circumcision benefits

 

SUMMARY OF SUBTOPICS OF CIRCUMCISION:

  1. Urinary Tract Infection (UTI)
  2. HIV Infection/AIDS
  3. Sexually Transmitted Diseases (STDs)
  4. Cervical Cancer in Female Sexual Partners
  5. Invasive Penile Cancer
  6. Local Problems- Phimosis, Balanoposthitis, and Hygiene
  7. History, Religion, and Culture of Circumcision
  8. Women's Preference, Sexual Activity, Psych Effects
  9. Statistics and Miscellaneous
  10. American Academy of Pediatric Statements (AAP) 1971-1999
  11. Circumcision Methods, Local Anesthesia, and Risks
  12. Anti-Circumcision Groups
  13. Overall Summary Statement. Medical Proof of Circumcision Benefits
 

 

 


1. Urinary Tract Infections (UTIs), Kidney Infections:

 

Uncircumcised boys are about 10 times as likely to get serious kidney infections in the first year of life as are circumcised infants; even in adults circumcision protects against UTIs. These kidney infections are most dangerous in the first 3 months, during which time they often lead to hospitalization and can result in overwhelming blood infection and other serious infections. Kidney scarring has been shown to occur later. There is concern that future kidney failure and high blood pressure may follow infantile UTIs. Abnormal kidney function and hormonal secretion can occur with infant UTIs. Fecal contamination of the moist inner foreskin layer with bacterial attachment leads to these kidney infections. Circumcised infant boys also are able to avoid invasive procedures, such as catheterization and bladder tap in order to get a valid urine specimen to test for infection. Voided urine is sterile in circumcised boys but because the uncircumcised penis is often colonized with bacteria a voided specimen in the presence of a foreskin is likely to be contaminated.

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.



2. Human Immunodeficiency Virus (HIV) Infection/AIDS:

 

Uncircumcised men were first shown to be more likely to acquire heterosexual HIV infection almost 2 decades ago, in articles in the leading medical journals "Lancet" and "New England Journal of Medicine". Since then over 40 separate studies have shown that uncircumcised men are at least 2 times more likely to become infected with HIV on heterosexual exposure. The ease with which the foreskin tears during intercourse, leaving mini-abrasions through which the virus enters, can lead to the infections. It has been shown that certain specialized cells in the foreskin, Langerhans cells, trap the HIV virus but cannot kill it and serve as a means of allowing HIV to enter the system. Three randomized control study recently published showed that circumcision offers a 60-70% protection against acquiring HIV on exposure. This is in addition to the many previous convincing clinical studies showing significant protection against HIV by circumcision.

For documentation see Reference Section, from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.


 


3. Sexually Transmitted Disease (STDs):

 

As with HIV, mini-abrasions of the foreskin during intercourse is one explanation for the fact that uncircumcised men are more likely to acquire other STIs. The STIs for which uncircumcised men are at greater risk include syphilis, chancroid and genital herpes, all of which involve ulceration of the penile surface through which the infection enters. In 2002 it was shown that uncircumcised men are 3 times as likely to be carrying the human papilloma virus (HPV) as are circumcised men. HPV is not only the cause of genital warts but is the agent that causes both cervical and penile cancer. In 2005 a multinational study showed that Chlamydia infection is also 3 times as common in the presence of a foreskin. Chlamydia infection is one of the most common STIs and can lead to infertility. Local yeast infections and bacterial vaginosis in sexual partners have also been found to be more common in the presence of a foreskin.

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.


 


4. Cervical Cancer in Female Sexual Partners:

 

It has long been known that in population groups where circumcision is performed e.g. -Jews and Muslims - cancer of the cervix is rare and penile cancer almost nonexistent. In recent years the role of human papilloma virus (HPV) in both penile and cervical cancer has been proven, and these cancers are now being thought of as sexually transmitted diseases. A recent study of over 1900 couples in 5 countries found that penile HPV infection is about 3 times as common in uncircumcised males as in circumcised males and there is about a 2.5 fold increased risk of cervical cancer in women whose sexual partner is uncircumcised and has had multiple partners.

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.


 


5. Invasive Penile Cancer:

 

It has been known for over 100 years that circumcised men almost never get invasive penile cancer, a devastating disease which is more deadly than breast cancer (higher 5 year mortality rate). Each year about 1400 U.S. men get this disease and over 200 die, almost all of them uncircumcised. As with cervical cancer in women, in penile cancer the etiologic agent is HPV, and HPV is found 3 times more often on the uncircumcised than the circumcised penis

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.


