Circumcision, help please?

[Leanna]

So, being the crazy reader I am I have been reading about circumcision. And something I really like about CF is that I can ask and get BOTH sides of the story. There aren't a lot of places like that. So here I am.

First let me say what I don't want.

I don't want to hear, "I circumsized my sons and they are just fine." I don't want to hear, "I didn't circumsize my sons and they are just fine." Those remarks are completely useless to me because I don't care what everyone else is doing.... if everyone jumped off a bridge....

What I would really like is to hear whether there is a real reason to circumsize based on medical or scientific evidence.

Is there a greater risk of infection, UTIs, yeast infections, with circumcision or without, and do you have a link to this information? And what is the chance of needing a circumcision as an older man if you are intact? Is caring for an intact babe in diapers pose risks of infection from, say, poo creeping under the foreskin? Information along those lines would be great.

Thanks for helping as I re-examine this sensitive issue with an open mind.

 

[~Nikki~]

I'm glad you've brought this up because dh and I have been discussing the issue as well...

Here in Ireland they *don't* circumcise and the doctors around here seem to see it as barbaric. Also as a rule in England they don't circumcise. In these countries it's only done if it becomes medically necessary, or for Jews and Muslims for religious reasons. And here, there are practically no muslims, and only about 2000 Jewish people (from what I've heard) so it's not common at all. If you're not Jewish and you want to circumcise the doctors are not particularly helpful as they don't agree with it, so *if* we decide to circumcise any sons we'll probably have to go to England and especially ask for it to be done.

So I'm watching this thread with baited breath too...

Sorry I had nothing helpful to add though...

 

[megg]

From what I understand, there is really no medical reason to circumcise. I have heard that it is safer to not, but it was not from a source I would put alot of stock in.
We circumcised our son so he would look like daddy.

 

[tel0004]

Ive also heard there is no medical reason to, perhaps a decreased risk of STD's but it hasnt been proven or disproven.

 

[Robinsegg]

This looks like a good, informative site.
http://pediatrics.about.com/cs/weeklyquestion/a/022002_ask.htm

 

[jgonz]

I've heard arguments on both sides that sound completely medically true~ less chance of cancer if circ'd, less chance of STDs, less chance of giving the wife infections after marriage, etc. And then the anti-circ side says the same thing.

For *me & my DH* what was more important was that G-d said that all generations forever were to circumcize their sons. People thought we were sorta nuts to cling to the "Jewish" instructions on this, but it was Really important to us. We figured if G-d made it a point of Covenant for His people, then there Must be a medical reason that we just didn't know about yet (like the Food instructions~ medical science backs up every one of them now). An interesting side note: We just found out (about 3 yrs ago, and our youngest boy is now 6), that it's Highly likely that DH has Jewish blood. Interesting that we were so set on circumcision...

 

[GolfingMom]

I've heard arguments on both sides that sound completely medically true~ less chance of cancer if circ'd, less chance of STDs, less chance of giving the wife infections after marriage, etc. And then the anti-circ side says the same thing.

For *me & my DH* what was more important was that G-d said that all generations forever were to circumcize their sons. People thought we were sorta nuts to cling to the "Jewish" instructions on this, but it was Really important to us. We figured if G-d made it a point of Covenant for His people, then there Must be a medical reason that we just didn't know about yet (like the Food instructions~ medical science backs up every one of them now). An interesting side note: We just found out (about 3 yrs ago, and our youngest boy is now 6), that it's Highly likely that DH has Jewish blood. Interesting that we were so set on circumcision...

The more I read, the more I found that : "Medical grounds for circumcision that are most commonly cited are: Reduced risk of urinary tract infections (UTI); reduced risk of penile cancer; reduced risk of cervical cancer in partners; reduced risk of sexually transmitted disease (STD)."

 

[Joykins]

The answer to your question is No.

 

[~Mrs. A2J~]

Here's a great Position Paper from the American Academy Family Physicians Care & Research.

