circumcision

At the risk of generating email flames, I will present these facts about infant circumcision. The reason for this attack of foolhardiness is that there are about 7,000 sites on the Internet devoted to harangues about circumcision - mostly virulently "anti-." A bit of balance from the medical perspective would not hurt, and is presented for that purpose alone. This does not represent an endorsement of circumcision; my own personal opinion is my own business and I won't discuss it. Likewise, what you do with your son is your business and I won't discuss that either. And what somebody else does with his son is really none of your business. This is therefore a no flames topic of course - keep your opinions to yourself, please.

A nonretractable foreskin is normal up to about age three and should never be forced back.
Phimosis in older males can cause urine blockage with acute hypertensive kidney damage.
Balanitis or balanoposthitis - an acute pus-producing infection of the foreskin - is unheard of in circumcised males.
Painful zipper injuries are fairly common in uncircumcised males.
Of the 60,000 cases of penile cancer reported since the 1930's, fewer than 10 occurred in circumcised men. The risk of penile cancer in uncircumcised men is 1 case per 380-600 men; in circumcised men it is 1 case per 75,000 to 8 million men.
Prostate cancer may be increased for uncircumcised men.
Cervical cancer is increased in the partners of uncircumcised men.
Every study ever done has shown increased incidence of urinary tract infection in uncircumcised males. One in 25-100 uncircumcised males will get at least one urinary tract infection. These infections can cause scarring of the kidney and ultimately hypertension or kidney failure.
Sexually transmitted diseases are more common in uncircumcised men.
Penile hygeine is said to protect against the complications of the uncircumcised state. While this may be true, there is actually no study to show any benefit to penile hygeine, nor any practical way to do such a study if you consider the problem of actually documenting scrupulous hygeine over very long periods of time.
Significant bleeding from circumcision is rare. 1-2 per 1,000 performed may need pressure to stop bleeding. 1 in 4,000 will need a stitch to stop the bleeding. In the forty years between 1953 and 1993, three boys died of hemorrhage due to circumcision; two of these were boys circumcised at home by non-medical persons (Jewish mohels). During the same time period, 9,000-12,000 men died of penile cancer.
Serious infections develop in about 1 in 4,000 cases.
About one in 15,000 boys undergoing circucism suffers trauma necessitating plastic surgery. Perhaps one boy in a million suffers loss of the penis due to surgical mistake.
Anesthesia of the penis is readily accomplished with a dorsal penile nerve block. Topical creams can be used but are less effective.

These statistics from Thomas E. Wiswell, Jefferson Medical Center, Philadelphia.

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