To circumcise or not to circumcise?
WHETHER it’s through cultural or religious beliefs or by personal choice, thousands of families every year take the decision to circumcise their baby boys.
According to Dr Anona Griffith, paediatrician at Gateway Plaza, Old Harbour, the surgical process involves the removal of the sheath-like tissue (foreskin) that forms a hood over the head and tip of the penis.
“At birth, the foreskin is closely adherent to the penis, covering all of the head of the penis, usually allowing only a small hole to be seen at the tip, which allows for urine to be passed. It becomes increasingly mobile [as the child grows], and is able to turn over or retract — usually about two years,” Dr Griffith explained.
She said that the decision to circumcise is based on several factors, medical reasons being the least of them. The reasons are usually more closely related to societal habits, religion, family status and identity, and other cultural and personal experiences.
“Circumcision is not routinely done at birth in Europe, similarly in Jamaica, but can be requested if so desired. However, many different health bodies, including the CDC [Centres for Disease Control and Prevention] and AAP [American Academy of Paediatrics], have recognised the challenges that accompany the decision whether to circumcise or not,” she advised.
“Their positions have acknowledged the benefits of the procedure, but have also considered that they are insufficient to recommend that the practice should become universal. They have also agreed that it should be left up to parents to make the final decision,” Dr Griffith underscored.
While circumcision is most common among newborns, the procedure is also carried out on older children and even on adults. In newborns, the procedure is done in the first seven to 14 days of life, while in the case of older children and adults, the timing is usually medically related and decided by a medical team. In most cases, the reason for circumcision is that the foreskin gets so tight that it becomes painful and swollen.
As with any medical procedure, there are a number of benefits and drawbacks. Known benefits include:
•A reduction in the number of urinary tract infections, especially in boys less than one year old.
•A decrease in the risk of acquiring and transmitting infections such as HIV (Human immunodeficiency virus), genital herpes, syphilis HPV (Human Papilloma Virus), which is the leading cause of cervical cancer in women and which also causes penile cancer in males.
•Decreasing the risk of penile cancer.
The opponents of circumcision believe the foreskin is a functional part of the body that serves a purpose and as such should be allowed to remain.
These functions include:
•Protection of the head and tip of the penis.
•Enhancing sexual function and pleasure, as it is a highly erogenous area.
•Facilitating sexual intercourse.
They have highlighted the following as risks:
•Infection if done in a non-sterile environment.
•Erectile dysfunction risk is found to increase due to the desensitisation and thickening of the exposed erogenous tissue.
•Trauma and pain.
The procedure is relatively simple and can be office-based, using local anaesthesia. Recovery and healing takes place over the course of five to seven days.
Possible complications of the procedure include:
•Bleeding
•Redness and swelling
•Reluctance to urinate
•Infection is a possible complication and may be evident as pus, swelling, redness and fever if significant.
Medical attention must be sought in these cases.
Dr Griffith said that the decision to circumcise or not must remain with the parents. However, if you decide against it, you must ensure that proper genital hygiene is promoted, such as retracting the foreskin as it becomes less adherent, washing the penis with soap and water, and always returning the foreskin to its normal position.