Circumcision: Position Paper on Neonatal Circumcision

Neonatal circumcision is one of the most common surgical procedures performed in the United States. However, little is known about the long-term risks and benefits. There have been few methodologically generalizable prospective studies concerning medical outcomes.

The AAFP Commission on Science has reviewed the literature regarding neonatal circumcision. Evidence from the literature is often conflicting or inconclusive. Most parents base their decision whether or not to have their newborn son circumcised on nonmedical preferences (i.e. religious, ethnic, cultural, cosmetic). The American Academy of Family Physicians recommends physicians discuss the potential harms and benefits of circumcision with all parents or legal guardians considering this procedure for their newborn son.


Epidemiology


An estimated 1 million circumcisions are performed each year in the United States. (1) The rate of circumcision began rapidly to increase prior to World War II. The percent of men circumcised increased from 34% in 1932 to 60% in 1935. (2) In 1960, over 80% of men in the United States were circumcised. However, the percentage is now decreasing, and in 1992 the prevalence of circumcised men was estimated to be 77%. (2) One study found that between 1987 and 1996, 37% of newborn males were circumcised during newborn hospitalization. (3) Circumcision rates are shown to differ among racial and ethnic groups. (2)


Contraindications to Neonatal Circumcision


Circumcision should not be performed until at least 12 to 24 hours after birth to ensure that the infant is stable. This period of observation allows for recognition of abnormalities or illnesses that should either be addressed before circumcision (e.g., hyperbilirubinemia or infection) or would be a contraindication for the procedure (e.g., bleeding diathesis). When there is a family history of a bleeding disorder, appropriate laboratory studies should be done to identify a possible clotting dysfunction. Infants with genital-urinary congenital anomalies, particularly hypospadias, should not be circumcised because the foreskin is frequently used in reconstruction. Premature infants should meet criteria for discharge from the nursery before circumcision is performed. (4)


Complications of Neonatal Circumcision


Neonatal circumcision has an estimated complication rate ranging from 0.1% to 35%. The vast majority of complications are infection, bleeding, and failure to remove enough foreskin. (5) One study of more than 350,000 newborns identified a complication rate of 1/476 (3) and another study estimated a complication rate of 1/100. (4) Meatitis and meatal stenosis are more serious complications that have been reported to occur in 8% to 21% of circumcised infants, (6) however no well-controlled cohort study has clearly identified a causal relationship between circumcision and meatitis. (7) Although meatitis is believed to occur more frequently in circumcised infants, balanoposthitis is believed to occur more frequently in uncircumcised children. (8) Serious complications, such as necrotizing fascitis, urethral fistula, partial penile amputation, penile necrosis, and concealed penis, have been reported. (9) Death is rare, and mortality risk has been estimated to be 1/500,000 procedures. (10)


Urinary Tract Infections


Male infants account for 75% of urinary tract infections (UTIs) among infants less than 3 months of age, and comprise 11% of UTIs in infants between 3 to 8 months of age. (11) One study found that of 62 male infants with a confirmed UTI, 95% were uncircumcised. (11) Another study reviewed a 5-year period of U.S. military hospital records and found that 0.14% of 80,274 circumcised infants and 1.4% of 27,319 uncircumcised infants developed a UTI. (12) Although an uncircumcised infant has been estimated to have 3 to 20 times the risk of developing a UTI compared to a circumcised infant, the absolute risk increase is about 1%. (12) One study reports that 195 circumcisions are needed to prevent one UTI, (4) and another reports a number needed to treat (NNT) of 90. (3) Upper tract urinary infection, namely pyelonephritis, is reported to occur in 21% to 78% of infants and children with symptomatic UTI. (13) Renal scarring is estimated to develop in 10% to 15% of cases of pyelonephritis, and of those approximately 2% to 3% will develop end-stage renal disease. (14)


