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Male Circumcision

Circumcision is the surgical removal of the prepuce of the foreskin that covers the tip of the penis. The prepuce is a normal part of the external genitalia. It protects the the glans, from chafing and abrasion during intercourse and from general wear and tear. It protects the glans from irritation in infancy when the baby is incontinent. It provides lubrication. It also contains erogenous tissue, in other words it contributes to sexual arousal.

The United States has one of the highest rates of male circumcision at 60 per cent. This is down from the rate of 85 per cent previoulsy recorded in the 1970s. Over 1.25 million infants are circumcised annually, that’s more than 3,300 babies each day. Male circumcision has often been carried out for reasons of hygiene. Men who have had a circumcision seem to contract urinary tract infections less. It is also thought that circumcised men have a lower rate of penile cancer, a very rare form of cancer. Research is unclear about whether circumcision reduces the risk of cervical cancer in female sexual partners.

When the procedure takes place depends on need. In the United States most circumcisions take place for social, cultural and sometimes for religious reasons and therefore tend to happen in the first few days or weeks of life. It is known that the older the infant or child the more complicated and riskier the operation is. Circumcision takes about 10 to 15

minutes but it does depend on the condition, if any, being treated. Anesthesia type will depend on the patient’s age. Babies will often only have a numbing medicine (which are not always that effective and the baby often experiences pain). Otherwise circumcisions may be undertaken with a general anesthetic.

It is thought that between 2-10 per cent of circumcisions result in complications. The long term consequences and severity of the complications may not be apparent until the child grows up and experiences difficulties. Bleeding and infection are the most common problems. The child’s urine tends to irritate the exposed glans and in rare cases can cause infection. Pain is common in any wound and circumcision is no exception but these should be short term. A few men experience discomfort or pain during erections and at the scar site. Disfigurement can occur when too much skin is removed, erectile curvature from uneven skin loss. Scarring may also cause numbness.

The sexual consequences are difficult to accurately calculate. It is difficult to calculate sensory and pleasure components between the differences of intact and circumcised men. Studies by NOHARMM report progressive sensory loss causing sexual dysfunction. Problems included erectile problems, ejaculatory difficulties, anorgasmia, difficulty with adequate stimulation during vaginal intercourse.

Psychological trauma has also been reported. Rage, resentment, depression, genital dysmorphia, low self esteem and even dependence on alcohol, drugs, food and sex to relieve suffering as a result of the circumcision. Interestingly men in the NOHARMM study reported that they have not sought medical help for the problems associated with circumcision because of embarrassment, fear of ridicule, mistrust of doctors and thinking no recourse available.

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