to equal concentrations of the two dye solutions in the cell culture media..."

    4. "use of an in vitro skin model for determining epidermal and dermal contributions to irritant responses

    authors: slivka sr zeigler f

    source: j toxicol, cutaneous ocul toxicol1993;12(1):49-57
    .... an in vitro skin model was used to study the responses of epidermal and dermal cells to irritants. this model consists of neonatal foreskin fibroblasts grown into a three-dimensional dermal structure on a nylon mesh....."

    5. "in virto toxicity of various classes of test agents using the neutral red assay on a human trhee-dimensional physiologic skin model
    authors: triglia d braa ss yonan c naughton gk

    source: in vitro cell develop biol 1991;27a(3):239-244. (28 refs)

    toxicity data were presented for the following classes of test agents: 15 detergents, five alcohols, ten metal chlorides, five perfumes and colognes, four shampoos, three conditioners, three moisturizers, three pesticides, and four antimicrobial preservatives. dose dependent cytotoxic responses were observed for all test agents in each category. a new three dimensional human skin model consisting of several layers of actively dividing and metabolically active human neonatal foreskin derived fibroblasts and epidermal keratinocytes grown on nylon mesh were used to assess the toxicity of these agents. a slight modification of the published neutral red viability assay was used for endpoint determination. the potential utility of the human dermal fibroblast epidermal keratinocyte, three dimensional substrate as an in-vitro toxicology assay system was described. "


    mattek corporation manufactures all kinds of human tissue substitutes, all the ones ending in -derm, and epiocular being derived from neonatal foreskin. it's interesting to see the other human tissues they use too, breast tissue, oral tissue from people undergoing tooth extraction.

    "human collagen

    injectable collagen derived from newborn foreskin left over after circumcision. to create the product, fibroblasts-the cells that produce collagen-are isolated from the foreskin, and replicated in a culture where they are primed to pump out collagen. mcghan medical corp. has petitioned the fda for approval of two formulations of the foreskin-derived collagen: cosmoderm, which is thinner, and cosmoplast, a thicker version.

    to fill fine lines, deep wrinkles and scars, and plump lips.

    three to six months.

    it hasn't been priced yet but doctors expect it to cost about the same as bovine collagen: $300 and up.


    * no allergy test or waiting period required.
    * can be used on patients with a bovine allergy.
    * mixed with anesthetic so less painful than hylan gel or products derived from cadaver tissue.


    * potential side effects include: redness, swelling, bruising, infection and small risk of allergic reaction. "

    *mcghan medical corp is now known as inamed aesthetics,

    more info:
    choices to consideron the list of soon-to-be-marketed products are a series of bioengineered human collagen products from mcghan - cosmoderm-i nst, cosmoderm-ii nst, and cosmoplast nst. this material is derived from cultured neonatal foreskin using a single line cell source, and each of these products is said to have the same performance characteristics as their respective bovine collagen counterparts - zyderm-i, zyderm-ii, and zyplast. however, with the bioengineered human material, the need for skin testing is obviated.

    a number of recently available filler agents, including cymetra (life-cell), fascian (medical aesthetics international), and dermalogen (collagenesis) are developed from allogeneic material obtained from tissue banks - an industry not currently under the regulation of the fda.

    cymetra is a micronized form of alloderm, which is acellular freeze-dried human cadaver dermis. the material for production of these agents is obtained only from american association of tissue banks (aatb) guideline compliant facilities.

    ( content: interest in restoring volume stimulus for new fillers same article.
  11. by   Jelli_Belli
    Wow, what amazing posts from onehusbandsevenkids and RNmomof2. It's amazing the information you can find with a little research.
    I wish I had those websites when my sister in law was trying to decide whether or not to circ my nephew. As it is my husband and I always watch Penn&Teller's show "********" on Showtime and they did an episode on the myths surrounding circumcision and it did a wonderful job of debunking all the lies that mainstream culture feeds new mothers. Anyhoo, she watched it and needless to say she was smart enough to make the right decision. Thanks for the info though, I'm always trying to convert the masses. :spin:
  12. by   nursejohio
    Quote from ZASHAGALKA

    This might explain why heterosexual transmission is much less rampant in the United States specifically, and West generally. There is a much higher incidence of circumcision here.

    Before I jump on the "let's mutilate baby boys for the sake of infections they may or may not ever be exposed to" bandwagon, I'd have to see more research. I understand that circumcision influenced the infection rate in Africa, but what kind of patient population did they use? Did they have access to condoms, information on their proper use, access to adequate hygiene practices (running water, soap, and education on how to care for an intact penis)? If they aren't able to have the cleanliness we take for granted, and have no access to condoms.... maybe circs are an option.

    Has anyone considered the impact of societal norms? Most American girls can feel secure insisting on condom use, even if they choose not to. On a continent that still largely practices female mutilation, what are the odds that a girl can say "Not until you have some protection?" That needs to be considered as well as the hygeine, condoms and education as well.

    I'd give more weight to the findings if there was some information about the socio-economic and education status of the study groups. As a rule, even the 'more prosperous' African nations are pitifully poor by US standards and as such, don't have access to the same resources we have. Proponents of circ'ing will jump on this as "proof" that they're right, most without questioning what the results would be applied to men in the US. A more appropriate study would be studying 2 groups of American men, hetero and homosexual to see if there was a significant difference in infection rates between circ'd and intact.

    Check out post # 6 with numbers. Our circ rate (60%) is surpassed only by Israel (90+%) but our HIV rate (250k) is double that of our closest follower (Japan with a 0.2 circ rate, HIV rate of 125k). Countries with a circ rate 1/10 of ours have infection rates that put ours to shame.

    Just a few points to ponder before jumping into the 'boys should all be cut' or 'boys should all be left as god made them' debate
    Last edit by nursejohio on Dec 21, '06 : Reason: found the number in post #6...oops
  13. by   nursejohio
    Quote from Focker
    Are you guys not aware that they use local anesthesia when they do a circumcision?
    Most younger docs will attempt to place a local block. A lot of older ones still don't because "it's quick and he won't remember it anyway" I've heard docs tell parents they always use anesthetics to get the consent signed and watched them go right into the circ room and start chopping away without so much as EMLA, much less the lidocaine nerve block they said would be used. I wrote up incident reports each time, but I doubt anything's changed.