If you are having a boy, circumcision may have crossed your mind or be a mandatory part of your culture. This month, Dr Jinan Harith Darwish clarifies any questions you may have regarding this subject.
The practice of circumcision dates to ancient times. In Egypt, prior to biblical times, circumcision was performed to improve male hygiene. Later, customary circumcision of male infants was part of the Abrahamic covenants with Jehovah, giving rise to religious circumcisions that continue to this day in the Muslim and Jewish faiths.
At birth, the foreskin is attached to the end of the penis, an area known as the glans. Circumcision in the male is the removal of the foreskin of the penis. In 2012, the American Academy of Paediatrics (AAP) task force on circumcision of the male infant concluded that the health benefits of newborn male circumcision outweigh the risks. There are numerous medical benefits to male circumcision.
In the uncircumcised male, the space between the foreskin and the glans must be cleaned frequently. Advocates of circumcision argue that it is hard for uncircumcised children and men to sustain correct hygiene. Uncircumcised males are at amplified risk for inflammation of the glans; this problem seldom occurs in circumcised men. Uncircumcised boys who observe good penile hygiene are less likely to experience penile inflammation. Studies consistently report that uncircumcised male infants are at higher risk of urinary tract infections when compared with circumcised male infants.
Male circumcision does not appear to adversely affect penile sexual function or sensitivity or sexual satisfaction. Studies suggest that circumcision helps decrease the risk of acquisition of HIV, HPV and, perhaps, herpes simplex virus type 2 (HSV-2). There is also some data that it may protect against trichomonas and cancroid infection.
Circumcision does not guard against infection from gonorrhoea, chlamydia trachomatis or syphilis. It is imperative to note, therefore, that many circumcised men do acquire these diseases. Circumcision may lower the risk of acquiring the infection, but it does not abolish it.
Cancer of the penis is rare, but uncircumcised men are at increased risk of developing the disease. Good hygiene and human papillomavirus (HPV) immunisation may reduce or negate this risk. Cervical cancer is more common in women whose male sexual partners are not circumcised. HPV immunisation may reduce or negate this risk.
There are a few situations that may cause a circumcision to be deferred. For instance, babies who are born with a defect of the penis should be evaluated by a urologist, who may recommend delaying circumcision. If there is a family history of a bleeding disorder or the baby has bleeding problems, circumcision is delayed until it has been determined that the baby is not at increased risk of bleeding during the procedure.
Making the decision to circumcise an infant outside religions and cultures that mandate circumcision can be difficult for some parents. A father may be apprehensive that his son’s penis appear similar to his own or other men’s. Some parents may be concerned about the risks versus the benefits of the procedure.
A decision is best made before the baby is born, although parents should feel at ease discussing their questions or concerns with their paediatrician after the son’s birth. The procedure, which on average costs BD40, can be performed at a private hospital before the mother and baby are discharged, or can be performed as an outpatient procedure as late as three months after birth. After three months, the procedure usually requires general anaesthesia.