The Circumcision Discussion

Specialties Ob/Gyn

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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 :)

Not only were there one million more cases of chlamydia last year than the previous year, gonorrhea and other sexually transmitted diseases are on the rise. And, all this in a country with the highest rate of circumcision in the world.

The article I read said the rate was up due to more testing.

But you do have a good point - we do have a large STD problem in the USA . . ..and we do have the highest rate of circumcision.

steph

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Specializes in Nurse Educator; Family Nursing.

Actually, the article said the increase MIGHT be the result an increase in risky sexual behavior. "The number of newly diagnosed cases of the three most common sexually transmitted diseases rose for the second year in a row in the U.S., driven in part by an increase in risky sexual behavior, the Centers for Disease Control and Prevention reported Tuesday." The LA Times article went on to suggest that the rates had increased because of reduced public health funds, increased testing and a resurgance of risky sexual behavior in some groups.

Read more at http://www.latimes.com/news/nationworld/nation/la-sci-std14nov14,1,1357070.story?coll=la-headlines-nation

I believe the tests we are using now (the DNA probe versus the culture) is much more accurate in diagnosing chlamydia and gonorrhea (the rate of which increased 5.5% last year). Now we have a "super" GC to deal with that is resistant to most antimicrobials.

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Specializes in Community, OB, Nursery.

Still think that's pretty significant. Circ ain't the answer.

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Specializes in midwifery, NICU.

This thread is so interesting to read. Arwen..as usual babe, you put your points across sooo well! Since we dont routinely circ in Scotland, I really have no experience of the procedure on a newborn. But, my hubs is circ'd (at aged 4, after the toilet seat fell on his wee man!!:imbar), and he (and I) are happy with that!!!:lol2: My son is not, was never an option, and I dont know if I would have done it when he was an infant. My brother has just had the op, at aged 34, because he NEEDED it! So, it was his choice, as an adult.

What i question, is the hygeine issue after circing a newborn. What happens when they pee and poop in the nappy.(diaper!, sorry, am scottish, and here its a nappy!!:lol2:), but, surely with a fresh wound and all that poop stuff in the nappy, (ok...Diaper!!:lol2:), theres a greater risk of infection, and of pain with each pee on a raw area????? Would it not be less painful and more hygenic to do the procedure, IF it were required, later on???

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Specializes in Community, OB, Nursery.

I find the post-circ hygiene issue to be a HUGE one. In most cases, the member is covered with a vaseline gauze (Gomco circs, anyway) so the poop USUALLY doesn't come into direct contact with the would. However, there are numerous instances where the gauze wasn't wrapped so well to begin with and it falls off, or baby somehow wriggles out of it (they are little Houdinis!!), or um, they didn't have a lot to work with ;) so there is not much to hold the gauze in place. And, we take it off after about 24hrs anyway.

Then yes, the gauze is off and here it is sitting in the poo. While we're doing circ checks we check diapers too, and we caution parents to do the same. Whether they actually do that at home is another story. And yes, cleaning these babes' memberes after a poopy diaper is not much fun. Their screams can be unbelievable, and it's different than an "I don't like you changing my diaper" scream. I cringe everytime I change a poopy post-circ diaper. I can't imagine having to pee over all that raw skin and don't understand why some parents think it's no big deal.

Just anecdotally, danissa, does your son care that he's not circed and your husband is? Did he ever care or notice?

ETA: Elvis wasn't circumcised! :) Just an interesting tidbit.

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Specializes in Accepted...Master's Entry Program, 2008!.
Would it not be less painful and more hygenic to do the procedure, IF it were required, later on???

Naturally, YES!!!!!!!!!!!!!!

It also leaves the owner with some say in the matter!

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Specializes in midwifery, NICU.

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!!:lol2: 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!:o

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Specializes in DOU.
Not only were there one million more cases of chlamydia last year than the previous year, gonorrhea and other sexually transmitted diseases are on the rise. And, all this in a country with the highest rate of circumcision in the world.

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?

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Specializes in Community, OB, Nursery.
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?

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Specializes in Community, OB, Nursery.

It also leaves the owner with some say in the matter!

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!

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Specializes in DOU.
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.)

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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!!:lol2: 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!:o

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 member. We simply slather the member in petroleum jelly and usually there isn't a problem.

NO GAUZE. :madface:

steph

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