The Risks and Disadvantages of Circumcision
Surgical Risks
The major disadvantage associated with circumcision stems
from the fact that it is a surgical procedure, and as such
inherently carries some risks. These can be summarized as
follows
[1]:
-
Excessive bleeding: Occurs in 1 in 1000 - treated with pressure or
locally-acting agents, but 1 in 4000 may require a ligature and 1 in
20,000 need a blood transfusion because they have a previously
unrecognized bleeding disorder. Haemophilia in the family is of course
a contra-indication for circumcision.
-
Infection: Local infections occur in 1 in 100-1,000 and are easily
treated with local antibiotics. Systemic infections may appear in 1 in
4,000 and require intravenous or intramuscular injection of
antibiotics.
-
Subsequent surgery: Needed for 1 in 1,000 because of skin bridges, or
removal of too much or too little foreskin. Repair of injury to penis
or glans required for 1 in 15,000. Loss of entire penis: 1 in
1,000,0000, and is avoidable by ensuring the practitioner performing
the procedure is competent. Injuries (rare) can be repaired [12] and in
the infinitely remote instance of loss of the penis it can be
re-attached surgically [96].
-
Local anaesthetic: The only risk is when the type of anaesthetic used
is a dorsal penile nerve block, with 1 in 4 having a small bruise at
the injection site. This will disappear.
-
Death: The records show that between 1954 and 1989, during which time
50,000,000 circumcisions were performed in the USA, there were only 3
fatalities. It should also be noted that during the
same period there were 11,000 deaths from penile cancer, a disease
which essentially only occurs in uncircumcised men.
It is important to consider these statistics in context. If
the circumcision is performed carefully by an experienced
operator, the procedure is totally safe - as a matter
of fact one of the safest around.
Other Disadvantages
Disadvantages that are often quoted include:
-
Meatitis: normally found in infants when the meatus gets inflamed
due to diaper rash, which makes passing water painful.
Treatment is usually easy and swift, while in extreme cases
scarring may occur. Very rarely the opening might need
stretching. The risks of meatitus can be almost eliminated
by proper hygiene (e.g. frequent diaper changes).
-
Loss of sensitivity: there are some men who complain that
circumcision leads to a loss of sensitivity of the penis
due to the fact that the glans becomes thicker and the
absence of the foreskin. There is, however, no scientific evidence
that circumcision reduces the sensitivity during intercourse.
Even though there are several thousand men who have tried
to restore their foreskins (e.g. by stretching) and mourn
the loss of their foreskins, there are thousands of men
who decided to have themselves circumcised as adults
because they were, amongst others, unhappy about the
way they experienced intercourse with a foreskin. It should
be remembered that there are several million men in North America
who were circumcised as infants and who are perfectly
happy about their status.
-
Pain:
regarding the issue of pain experienced by the infant during the procedure,
the AAP states: In summary, analgesia is safe and
effective in reducing the procedural pain associated with
circumcision and, therefore, adequate analgesia should be provided if
neonatal circumcision is performed."
Medical results have furthermore shown that local
anesthetics (administered by injection), when properly administered,
completely do away with the pain other than the needle
sticks and the infiltration of the anesthetic.
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References
1. T.E. Wiswell,
"Circumcision circumspection",
N Engl J Med 1997; 336:1244-5.
(other references still to be added).
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