The following
was sent to me, it does not necessarily reflect the opinions
of Coolnurse.com.
Unnecessary
Circumcision
By
George C. Denniston, MD, MPH
In recent
years, the debate on circumcision has been conducted on a
relatively low plane, with proponents arguing that circumcision
may prevent some rare conditions. Opponents of circumcision
argue that it simply has no medical benefits, and is a violation
of a mans right to grow up with an intact body. Perhaps the
subject can be simplified and raised to a higher plane by
focusing on the positive value of the foreskin. Before birth,
the glans penis is covered with skin. This skin is not loosely
attached. Indeed it is as tightly attached to the glans as
is the skin on the hand.
At approximately
17 weeks of intrauterine life, cells in the area of separation
between the future foreskin and the glans initiate the process
of creating the preputial space (the space between the glans
penis and the intact foreskin). This process is completed
by the age of 3 years in 90% of boys, but it may take as long
as 17 years for some boys to have a fully retractable foreskin.
At birth,
the separation of the foreskin from the glans has just begun.
The newborn's penis is, of course, not yet fully developed.
Not only does circumcision interfere with its development,
but it requires that the surgeon tear the skin from the sensitive
glans to permit removal. As a result, scarring occurs, the
surface of the glans thickens, and the urinary opening often
gets smaller.
If physicians
would simply leave the newborn's penis alone, as Dr. Benjamin
Spock recommends in the latest edition of Baby and Child Care,
the foreskin would be left to fulfill its several functions.
In infancy, the foreskin protects the glans from irritation
and from fecal material. In adulthood, the function of the
foreskin may at first seem obscure. The shaft and the glans
of an intact (uncircumcised) man's penis are covered by skin.
Retracting the foreskin reveals the glans and makes the skin
on the shaft somewhat loose.
Of what
use is this redundant skin? During erection, the penile shaft
elongates, becoming about 50% longer. The foreskin covers
this lengthened shaft. It is designed to accommodate an organ
that is capable of a marked increase in diameter, as well
as length.
In addition,
the foreskin is the most sensitive part of the penis and can
enhance the quality of sexual intercourse. Anatomical studies
demonstrate that > the foreskin has a greater concentration
of complex nerve endings than the glans. If there were any
possibility that the foreskin could contribute significantly
to sexual enjoyment, is that not a cogent reason for rethinking
our motives for this ritual procedure?
History
shows that the arguments in favor of circumcision are questionable.
At the beginning of this century, one of the reasons given
for circumcision was to decrease masturbation, which was thought
to lead to insanity and other "morbid" conditions. We now
know that circumcision does not prevent masturbation, nor
does masturbation lead to insanity.
More recently,
circumcision was promoted as a means of preventing cervical
cancer in the man's sexual partners; this notion has been
proved incorrect.
The current
excuses are that failure to remove the foreskin may contribute
to urinary tract infections and penile cancer, but neither
of these contentions has been proved. Even
if either were correct, the risk of urinary tract infection
in an uncircumcised infant is only one in one hundred. Performing
100 mutilative surgeries to possibly prevent one treatable
urinary tract infection is not valid preventive medicine -
it is just another excuse.
Penile
cancer occurs in older men at the rate of approximately 1
in 100,000. The idea of performing 100,000 mutilating (by
definition) procedures on newborns to possibly prevent cancer
in one elderly man is absurd. Applying this type of reasoning
to women would lead to the conclusion that removing all breasts
at puberty should be done to prevent breast cancer.
One thousand
years ago, the Jewish sage Maimonides said that the effect
of circumcision was "to limit sexual intercourse, and to weaken
the organ of generation as far as possible, and thus cause
man to be moderate... for there is no doubt that circumcision
weakens the power of sexual excitement, and sometimes lessens
the natural enjoyment; the organ necessarily becomes weak
when... deprived of its covering from the beginning."
Who has
the right to order or perform such surgery on a newborn infant?
I contend that no one does - certainly not the physician who
should know better - since there is no proven medical reason
to do so, and the procedure is known by many to be harmful.
Circumcision can always be performed in adulthood for men
who desire it, with fully informed consent.
Physicians
who continue to perform routine circumcision are not only
harming infants but are also harming the integrity of the
medical profession. It is hard to accept that these physicians
- many of whom have been circumcised themselves - are using
their medical licenses to continue this contraindicated practice.
This is tragedy perpetuating itself.
I have
comments from other readers that are worthy of posting in
order to give both sides of this topic. For more, to page
II
To find
out more about Penile Cancer - Go
there...
