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Winnipeg Free Press - PRINT EDITION

It's well past time to end male circumcision

Problems outweigh purported benefits

By: W. Gifford-Jones MD.

Posted: 03/26/2010 1:00 AM | Comments: 0 (including replies)

Petar Petrov / The Associated Press Archives A Bulgarian boy reacts as a doctor performs a circumcision. There is no health benefit to the surgery.

Why did my loving parents do this to me many years ago? I'm sure their doctor told them it was the hygienic thing to do. But I'm equally sure I must have been screaming like hell while it was being done. Today, millions of circumcisions are still performed. But it's time to stop this shocking brutality and the complications associated with it.

Dr. Guy Madder, a surgeon at the Queen Elizabeth Hospital, Adelaide, Australia, reports in the Annals of Family Medicine that there is no convincing evidence that circumcision decreases the risk of sexually transmitted disease, urinary tract infections or penile cancer.

The rituals of some religious faiths require circumcision. But apart from these circumstances, it's hard to justify this procedure. In fact, a reading of the world's medical journals makes your hair stand on end when you read of potential surgical complications.

How common are complications? This depends on how you label a complication. For example, penile foreskin is anatomically the most sensitive part of the organ. It ensures satisfactory sex. It's therefore reasonable to argue that in this instance the complication rate is 100 percent because it decreases sexual satisfaction.

There's another aspect never mentioned in the discussion of the pros and cons of this surgery. Today, erectile dysfunction (ED) drugs are being used by an increasing number of males, and not all of them are in their senior years. I admit I have no statistics on this matter. But I wonder how many males who require ED drugs could have experienced a longer and more satisfactory sex life, if this sensitive foreskin had not been removed.

But why do some of the complications of this procedure make one's hair stand on end? Compared to brain surgery, circumcision is a minor procedure, and is normally performed without complications. But no surgical procedure to my knowledge has ever been devised, regardless of minor, without possible untoward results.

The world's medical journals are full of reports dealing with a variety of surgical complications. And the vast majority of severe complications are not an act of God, but technical human errors made during the procedure.

A primary problem is the incorrect use of the circumcision clamp. In some cases too much foreskin is pulled into the clamp resulting in injury, not only to the shaft of the penis, but also to the urinary tube (urethra) that runs through it. The most traumatic complication in the past caused the amputation of part of the penis.

Such traumatic injuries to the penis and urethra often result in urinary stricture and difficulty passing urine. Or, the injury may result in a urethral fistula, in which urine is discharged through an abnormal opening. These complications are not easy to repair, and what starts out as a minor procedure becomes a major one. Moreover, some of these injuries only become apparent following discharge from hospital.

There have been bizarre problems one would never think of happening. For instance, one newborn screamed during the procedure with such intensity that the stomach ruptured requiring emergency surgery. Another developed heart failure and died. Still another from a bleeding disorder.

Why wouldn't babies scream like hell when circumcised without anesthesia? And how many males who have it done later in life would agree to this procedure without anesthesia?

Today we criticize those cultures that believe in the barbaric act of female circumcision. Yet Western doctors continue to carry out this sadistic procedure in males without their permission. That's why some argue that circumcision violates the United Nations Declaration of Human Rights.

Amen to that.

Republished from the Winnipeg Free Press print edition March 26, 2010 A21

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