I absolutely will not...

[LifetimeDoc]

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My point was many of the supposed benefits of unc'ed are the same as hair. Shaving is a response to culture as is circumcision.

In the end it's an individual decision and I won't push an agenda.

So if the culture or religion requires genital mutilation, such as in female-circumcision or to a lesser degree male-circumcision, it's alright?

I would think as physicians we would be more concerned about the wellbeing of our patient, and cultural issues would be secondary to health. If you get into a cultural issue, you would put it in the context of "what is best for the health of the patient" and not in terms of what is best for their particular groups sensibilities.

In the end, the patient has choice and it's up to the physician to push the agenda of "health" to the patient. If the patient chooses to ignore the physician's advice about health matters, they are free to do so.

 

[Pharos]

Having watched someone burn alive after a car accident (we arrived to find the car fully involved, driver pinned inside screaming), I would have to say in a situation like that....I would have shot him to put an end to his suffering if it were not for the legal issues.

Now on the medical side of things, I don't see why some gorked out patient is any different that a beloved family pet, or why we should expect to let another human being suffer through some painful form of cancer just so a percentage of us don't violate their belief in a higher diety. Sorry, it should be the patient's choice, not anyone elses.

Very good points.

 

[Gabby]

Mutilation is mutilation. Besides, robbing a male of part of his sex organs is not the job of a doctor. And trying to justify one unnecessary medical procedure because it's less risky than another doesn't make any logical sense. There already is one poster here that is in favor of male circumcision so that it reduces the sex drive in the male. So doctor's should participate in such a thing? I'm astounded to believe people would think of such a thing these days in the USA.

Actually, what the poster said was that protecting females from cervical cancer was more important than the males having an even bigger sex drive since they have more of a sex drive than females do now anyway. And she's right. No one is cutting the thing off or preventing men from having an orgasm. If they were, I'd agree with you. But if taking away a cancer risk for women means that the men may be a little less sensitive down there, I really don't understand the debate. Cancer...mind-numbing orgasm. I don't understand why you think the latter is more important.

Also, may I suggest the men who've been circumsized later in life and complain that their sexual gratification has been compromised may be feeling that way because they're fully aware that they were circumsized. It's just a thought since I haven't seen any scientific research about the sex drive when it comes to this procedure.

The crack the other poster made about her husband was a joke. That's how it read to me anyway.

 

[lilnoelle]

Actually, what the poster said was that protecting females from cervical cancer was more important than the males having an even bigger sex drive since they have more of a sex drive than females do now anyway. And she's right. No one is cutting the thing off or preventing men from having an orgasm. If they were, I'd agree with you. But if taking away a cancer risk for women means that the men may be a little less sensitive down there, I really don't understand the debate. Cancer...mind-numbing orgasm. I don't understand why you think the latter is more important.

Also, may I suggest the men who've been circumsized later in life and complain that their sexual gratification has been compromised may be feeling that way because they're fully aware that they were circumsized. It's just a thought since I haven't seen any scientific research about the sex drive when it comes to this procedure.

The crack the other poster made about her husband was a joke. That's how it read to me anyway.

Thank you, it was a joke. 🙂

 

[Law2Doc]

Also, may I suggest the men who've been circumsized later in life and complain that their sexual gratification has been compromised may be feeling that way because they're fully aware that they were circumsized. It's just a thought since I haven't seen any scientific research about the sex drive when it comes to this procedure.

If loss of the foreskin is truly loss of sensitivity, then all most men are losing in terms of sex drive is a tendency toward premature ejaculation. There is a cottage industry on ointments and prophylactics that dull sensitivity, and so I suspect circumcision has been a blessing for many in this respect. I doubt there is any scientific research on this either, but it's a decent counterpoint.

I can't believe this thread is still going on.

 

[LifetimeDoc]

Actually, what the poster said was that protecting females from cervical cancer was more important than the males having an even bigger sex drive since they have more of a sex drive than females do now anyway. And she's right. No one is cutting the thing off or preventing men from having an orgasm. If they were, I'd agree with you. But if taking away a cancer risk for women means that the men may be a little less sensitive down there, I really don't understand the debate. Cancer...mind-numbing orgasm. I don't understand why you think the latter is more important.

Also, may I suggest the men who've been circumsized later in life and complain that their sexual gratification has been compromised may be feeling that way because they're fully aware that they were circumsized. It's just a thought since I haven't seen any scientific research about the sex drive when it comes to this procedure.