Sexually Transmitted Diseases and Human Immunodeficiency Virus


Overall, the studies investigating the association between having a sexually transmitted disease (STD)-excluding human immunodeficiency virus (HIV)- and being circumcised are inconclusive. (4) Although a number of studies did find that uncircumcised men had higher rates of STDs, the majority of these studies had methodological limitations. (5) The foreskin is thought to provide a moist environment to harbor bacteria and viruses, and some studies suggest an association with being uncircumcised and developing ulcerative STDs (i.e., syphilis, chancroid, and genital herpes) (15); however, the evidence does not show an association of being uncircumcised with developing nongonococcal urethrits or genital warts. (16) From one study of 2,776 documented cases of a STD, uncircumcised compared to circumcised men had an odds ratio of 4.0 (1.9 to 8.4) of having syphilis, an odds ratio of 1.6 (1.2 to 2.2) of having gonorrhea, and an odds ratio of 0.7 (0.5 to 0.9) of having genital warts; the association for nongonococcal urethritis, chlamydia, and genital herpes was not significant. (17) Some believe that the risk of having a STD is more strongly related to sexual practices than to the presence of a foreskin. (2)

Most of the studies on the relationship between acquiring HIV and being circumcised have been conducted in developing countries, particularly those in Africa. Because of the challenges with maintaining good hygiene and access to condoms, these results are probably not generalizable to the U.S. population. These studies did, however, find an association between contracting HIV and being uncircumcised. Based on two of the African prospective studies, an estimated 10 to 20 circumcisions are needed to prevent one infection of HIV. (4) A literature review estimated that the risk ratios of HIV sero-conversion for uncircumcised men compared to circumcised men ranged from 2.3 to 8.1. (18) Limitations to the studies from which these risk ratios are derived include poor sampling, a low rate of acquiring the disease, and not controlling for confounders such as the number of sexual partners or other sexual practices. Because ulcerative STDs are more common in uncircumcised men than circumcised men, one hypothesis is that these lesions increase the probability of one becoming infected if exposed to HIV. (19)


Cancer of the Penis


Penile carcinoma is a rare disease in the United States with an estimated 750 to 1,000 cases diagnosed each year. There is a large variation in the incidence of penile cancer among countries where most men are uncircumcised. For example, Denmark has an annual incidence of 0.8 cases per 100,000 men compared to India which has an annual incidence of 10.5. (4) As with UTIs, the relative risk for uncircumcised men is a moderate 3.2, but the annual absolute risk increase is extremely small at 0.31 cases per 100,000 men per year, which would correspond to a NNT of over 300,000 to prevent one case of penile cancer per year. (20,4) However, one study estimates that 600 circumcisions are needed to prevent one lifetime case of penile cancer, and another study presents a NNT of 900. (21,3) Based on these NNTs, the absolute risk reduction for preventing one case of penile cancer per lifetime is less than 0.2%. In general, careful hygiene is believed to be important in preventing penile cancer. (5)


Cancer of the Cervix


Both cervical carcinoma and dysplasia are associated with specific serotypes of human papillomavirus (HPV). Because the foreskin provides a hospitable environment for viruses, some believe that a woman whose partner is uncircumcised may be at increased risk for cervical carcinoma. (22) The studies, which are methodologically challenged, have had conflicting results, yet most have found no association. (23) Clearly identified independent risk factors for developing cervical cancer include early age of first sexual activity, multiple partners, and smoking. In summary, the evidence to support an association between circumcision status and the risk of developing cervical cancer is inconclusive.


Sexual Functioning and Penile Problems


The effect of circumcision on penile sensation or sexual satisfaction is unknown. Because the epithelium of a circumcised glans becomes cornified, and because some feel nerve over-stimulation leads to desensitization, many believe that the glans of a circumcised penis is less sensitive. Opinions differ about how this decreased sensitivity, which may result in prolonged time to [bless and do not curse][bless and do not curse][bless and do not curse][bless and do not curse][bless and do not curse][bless and do not curse], affects sexual satisfaction. An investigation of the exteroceptive and light tactile discrimination of the glans of circumcised and uncircumcised men found no difference on comparison. (24) No valid evidence to date, however, supports the notion that being circumcised affects sexual sensation or satisfaction.