 


6. Local Problems- Phimosis, Balanoposthitis, and Genital Hygiene:

 

Local foreskin infections (balanoposthitis) can occur at any age in uncircumcised males, but is most common at age 2-5 years, an age when the foreskin has often not yet completely separated, and cannot be fully retracted, and genital cleanliness is more difficult to accomplish. In addition between 0.5% and 1% of boys will never be able to retract their foreskin due to a pinpoint opening at the end (phimosis) and will have to be circumcised at a later date when the procedure is more complex and difficult, and about 10 times as expensive. Phimosis becomes most troublesome beginning with puberty; painful erections occur since the foreskin can't retract over the glans. An incomplete form of phimosis, called paraphimosis, occurs when the foreskin is tight but can be retracted over the glans. The glans may then become trapped resulting in severe pain and swelling. Newborn circumcision leads to improved genital hygiene throughout life, but most importantly in infancy, early childhood and old age when personal hygiene may be inadequate. Uncircumcised males are more likely to develop a wide variety of skin disorders including psoriasis, lichen planus, and seborrheic eczema.

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.


 


7. History, Religion, Culture of Circumcision:

 

Circumcision has been performed for thousands of years and is part of a number of religious and cultural traditions. From the religious standpoint, it is part of the Judeo-Christian belief. Circumcision was a covenant between Abraham and God in the Old Testament, and the New Testament tells us that Jesus was circumcised in the accepted Jewish fashion at age 8 days, as were all the early apostles and disciples. Moslems also perform circumcision, but it is done at various ages in children and early adulthood.. From the secular standpoint it has been theorized that desert-dwelling people in tropical lands began to be circumcised for reasons of cleanliness ("circumcision and sand") and to avoid severe foreskin infections. During World War II, poor hygienic conditions during the African invasion in the desert areas resulted in foreskin problems in over 146,000 US soldiers, and led the Armed forces to perform adult circumcision among many recruits. This WW II experience is the likely explanation for the fact that following the war in the 1950s and 1960s almost 90% of US newborns were circumcised.

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.



8. Women's Preference, Sexual Activity, Psych Effect:

 

Sexual function is not adversely affected by newborn circumcision. On the contrary, published evidence shows that circumcised men have a wider variety of sexual activity, and women prefer circumcised men, mainly because of better genital hygiene. Over the past 5 years multiple clinical studies involving men circumcised as adults have shown that it is a myth that the foreskin is important in sexual pleasure and sensitivity. It was found that there was no significant difference in sexual pleasure or sensitivity before or after circumcision. This is not surprising in view of the complicated cascade of neurological, hormonal, metabolic, emotional and vascular factors involved in the sexual act. A survey of U.S. Midwestern women who had sex with both uncircumcised and circumcised men found that they preferred circumcised men by a margin of 3 to 1. The main reason was improved genital hygiene, but the women felt the circumcised penis looked and felt better, and interestingly, most of them felt that it looked “more natural”. A survey of prostitutes published in the London Times found that 90% preferred the circumcised penis, again for reasons of improved hygiene. Issues of smegma, debris and odor apparently are important to women who deal with many penises.

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.



9. Statistics and Miscellaneous:

 

Recent statistical evidence from the Center for Disease Control (CDC) agencies indicates that in the United States (US) newborn circumcision rates remain high. A 2007 CDC report found that 79% of US males are circumcised (86% of non-Hispanic whites). There have been increases in circumcision among blacks and in newborns from the Midwest and the South, areas of the country with the fewest new immigrants. In specific communities high circumcision rates are being reported: 84% in Atlanta, Georgia, 85% in Houston, Texas, and 92% in a Wisconsin community served by a pediatrician opposed to circumcision. Falling circumcision rates in the West, particularly in California, reflect the fact that over 50% of births in the state are in Hispanics who do not circumcise on a cultural basis. Among non-Hispanic white males the rate in California remains about 80%. Lower NIH newborn incidence figures must be viewed with caution since they only represent coded data from the hospital of birth. In Alaska and Georgia it was found that about 15% of newborn circumcisions are not coded on discharge. Further, recent published evidence shows that 7-10% of males are circumcised for medical or personal reasons after the newborn period. These errors in coding and post-neonatal circumcisions accounts for the discrepancy between the 60-65% newborn rate reported by the NIH and the 80-85% circumcision rate found in surveys of older boys and in the 2007 CDC report. A survey reported in 2005 found that the U.S.circumcision rate was increasing recently, a finding attributed to the increasing awareness by the American public of the preventive health benefits of circumcision.