The crack the other poster made about her husband was a joke. That's how it read to me anyway.

Having a foreskin doesn't make you a sex maniac, or increase your sex drive. There is no connection between the two: you are simply removing part of the sensitive part of the man's sexual organ. It's also there to protect the glans of the penis. So is reducing the number of sex partners, wearing a condom, etc. The whole thing over protecting against cervical cancer is easily fixed by personal hygeine. I would suggest that someone who has poor personal hygiene is probably going no not only going to increase his partner's risk of cervical cancer but is also likely to give her HIV or other STDs. I'm sure we could come up with all kinds of medical procedures that we could push on others that would reduce the need for people to take care of themselves, but it doesn't make these practices right.

I've browsed through several scientific articles regarding HIV transmission, reduction in cervical cancer, reduction in the transmission of various STDs, cancer reduction, etc. The results are mixed, and nobody can agree whether circumcision is helpful or not, and if it is helpful it's a small improvement. Many results show an improvement, but don't take into consider factors that circumcised men tend to be in affluent areas where education about safe sex is more commonplace.

I don't understand why people have this push to get male children circumcised. The only reasons I see are: religious, because our parents did it mentality, mixed reviews about STD/Cancer benefits, some misguided ideas to "reduce sex drive" which makes no sense at all.

 

[Law2Doc]

I would suggest that someone who has poor personal hygiene is probably going no not only going to increase his partner's risk of cervical cancer but is also likely to give her HIV or other STDs.

I don't know that there is any correlation to poor hygeine and HIV. The latter most typically requires doing certain actions (unprotected sex or needle use). You can be perfectly hygeinic and get HIV. And the most unhygeinic members of the population probably perhaps don't get the opportunity to hook up as frequently as the cleanest.

 

[Gabby]

I don't understand why people have this push to get male children circumcised. The only reasons I see are: religious, because our parents did it mentality, mixed reviews about STD/Cancer benefits, some misguided ideas to "reduce sex drive" which makes no sense at all.

Once again, you're misinterpreting what's been said. No one on this thread said you should do it to "reduce sex drive." Many people said -- whether misguided or not -- if a reduced sex drive is a side effect, it isn't that big a deal. There's a huge difference in those two statements.

 

[LifetimeDoc]

I don't know that there is any correlation to poor hygeine and HIV. The latter most typically requires doing certain actions (unprotected sex or needle use). You can be perfectly hygeinic and get HIV. And the most unhygeinic members of the population probably perhaps don't get the opportunity to hook up as frequently as the cleanest.

True, there is no direct correlation. But my suggestion is more along the lines of if you don't take care of your hygiene, you are more likely not to care about your health and whether or not you contact a STD or whether you pass it along to others.

 

[rotatores]

Originally Posted by Law2Doc
It is somewhat unlikely that you will be asked to perform a circumcision while in med school. Chill.

Not true at all. I did around 15 circs as a MSIII and around 5 as a MSIV.

rotatores

 

[Doula-2-OB]

Not true at all. I did around 15 circs as a MSIII and around 5 as a MSIV.

rotatores

What happens if you refuse? I'm still not getting my question answered despite 10 highly entertaining pages of chatter!

 

[Dr.Meow]

That article states a "higher incidence of penile cancer," but does not present any quantitative data to support this -- Strike 1!

The article does not present any explanation for why penile cancer is caused by smegma -- Strike 2! (Repeat after me, "Correlation does not equal Causation")

The only number given is that 1 in 100,000 (= 0.001%) of men in the United States contract penile cancer. That means only approximately 30 people in the US currently have penile cancer. ONLY 30! How could any meaningful data be obtained from A SAMPLE SIZE OF 30! BIG STRIKE 3!

Sorry, but I don't really think that I can take that article seriously.

EDIT: Sorry, I was always bad at doing math in my head. 1/100000 = 3000 people in the US. Still, unless EVERYBODY participated in the study (very unlikely,) it seems unlikely to be a large enough sample size from which to obtain statistically significant data.

....Only about half of the 300 million Americans are men! (teehee!)..... n = 1500.... agreed.... very small sample!

 

[DrBowtie]

So if the culture or religion requires genital mutilation, such as in female-circumcision or to a lesser degree male-circumcision, it's alright?

