Winnipeg Free Press - PRINT EDITION

New circumcision method faster, safer: MD

Procedure popular with local Filipino families

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Circumcision is less common since pediatricians dismissed the practice as not beneficial and Manitoba Health stopped paying for it as a routine procedure.

But to Winnipeggers from the Philippines, it's customary to have a male infant's foreskin removed and they're willing to pay to have it done.

"I'd been getting lots of demand from my patients, specifically in the Filipino community," said Dr. Jay Buenafe.

In the Philippines, non-religious circumcision is routine and is performed on more than 80 per cent of baby boys, the World Health Organization reports.

"I was trying to look for a better way, a faster way to do it," said Buenafe, who came to Canada from the Philippines in 2002.

He went to Vancouver to learn Dr. Neil Pollock's circumcision technique and Buenafe started using it at his Jefferson Avenue clinic this month.

His Vancouver mentor has performed more than 30,000 circumcisions, according to his website, and has pioneered a 30-second "virtually painless" technique that has "changed the standard of care in British Columbia." Pollock says the techniques for providing this surgery "are only as safe as the operating physician's experience, which translates to the actual number of circumcisions the physician has carried out."

Buenafe charges $299 to perform the procedure on babies younger than two months.

"I still do family practice," said Buenafe. He's been performing circumcisions for a number of years for Filipino-Canadian patients' newborn boys "and people from different religious sectors and foreign countries who have this as a tradition," he said.

"This is the bulk of my practice."

His first circumcision using Pollock's method was on a Congolese woman's baby, he said. Topical creme numbs the area and a needle freezes it while soft music is played and a special clamp that has a better cosmetic result is used to make sure just the right amount of tissue is removed, he said. Parents can watch the procedure performed on their baby in his clinic or online.

"This is a new skill, and I hope to build up the practice," he said. "The advantages of this technique are it's much faster. We have an extremely low complication rate," he said.

Of every 1,000 boys who are circumcised, 20 to 30 will have a surgical complication, such as too much bleeding or infection, Manitoba Health says.

The Pollock method has one surgical complication in 400, said Buenafe.

Two out of every 1,000 circumcised babies will be hospitalized for urinary tract infections, says Manitoba Health. Buenafe says it's one out of 1,000 for the method he's using.

Buenafe acknowledged the medical establishment hasn't given its blessing to the method.

"The Canadian Pediatric Society still doesn't recommend it," he said. "There's not enough evidence yet to say it's more beneficial."

Since 1982, the Canadian Pediatric Society has said there is no point to circumcision.

A society spokesperson said Wednesday the Pollock method Buenafe performs hasn't been reviewed. It can't comment on it specifically but their position against circumcision stands: "The overall evidence of the benefits and harms of circumcision is so evenly balanced that it does not support recommending circumcision as a routine procedure for newborns."

Manitoba will only cover the cost of a circumcision if it's needed to treat a medical condition, a government spokeswoman said Wednesday. Then it pays $145.60.

carol.sanders@freepress.mb.ca

Republished from the Winnipeg Free Press print edition April 19, 2012 A8

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