When circ's go bad...

rnmi2004 · Feb 25, 2005

Routine infant circumcision, while not a pleasant or necessary procedure, is in a whole different ballpark than female genital mutilation (FGM). There are complications that can occur with RIC, but the majority of infants grow up without circumcision affecting their daily life. Unfortunately for women who suffered through FGM, it has lasting physical and psychological effects.

I am by no means defending RIC, but I feel that when people try to compare the two it is doing a disservice to the victims of FGM. JMHO.

For more information, check out

http://www.amnesty.org/ailib/intcam/femgen/fgm1.htm#a4

fergus51 · Feb 25, 2005

I don't like the comparisons between FGM and male circs either, but there are some similarities when looking at the milder forms of FGM (not complete infibulation). Usually people who are against FGM point to the complications, but many of those could be avoided by allowing docs to do it in a sterile environment. The question then becomes is it ok to cut off a normal part of a child's genitals if we minimize the chances of infection and other complications? The reasons people are in favor of it are the same reasons people use to promote male circs (hygeine, religion, societal norms, etc). I know in Canada this is considered child abuse and had to be reported to authorities. The first time I saw a woman who had this done, I didn't even know what I was looking at for a second.

Nursewise · Feb 25, 2005

Actually, there are very few laws to help little girls in the USA, regarding genital surgery. And even where there are, they are rarily enforced.
One of the medical groups (composed of OB/Gyn MDs) in the USA recently asked to rescind laws against female genital mutilation. The reason was to do it in a safe sterile way rather than the parents going "underground" and it being done unsafely.

The Federal Prohibition of Female Genital Mutilation Act of 1995 states...

"Except as provided in the subsection (on medical necessity), whoever knowingly circumcises, excises, or infibulates the whole or ANY PART of the labia majora or labia minora or privy parts of another person who has not attained the age of 18 years shall be fined under this title or imprisoned not more than 5 years, or both."

"No account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that or any other person that the operation is required as a matter of custom or ritual."

The law covers any and all such procedures, however minimal.This sounds like Congress has taken this very seriously.

Nursewise

DutchgirlRN, ASN, RN · Feb 26, 2005

I don't believe in routine circumcision. When my 15 y/o was born people thought I was crazy not to get him circumcized. The pediatrician assured my husband that less than 1% of males ever have a problem with not being circumsized. I had done my homework and really had to present my husband with alot of information before he would agree to no circumcision and when the pediatrician added his two cents he was finally convinced.

When our son was 3 years old he developed phimosis. He had to be circumcized and it was very traumatic for him, he couldn't wear pants for over 3 weeks, and ran around in a large t-shirt all day. If I were to have another son (not happening I'm 49) but I would have him circumcized. I realize another son wouldn't necessarily have the same problem but I would not take the chance.

When we sat him down to explain what was going to happen we told him "when you get home you'll look just like daddy". His eyes got really big and he replied "no mama that's too big" !

allnurses Guide · Feb 26, 2005

I can understand the debate about infant circs - but why are you, or anyone else, especially women, concerned about adult circs? Why do you think it's "fun" to tell an adult male about YOUR personal opinion about circs?
Perhaps you'd like my opinion on labial reduction and contouring, which seems to be all the rage at my hospital right now. Should I offer that opinion to my patient should she ask? Do you think she'd appreciate the male perspective? I doubt it!!!
Oh, I know, how about this? Maybe when a woman comes in for a tubal ligation I could call her husband a wimp - if she asks for my opinion of course - since I think any man who would let his wife go through a potentially life-threatening surgery because he's too much of a baby to have his vas snipped is a first class wimp. After all - it's my opinion, perfectly valid in my mind.
Your personal opinions have no place when patients are getting ready for surgery. It's THEIR decision, not yours.

You are right about personal opinion. What I do is give the parents an information sheet I found with questions to ask the doctor about circumcision. One of the most important is pain relief. Do you use anything to block the pain of circs? One of our docs is adamantly against it because he saw one baby who had permanent nerve damage from an injection of lidocaine prior to a circ and he won't use meds. He doesn't think baby boys should be circ'd but he will do it. I hate watching him to circs.

I thought of a new bumper sticker . .

REAL MEN DON'T LET THEIR WIVES GET TUBALS; REAL MEN GET VASECTOMIES

steph

fergus51 · Feb 27, 2005

I'm confused. Admittedly I don't have a member, but I though phimosis simply meant that the foreskin could not be retracted completely and that was fairly common up until about 5 years. According to this about 10% of 3 year olds will have phimosis

http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/urology/pandp.html (the site also differentiates between paraphimosis and phimosis).

Did your 3 year old have anything wrong other than not being able to pull the foreskin back? Just curious.

allnurses Guide · Feb 27, 2005

Fergus . . . . it is my understanding that young boys shouldn't try to retract the foreskin. And never for infants.

Guess I'll have to research it. But I'm pretty sure there is no need until they are a bit older than 3.

steph

fergus51 · Feb 27, 2005

That's what I thought, which is what confuses me about a 3 year old needing a circ because of phimosis when phimosis at that age is normal. But again, I have no member so I'm just asking.

ShannonC · Feb 27, 2005

You are right about personal opinion.
steph

You know, this has got me thinking, and feeling sort of "second-guess"ish about when I state my opinion. I mean, okay, it's not like I am out there campaigning for new parents to leave their boys intact. BUT, if a patient or her husband says to me about a circ "we haven't decided what to do yet. What did you do, and why?" or if they ask me "what do you think?", I respond with the honest way that I feel. I say "I didn't circ. my son based on the research showing that there was no strong medical need. That combined with years of seeing the procedure done and seeing how much pain the babies go through made the decision easy for me." Perhaps, though, I need to just leave the way *I* feel about it out if it, even if they ask. Like, maybe I need to fudge it and tell them something neutral. I don't know... it seems like a personal opinion was asked for, so I give it. But this has me wondering if I need to be adament about keeping it to myself.

It's an interesting issue--sort of like names. If parents are deciding which name to name their child and they throw options at me, I hesitate to offer my opinion because it's so personal.

I don't know... I guess I'm just pondering out loud!

allnurses Guide · Feb 27, 2005

Shannon . . the pt. education I give parents mentions the controversy about circumcision. :) To tell the truth I did that on purpose because I think they need all the information. Especially about pain relief . . . I want them to know when that one particular doc takes their son for his circ, their son won't be medicated.

Keep in mind all my boys are circ'd, and very happy that they are, think I'm a nut for thinking I was wrong to have them circ'd. I was married to another man with my first two boys and then my second hubby and I had a daughter and then a son . . . . BOTH husbands wanted the boys circ'd.

So, as I mentioned, the funny thing is men seem to be completely ok with circumcision.

It is we moms who are usually the ones questioning it. :)

steph

DutchgirlRN, ASN, RN · Feb 27, 2005

His phimosis was caused because the skin had actually grown (adhered)to the head of his member, he was having erections during the night and in the morning and screaming in pain. Also hurting but not screaming when urinating and he had no UTI. It was anytime the skin needed to move. The skin had to be scraped off because it wasn't loose. The urologist said it was the worst case he had ever seen. The head of his member looked like a bloody plup when he was done. It scabbed over and then the whole head was one big scab. It was really awful. He looks great after the fact. But I hated to have him go through that. Thankfully he doesn't remember any of it.

dansamy · Feb 27, 2005

My boys were circ'ed as infants. At the time, I deferred to their father for the decision. Although, if I had it to do over, I would refuse the consent.