Sunday, October 4, 2009

The Health Risks of Uncircumcision


For my dearest blog fellows who are pregnant with baby boy, this is the time to think about circumcision. Especially for Asian people, circumcision is not widely practised as in Western countries.

Keep reading below and you will know how important is circumcision, BOTH for your boy and for his future wife.

Let's go back in history. If you happened to think that circumcision is unimportant as our ancestors back then never even have this procedures done, you are correct! But, only applicable for that period of ancient time, when our ancestors are still naked. In fact, the foreskin plays important role to protect the tip of penis from dust, sand, insects, and infections.

The above doesn't apply anymore in our time, where we are all wrapped in clothes, often dirty and sweaty. This has made it became unhygienic, especially for people who live in hot weather countries.

The reason why circumcision is important, because the inner lining of the foreskin is very thin. This does not give protection against injury and infection like normal skin does. In fact, 'smegma' or a whitish residue of dead cells and other material, is collected under the foreskin. This attracts bacteria and other microorganisms.

Statistically, uncircumcised men are more exposed to infectious diseases such as:
  • Thrush
  • Human papilloma virus
  • Syphilis
  • HIV
  • Urinary tract infections
  • Other inflammatory conditions of the skin
  • Phimosis, a narrowing of the opening the foreskin that prevents it being retracted and makes sex painful
  • Higher chance of prostate cancer

Meanwhile, their female partners are more prone to:

  • Genital herpes
  • Chlamydia
  • Pelvic inflammatory disease
  • Infertility
  • Higher chance of cervix cancer

There is a one-in-three chance of an uncircumcised man developing one or more of these conditions over his lifetime.

However, there are always risks involving with any surgical procedure. In one in 500 circumcisions there's some minor bleeding. In about 1 in 1000, the circumcision needs to be redone. It is noteworthy though, that complications are fewest when it's done between birth and 4 months, although the procedure can be done at any age. Serious complications that requires hospitalisation is very rare. Mutilation or loss of the penis, and death, are practically unheard of if the surgeon is competent.

All in all, the benefits of circumcision still outweigh the risks of the procedure.

And to mothers to baby boys, now you can make your informed decision on whether or not to circumcised your boy, or leave it to him to decide later in his life.

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For reference:
• World Health Organization's website : http://www.who.int/mediacentre/news/releases/2007/pr10/en/index.html
• Professor Brian Morris's website : www.circinfo.net
• The Royal Australasian College of Physicians policy statement on circumcision : http://www.racp.edu.au/
• Why circumcision is a biomedical imperative for the 21st century - BioEssays abstract : http://www.ncbi.nlm.nih.gov/sites/entrez

12 comments:

Caroline said...

Ms. Sienna,

How do I begin? First of all, I don't know where you heard this information, but "uncircumcision" is not a state of being. Being "circumcised" is. Most men who were not circumcised prefer to be called "intact" or "natural". And over 80% of the world's men fall into this category.

Second of all, being intact does not pose health risks, as you say. Circumcision started in the US in the early 1900's as a cure for masturbation. Yes, it's true. Back then, masturbation was thought to cause insanity, and every other illness known to man. Even though it didn't work, people never stopped searching for diseases which they thought circumcision would cure.

Third of all, the way you described the foreskin is completely inaccurate. Not only is it normal, healthy, functional, protective, and errogenous tissue, but it is actually double layered, so that it folds back on itself to provide a DOUBLE layer or protection to the head of the penis. And you might be surprised to hear this, but females produce smegma too under their labia and clitoral hood. But we wash it off, don't we?

Caroline said...

Sienna,

please go read the position statements on circumcision from various medical organizations around the world
http://www.cirp.org/library/statements/

including this recent one from the Royal Australasian College of Physicians
http://www.racp.edu.au/page/health-policy-and-advocacy/paediatrics-and-child-health
(click Circumcision: Current College Position)

Also, please see
doctorsopposingcircumcision.org

and doctors in their own words, including nationally syndicated radio host Dr. Dean Edell

"Doctors Opposing Circumcision" channel
http://www.youtube.com/view_play_list?p=BC354EC34E141BD3

Mark Lyndon said...