Anesthesia


Newborns experience pain during circumcision. (1) When anesthesia is used, methods include the topical eutectic mixture of local anesthetics (EMLA), the dorsal penile nerve block (DPB), and the ring block. A randomized controlled trial investigating these methods in 52 infants found that all provided more analgesia than placebo based on heart rate, cry, and methemoglobin levels, and that the ring block was the most effective. (25) Complications from local anesthesia are uncommon and consist mainly of hematomas and local skin necrosis. The most common complication is bruising; one study on complications found bruising in 11% of neonates who had a DPB, (26) and another found a minor complication rate of 1.2%, of which bruising was the most frequent. (27) There have not been any studies to evaluate the long-term complications of the various analgesics.


Future Need for Circumcision


Penile cancer is claimed by some to be an indication for circumcision in the adult, but its prevalence is low. Recurrent balanitis is an indication, particularly in men with diabetes mellitus. A frequent indication is phimosis, which cannot be diagnosed in the newborn because the cleavage plane between the glans and the deep preputial layer of the penis in not developed at birth; often the foreskin is not retractable until 3 years of age. An estimated 10% of men will develop phimosis. (28,29) Although neonatal circumcision has fewer complications than adult circumcision, evidence to support routine neonatal circumcision in order to prevent the need for adult circumcision is not available.


Informed Consent and the Medical Ethics of Circumcision


Obtaining informed consent for medical procedures is an important practice. In emergent cases when a parent or legal guardian is not available to give consent, a procedure will often be performed if it is judged to be life-sustaining and in the best interest of the patient. When a person having a procedure is unable to give consent and a guardian is present, the guardian’s consent is acceptable. This occurs for routine medical procedures of clear benefit to children such as immunizations. A physician performing a procedure for other than medical reasons on a nonconsenting patient raises ethical concerns.

While routine circumcision is widely practiced, the small medical benefits of circumcision lead many to consider routine circumcision to be a cosmetic procedure. This leads to questions regarding medical ethics and whether and how to present to a parent a balanced discussion of the relative benefits and harms of the procedure. Key to the ethical discussion is respect of the parent’s religious, ethnic, or other cultural beliefs for which circumcision is practiced.


Economic Analysis


One cost-effectiveness analysis estimated that the lifetime cost difference for men who were circumcised was $25, with a benefit of 10 additional days of life. (30) Another analysis estimated that routine circumcision cost $102 per person, resulting in 14 hours of extended life. (31) These findings suggest that cost factors should be removed from the decision of circumcision. (4)


Summary


Considerable controversy surrounds neonatal circumcision. Putative indications for neonatal circumcision have included preventing UTIs and their sequelae, preventing the contraction of STDs including HIV, and preventing penile cancer as well as other reasons for adult circumcision. Circumcision is not without risks. Bleeding, infection, and failure to remove enough foreskin occur in less than 1% of circumcisions. Evidence-based complications from circumcision include pain, bruising, and meatitis. More serious complications have also occurred. Although numerous studies have been conducted to evaluate these postulates, only a few used the quality of methodology necessary to consider the results as high level evidence.

The evidence indicates that neonatal circumcision prevents UTIs in the first year of life with an absolute risk reduction of about 1% and prevents the development of penile cancer with an absolute risk reduction of less than 0.2%. The evidence suggests that circumcision reduces the rate of acquiring an STD, but careful sexual practices and hygiene may be as effective. Circumcision appears to decrease the transmission of HIV in underdeveloped areas where the virus is highly prevalent. No study has systematically evaluated the utility of routine neonatal circumcision for preventing all medically-indicated circumcisions in later life. Evidence regarding the association between cervical cancer and a woman’s partner being circumcised or uncircumcised, and evidence regarding the effect of circumcision on sexual functioning is inconclusive. If the decision is made to circumcise, anesthesia should be used.