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.


10. American Academy of Pediatric Statements (AAP):

 

The AAP issued statements on circumcision in 1971, 1975, 1989, and 1999. The statements have been contradictory and misleading, often biased and not supported by medical evidence. The original 1971 statement by the AAP that there were “no valid indications for newborn circumcision” was erroneous. It represented a single undocumented sentence and the anonymous author(s) was apparently unaware of the large amount of published data on penile cancer, local infections, phimosis and genital hygiene. The most recent report, in 1999, although referencing the data showing preventive health benefits against infant UTIs, penile cancer, HIV and local problems unexplainably concluded that the “potential benefits” were “not sufficient to recommend newborn circumcision”, but no benefit to risk ratio was offered and the AAP did not say how many benefits would be sufficient. In the period since the report (1999-2005) there have been multiple published studies confirming the protective benefits against infant UTIs, penile cancer, penile dermatoses, and HIV. In addition there has been compelling evidence that uncircumcised men are more likely to be carrying HPV and the Chlamydia organism and female sexual partners are more at risk for cervical cancer. It was recommended that in the face of this new evidence the AAP update amend its position, since the last reference in the 1999 reported was to a 1998 publication. Rather than update the 1999 report, the AAP in 2005 reaffirmed the flawed outdated 1999 report. The position of the AAP on circumcision beginning in 1971 and continuing to the present has been misleading and confusing at best and erroneous and irresponsible at worst.

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.


11. Circumcision Methods, Local Anesthesia, and Risks:

 

The newborn period is the window of opportunity for circumcision. Physiologically the infant is prepared to deal with stress- hormone levels of adrenaline, cortisone and thyroid are very high as are endorphins. The foreskin is thin and healing is rapid. Circumcision performed at an older age is more difficult, riskier, takes longer and about 10 times more expensive There are 3 acceptable methods for performing newborn circumcision: 1) Plastibell method, 2) Gomco clamp, and 3) Mogen clamp. All 3 methods should be done with local anesthesia. The key to a quick, safe, painless newborn circumcision depends more on the experience of the operator than on the technique used. The methods of local anesthesia include dorsal penile nerve block (DPNB), ring block and anesthetic cream. Having the baby suck on a sucrose (sugar) pacifier also decreases pain. The risks of a properly performed circumcision are rare (0.2-0.6%) and usually minor. Local infection and bleeding are the most common complications, but are generally easily controlled. In over 500,000 circumcisions in New York State there were no deaths or penile amputations. The rare reported deaths have almost all been due to general anesthesia, which in my opinion, should only be used in special circumstances. An experienced operator is the key to a quick and safe circumcision.

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.


12. Anti-Circumcision Groups:

 

Beginning in the 1970s many lay anti-circumcision organizations with picturesque acronyms have sprung up. The longest - lived and probably largest is NOCIRC (National Organization of Circumcision Information Resource Centers). Others include NOHARMM (National Organization to Halt the Abuse and Routine Mutilation of Males), NORM (National Organization of Restoring Males), RECAP (Re-cover A Penis), and BUFF (Brothers United for Future Foreskins). A San Francisco magazine, Foreskin Quarterly, aimed at gay men, focused on the sexual advantage of the foreskin. These activist organizations, particularly NOCIRC, mainly using anecdotes and testimonials, have gained a good deal of media attention and have had some influence in discouraging newborn circumcision, particularly in middle class educated “trendy” parents in certain sections of the country. The lay anti-circumcision organizations are well organized and dominate the media and the internet. Although the anti-circumcision forces consist mainly of laymen, there are some physician supporters. We have cited comments and opinions from some of these physicians. It is suggested, that before accepting the comments of these anti-circumcision physicians, you check the published medical evidence which can be found in the references and illustrations in other sections of this website. There are problems of credibility with a number of these physicians. Under the influence of lobbying by organized anti-circumcision groups 16 states, including California, will not pay for newborn circumcision in Medicaid recipients, thus depriving the poorest parents of the decision to provide a medically beneficial procedure for their newborns. So much for the anti-circumcision groups concern for human rights.

For documentation see Reference Section from the book “Circumcision, Sex, God and Science”, Edgar J. Schoen, MD, Book Surge, 2009.

 



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