You might also want to check out the following:

Canadian Paediatric Society
"Recommendation: Circumcision of newborns should not be routinely performed."

http://www.caringforkids.cps.ca/pregnancy&babies/circumcision.htm
"Circumcision is a 'non-therapeutic' procedure, which means it is not medically necessary."
"After reviewing the scientific evidence for and against circumcision, the CPS does not recommend routine circumcision for newborn boys. Many paediatricians no longer perform circumcisions.


RACP Policy Statement on Circumcision
"After extensive review of the literature the Royal Australasian College of Physicians reaffirms that there is no medical indication for routine neonatal circumcision."
(those last nine words are in bold on their website, and almost all the men responsible for this statement will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%. "Routine" circumcision is now *banned* in public hospitals in Australia in all states except one.)

British Medical Association: The law and ethics of male circumcision - guidance for doctors
"to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate."

Georganne said...

I have no idea where you got your "facts," but it is very distressing to think that somebody would agree to have a healthy, normal body part removed from their baby boy, based on this pack of misinformation. I hope you and your readers will take the time to learn the truth, by following some of the links left by other commenters. You can also look at www.intactamerica.org

Sienna said...

Thank you all for your comments.

Ok, I need to straighten the facts out.I am also not a supporter for routine circumcision for newborn boys. And whether or not circumcision is deem necessary, should be left for the parents to decide, or if the parents would want to delay this until the boys grow old enough to make decision for themselves.

I've read the links provided by you guys, and again, thank you for providing these links. So that parents would have more sources to read from in order to make their informed decision.

And to answer your questions, my sources are from World Health Organization where they recommend male circumcision for HIV prevention.

Also from, The Royal Australasian College of Physicians policy statement on circumcision, in which the benefits of circumcision is discussed, however it is suggested not to make it as routine procedure, in consideration of human rights.

And Caroline is correct, that foreskin is double layer. In fact, to quote from Professor Brian Morris' website, the foreskin is composed of an outer layer that is keratinized (as is skin generally), and an inner lining that is a mucosal surface. The inner lining thus resembles other mucosal epithelia such as constitute the cervix, nasal passages and rectum.

However, the inner layer of the foreskin lines a ‘preputial sac’, which becomes a repository for shed cells, secretions, and urinary residue that accumulates [122, 426]. It is also a hospitable environment for the growth of bacteria and other microorganisms.

The presence of a prepuce is likely to result in greater microtrauma during sexual intercourse, thereby permitting an entry point into the bloodstream for infectious agents.

The preputial sac has even been referred to by Dr Gerald Weiss, an American surgeon, as a 'cesspool for infection' [608], as its unfortunate anatomy wrapped around the end of the penis results in the accumulation of secretions, excretions (urine), dead cells and growths of bacteria as referred to above. Parents are told not to retract the foreskin of male infants, which makes cleaning difficult. Even if optimal cleansing is performed there is no evidence that it confers protection [639, 640]. Rather, the foreskin tends to trap and transmit micro-organisms, both to the man himself, and his sexual partners.

Furthermore, Dr Terry Russell, an Australian medical practitioner and circumcision expert states "What man after a night of passion is going to perform penile hygiene before rolling over and snoring the night away (with pathogenic organisms multiplying in the warm moist environment under the prepuce)" [482]. The bacteria start multiplying again immediately after washing and contribute, along with skin secretions, to the whitish film, termed 'smegma', that is found under the foreskin.


Nevertheless, circumcision has always been a debatable topic. My role here is to provide information on long term health benefits, and again, not a pro for routine circumcision.

Thank you all for your inputs.

Mark Lyndon said...

Hmm, you certainly sound like a "supporter for routine circumcision for newborn boys".

The RACP actually says there's no need to circumcise. Human rights are only raised in their position statement, because it's not clear whether or not "routine" circumcision of baby boys in Australia is even legal:
"The possibility that routine circumcision may contravene human rights has been raised because circumcision is performed on a minor and is without proven medical benefit. Whether these legal concerns are valid will be known only if the matter is determined in a court of law."

Like I said before, "Routine" circumcision is now *banned* in public hospitals in Australia in all states except one.

Women have a prepuce too (the clitoral hood) as well as a much larger "warm moist environment" where bad stuff can accumulate. Their genitals are harder to clean too, and they produce more smegma than men, but we don't cut parts off baby girls.

Professor Brian Morris is not a medical doctor btw, and his views are way out of line with those of the RACP (the national body of Australian doctors).