The American Academy of Family Physicians recommends physicians discuss the potential harms and benefits of circumcision with all parents or legal guardians considering this procedure for their newborn son. (2001)


References

1. Robson WL. The circumcision question. Postgraduate Medicine 1992;91:237-243.
2. Laumann EO et al. Circumcision in the United States. JAMA 1997;277:1052-7.
3. Christakis DA et al. A trade-off analysis of routine newborn circumcision. Pediatrics 2000; 105:246-9.
4. Learman LA. Neonatal circumcision: a dispassionate analysis. Clinical Obstetrics and Gynecology 1999;42:849-859.
5. Kaplan GW. Complications of Circumcision. Urol Clin North Am 1983;10:543-9.
6. Harkavy KL. The circumcision debate (Letter). Pediatrics 1987;79:649.
7. Anderson GF. Circumcision. Pediatric Annals 1989;18:205-213.
8. Fergusson DM et al. Neonatal circumcision and penile problems. Pediatrics 1988;81:537-541.
9. Niku SD et al. Neonatal circumcision. Urol Clin North Am 1995;22:57-65.
10. King LR. Neonatal circumcision in the United States in 1982. J Urol 1982;128:1135-6.
11. Ginsburg CM et al. Urinary tract infections in young infants. Pediatrics 1982;69:409-412.
12. Wiswell TE. Urinary tract infection and the uncircumcised state: an update. Clin Pediatrics 1993;32:130-134.
13. Rushton HG. The evaluation of acute pyelonephritis and renal scarring with technetium 99m-dimercaptosuccinic acid renal scintigraphy: evolving concepts and future directions. Urological Review 1997;11:108-120.
14. Roberts JA. Neonatal circumcision: an end to the controversy. South Med J 1996;89:167-171.
15. Moses S et al. The association between lack of male circumcision and risk for HIV infection. Sexually Transmitted Diseases 1994;21:201-210.
16. Parker SW et al. Circumcision and sexually transmissible disease. Med J Australia 1983;2:288-290.
17. Cook LS. Circumcision and sexually transmitted diseases. Am J Public Health 1994;84:197-201.
18. Moses S et al. Male circumcision: an assessment of health benefits and risks. Sexually Transmitted Infections 1998;74:368-373.
19. Caldwell JC et al. The African AIDS epidemic. Scientific American 1996;274:62-68.
20. Maden C et al. History of circumcision, medical conditions, and sexual activity and risk of penile cancer. J Natl Cancer Inst 1993;85:19-24.
21. Kochen M et al. Circumcision and the risk of cancer of the penis. Am J Dis Child 1980;134:484-6.
22. Burger R et al. Why circumcision? Pediatrics 1974;54:362-2.
23. Preston EN. Whither the foreskin? JAMA 1970;213:1853-8.
24. Masters WH et al. Human Sexual Response. Little, Brown and Company. Boston 1966.
25. Lander J et al. Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision. JAMA 1997;278:2157-2162.
26. Snellman LW et al. Prospective evaluation of complications of dorsal penile nerve block for neonatal circumcision. Pediatrics 1995;95:705-708.
27. Fontaine P et al. The safety of dorsal penile nerve block for neonatal circumcision. J Fam Prac. 1994;39:243-248.
28. Gairdner D. The fat of the foreskin. Brit Med J 1949;2:1433.
29. Herzog LW et al. The frequency of foreskin problems in uncircumcised children. Am J Dis Child 1986;140:254-6.
30. Lawler FH et al. Circumcision: a decision analysis of its medical value. Fam Med 1991;23:587-593.
31. Ganiats TG et al. Routine neonatal circumcision: a cost-utility analysis. Med Decis Making 1991;11:282-293.

Is caring for an intact babe in diapers pose risks of infection from, say, poo creeping under the foreskin? Information along those lines would be great.

The foreskin remains attached to the head of the penis until most boys are out of diapers. The foreskin starts to retract usually somewhere between the ages of 3-10 years old. As the foreskin is still attached no poop will get under the foreskin. Under no circumstances should the foreskin be forcibly retracted as that is what causes most problems in uncircumcised males.

 

[Linnis]

From what I've read there very rarely is a medical need to circumsize. In 1975 the American Academy of Pediatrics stated there is no medical need for routine circumcision of the newborn and in 1983 American College of Obstetricians and Gynecologists backed them up. They do say there are benefits but not enough to warrent routine circs on a newborn.

http://www.aap.org/advocacy/archives/marcircum.htm

According to my DH the foreskin remains attached until later in childhood and I later learned this after my nephew discovered he could move his last summer.

 

[Leanna]

How about this: http://www.askdrsears.com/html/1/t012000.asp

"Medical benefits - THERE ARE NONE! Do not circumcise your baby because you think there are some medical benefits. A recent review by the American Academy of Pediatrics looked at all the data from the past decades to see if there truly were any medical benefits. Their conclusion - NO. There are no significant medical benefits that make circumcision worth doing."

The more I read, the more I found that : "Medical grounds for circumcision that are most commonly cited are: Reduced risk of urinary tract infections (UTI); reduced risk of penile cancer; reduced risk of cervical cancer in partners; reduced risk of sexually transmitted disease (STD)."


http://www.cirp.org/pages/parents/FAQ/

I'm not sure which side you're on. Did you read that page? It says "medical grounds commonly cited" not that they are proven. Then the next 4 paragraphs disproves each of these ideas.

 

[katelyn]

Most of the info I've read that is pro-circ is more an emotional plea than statistical reasoning. I've even seen sites that show graphic pictures of what "can" go wrong in an uncircumcised male, yet they don't state any statistics of how likely it actually is to happen.

So far I haven't seen anything that really makes me feel the need to circumcise.

 

[~Nikki~]

Here's an article to read...I found it pretty scary...

http://www.sexuallymutilatedchild.org/lost.htm

 

[Katydid]

This is from this website:

http://www.circinfo.net/#summary

Lack of circumcision:

• Is responsible for a 12-fold higher risk of urinary tract infections. Risk = 1 in 20.

• Confers a higher risk of death in the first year of life (from complications of urinary tract infections: viz. kidney failure, meningitis and infection of bone marrow).

• One in ~400-900 uncircumcised men will get cancer of the penis. A quarter of these will die from it and the rest will require at least partial penile amputation as a result. (In contrast, invasive penile cancer never occurs or is infinitesimally rare in men circumcised at birth.) (Data from studies in the USA, Denmark and Australia, which are not to be confused with the often quoted, but misleading, annual incidence figures of 1 in 100,000).

• Is associated with balanitis (inflammation of the glans), posthitis (inflammation of the foreskin), phimosis (inability to retract the foreskin) and paraphimosis (constriction of the penis by a tight foreskin). Up to 18% of uncircumcised boys will develop one of these by 8 years of age, whereas all are unknown in the circumcised. Risk of balanoposthitis = 1 in 6. Obstruction to urine flow = 1 in 10-50.

• Means increased risk of problems that may necessitate circumcision later in life. Also, the cost can be 10 times higher for an adult.

• Is the biggest risk factor for heterosexually-acquired AIDS virus infection in men. 8-times higher risk by itself, and even higher when lesions from STIs are added in. Risk per exposure = 1 in 300.

• In the female partners of uncircumcised men is associated with higher incidence of cervical cancer, pelvic inflammatory disease, infertility from blockage of fallopian tubes, extopic pregnancy, genital herpes, and other conditions.


Getting circumcised will result in:

• Having to go through a very minor surgical procedure that carries with it small risks.