Sienna said...

Dear Mark,

Thank you again for your input.

Hope parents can get the most out of this discussion.

Anonymous said...

ME. In societies where a daily hot shower is the norm, and where condoms are commonly used during casual sex, there is no medical value to circumcision.


"Let's go back in history. If you happened to think that circumcision is unimportant as our ancestors back then never even have this procedures done, you are correct! But, only applicable for that period of ancient time, when our ancestors are still naked. In fact, the foreskin plays important role to protect the tip of penis from dust, sand, insects, and infections."

ME. Wrong. Circumcision was common in African and Australian paleolithic cultures.


"The above doesn't apply anymore in our time, where we are all wrapped in clothes, often dirty and sweaty. This has made it became unhygienic, especially for people who live in hot weather countries."

ME. Given a daily shower, the foreskin is NOT "unhygienic." And the foreskin is not useless; it is a major source of sexual pleasure.

"The reason why circumcision is important, because the inner lining of the foreskin is very thin. This does not give protection against injury and infection like normal skin does. In fact, 'smegma' or a whitish residue of dead cells and other material, is collected under the foreskin. This attracts bacteria and other microorganisms."

ME. The foreskin is no more delicate than the labia minora. We don't cut those, do we? Smegma is trivial to wash away.

"Statistically, uncircumcised men are more exposed to infectious diseases such as:
* Thrush
* Human papilloma virus
* Syphilis
* HIV
* Urinary tract infections
* Other inflammatory conditions of the skin
* Phimosis, a narrowing of the opening the foreskin that prevents it being retracted and makes sex painful
* Higher chance of prostate cancer"

ME. These alleged correlations have been established within societies. Trouble is, in most societies the uncircumcised are have inferior socioeconomic status which is correlated with poor health outcomes regardless of circumcision status.

The foreskin is not a causal factor in prostate cancer. Most cases of phimosis can be cured without amputation. Routine circumcision causes as many infections in infancy as it prevents. The circumcised USA has much higher rates of STDs than intact Japan and Europe.

If men used condoms during casual sex, most of these problems would vanish. It is possible that these problems would vanish if men washed before and after sex.


"Meanwhile, their female partners are more prone to:
* Genital herpes
* Chlamydia
* Pelvic inflammatory disease
* Infertility
* Higher chance of cervix cancer"
ME. Men who keep clean and use condoms, or abtain from an irresponsible sex life, are immune to the above.

"There is a one-in-three chance of an uncircumcised man developing one or more of these conditions over his lifetime."
ME. Urological data from Europe or Japan could easily easily verify this. Where has this comparison been made?

Anonymous said...

Prof. Brian Morris of the University of Sydney is not a source of reliable information. He is not trained in any of urology, pediatrics, or human sexuality.

The position of the RCAP is radically at variance with Morris's views.

Anonymous said...

It’s unfortunate that many ignorant people think that the results of a correlation study prove causation. An uncircumcised man can’t increase the likelihood of a woman being infertile or any of those problems you listed. The only thing that’s true out of this post was the sentence about phimosis. Fortunately, men who have tight foreskins can reverse phimosis by stretching the foreskin every day. The process takes a while and it can be found on some websites. Anyways, men who practice unsafe sex will get those STIs you listed and men who don’t clean their penis well enough will have a lot of smegma. It’s a lot healthier and sensual to remain intact. Men who are circumcised usually suffer from some keratinization of the glans. By the way, there is an interview with Dr. Drew and Dane Cook in which Dane Cook was asked if he was circumcised or not and if he had any problems. Dane Cook said that he was uncircumcised and that he didn’t have any problems.

Lorraine said...

A german court has now ruled parental circumcision of the child as assault. They now equate the act to "grievous bodily harm" and said that the child's rights superceeds the parent's right to religious freedom. http://www.boston.com/news/world/europe/2012/06/28/german-court-circumcision-boys-assault/omi06thp93OpofswCw3W8I/story.html

Michael said...

Uncircumcised guys are more susceptible to bacterial infections and odors. It is a fact. But if they practice good hygiene there shouldn't be any problems. In addition to retracting, washing and drying every day, using a penis health creme that contains Vitamin A is a solid move. This creme possesses anti-bacterial qualities, which will provide an extra line of defense in the ongoing battle with foreskin bacteria.