• Improved hygiene.

• Much lower risk of urinary tract infections.

• Much lower chance of acquiring AIDS heterosexually.

• Virtually complete elimination of the risk of invasive penile cancer.

• More favourable hygiene for the man’s sexual partner.

• More favorable sexual function.

• A penis that is regarded by most as being more attractive.

 

[Entertaining_Angels]

We circumcised for a few reasons. Most importantly, it was my husband's decision and I think fathers should be the ones making the decision...sexist, perhaps but oh well

Part of what went into the decision is that some males on my side were not circumcised and had a lot of physical problems as they got older due to not being circumcised.

Personally could care less who circumcises or does not circumcise their sons just so long as they don't judge others for it. The way I look at it, if God commanded it at one time and tells us in the NT that it doesn't matter one way or the other, it is not barbaric.

And, of course, we circumcised our son and he is just fine

 

[RedTulipMom]

We didnt circumcise either of my sons. I read all the pros and cons and felt that it just isnt medically necessary. My husband isnt as much of a reader as me so he asked the doctor "is it medically necessary?" and the doctor said "no it isnt. Its a choice people make usually depending on if the dad is circumcized or not because they want them to be like daddy". Well my hubby IS circumcised..but he agreed to NOT circumcise since it wasnt medically necessary

 

[Sascha Fitzpatrick]

As a nurse, my experience (anecdotally of course - I haven't been published! ) has been that those who aren't circumcised certainly appear to have a lot more problems in later life.

I know in my urological experience I would see more non-circ'd than circ'd in my regular day - of a ration of about 10 uncirc'd to 1 circ'd.

I'm not sure if this really helps you Leanna, but after what I've seen day to day in theatres courtesy of people not circumcising, I am going to circumcise my children.

My husband wants them circumcised, but that is to do with him being done as well, rather than anything 'medical'... he left the medical stuff up to me!

I did a lot of book study as well before making my mind up (I was still in the 'circumcised' sides of things after reading texts and what not), however it was more my own personal experience of nursing in urology theatres and wards that sealed it for me.

Sorry if this is no help at all!

Sasch

 

[HeKnowsMyName]

Leanna, Was your first child circumsized?

 

[Athene]

As a nurse, my experience (anecdotally of course - I haven't been published! ) has been that those who aren't circumcised certainly appear to have a lot more problems in later life.

I know in my urological experience I would see more non-circ'd than circ'd in my regular day - of a ration of about 10 uncirc'd to 1 circ'd.

What are the ratios of non-circ'd men to circ'd men in the general population, it's important to know that otherwise it's impossible to correctly determine whether or not non-circ'd men are more prone to health risks, it could well be that the reason why more non-circ'd men go to hospital is that there are more non-circ'd men.

 

[Athene]

What I would really like is to hear whether there is a real reason to circumsize based on medical or scientific evidence.

No there isn't, curcumcision became popular during the Victorian Era as a means to prevent masturbation, (female circumcision was also carried out for this reason). Male circ decreases the sensitivity of the penis because it thickens the skin at the end of the penis.

If you can access these journals I'd recommend you read them.

Male circumcision: a review of the evidence. The Journal of Men's Health and Gender. Vol 2, Issue 1, March 2005 pages 21-30

Circumcision in adulsts: effect on sexual funtion. Urology. Vol 63, Issue 1, Jan 2004, 155-158

An evidence-based approach to male circumcision: what do we know? Journal of Midwifery and womens Health. Vol 46, Issue 6, Nov-Dec 2001 p 415-422

Thre are slight health benefits attached to having a boys foreskin removed, and by slight I mean the slightest of slight benefits. IMO the decision of whether to circumsize or not to circumsize is more of an ethical question. Do you have a right to circumsize your child? A circumcision is a non-essential operation which will change a childs body, effect their sexual response, and the chances of complications arising from the procedure are around 2-10%.