I would think as physicians we would be more concerned about the wellbeing of our patient, and cultural issues would be secondary to health. If you get into a cultural issue, you would put it in the context of "what is best for the health of the patient" and not in terms of what is best for their particular groups sensibilities.

In the end, the patient has choice and it's up to the physician to push the agenda of "health" to the patient. If the patient chooses to ignore the physician's advice about health matters, they are free to do so.

🙄 I'm still not seeing how having or not having the foreskin really contributes to the "well being" of a patient. There are benefits to both and it really is a moot point. As I said earlier, pass me all of your circ cases, I'll do them.

 

[Law2Doc]

What happens if you refuse? I'm still not getting my question answered despite 10 highly entertaining pages of chatter!

I think this was answered a couple of times in the thread actually. Someone else has to do the procedure, making more work for them. Your superiors may get annoyed, particularly if they don't see eye to eye with your views, which do not seem to be grounded in the constitution, religion or other things that could give you a pass. It may come off like you are not eager to learn and do new procedures, or that you feel like you should call the shots as to what you will or won't do. Ultimately it can translate into a bad recommendation. Which can hurt you down the road. Not always, but sometimes.

 

[Callogician]

Let me pose a question to all of you naturalists out there: Do you not shave either?

I am not a against circumcision on account of being a naturalist. Naturalism is completely bogus because there is no unambiguous definition of natural. I could reasonably claim that computers are natural because they are created by a naturally occurring organism (How are they any less natural than a beaver's dam?).

Naturalists meaning leave your body the way it was made. AKA Non-circ supporters.

Stop assuming our motivation. I would argue against the naturalist as vehemently as you would. I am in favor of correction of congenital cleft lip, hypospadias, etc. due to proven benefits to the patient. It's health that I care about, not naturalism.

[n= 3000] seems unlikely to be a large enough sample size from which to obtain statistically significant data.

You're criticizing a study without reviewing the methodology and results. Ridiculous! You are obviously biased by your previously-held beliefs about circumcision.

protecting females from cervical cancer was more important than the males having an even bigger sex drive

Are you sure? What is the attributable risk of cervical cancer when marrying an uncircumcised male? Is it significant in comparison to the other factors?

"Clearly, the anatomically complete penis offers a more rewarding experience for the female partner during coitus"

Source: http://www.cirp.org/library/anatomy/ohara/

...and this isn't only in terms of mere animalistic pleasure...but also in terms of less irritation and a greater sense of "peace," "warmth," "mutual satisfaction," and "complete[ness] as a woman."

The article also says that circumcision increases the duration of coitus...but not without an apparent loss of quality.

Personally, I would much prefer to clean under my foreskin to minimize the risks of penile cancer and cervical cancer to enjoy a better and more intimate sexual experience with my partner.

*Note: I wanted to run on the treadmill last night, but I quit immediately due to irritation of my glans. This has happened multiple times (>10), and it's no exaggeration to say that I would enjoy superior health and fitness as an uncircumcised male.

 

[LifetimeDoc]

🙄 I'm still not seeing how having or not having the foreskin really contributes to the "well being" of a patient. There are benefits to both and it really is a moot point. As I said earlier, pass me all of your circ cases, I'll do them.

So women shouldn't have their breasts replaced with implants after a radical mastectomy? There is more to the well being of a patient than just physical well-being. I wish those in our field would understand that, that a person is more than just a machine that needs to be brought into physical homeostasis only. The benefits do not outweigh the use of an outdated medical procedure. If they did, the AMA and other medical organizations would encourage them.

 

[Callogician]

....Only about half of the 300 million Americans are men! (teehee!)..... n = 1500.... agreed.... very small sample!

Once again, this is ridiculous. Have you heard of a retrospective study? If they had a sample size of 100 cases and found a statistically significant disproportionate number of uncircumcised men, the results would be publishable. Review the God Damned methodology BEFORE criticizing the conclusion, dingus!

 

[Doula-2-OB]

I guess I'll just have to cross that bridge when I come to it. Sounds like some students never do them, some do them multiple times- I'll just have to see where I end up on that scale.

I think this was answered a couple of times in the thread actually. Someone else has to do the procedure, making more work for them. Your superiors may get annoyed, particularly if they don't see eye to eye with your views, which do not seem to be grounded in the constitution, religion or other things that could give you a pass. It may come off like you are not eager to learn and do new procedures, or that you feel like you should call the shots as to what you will or won't do. Ultimately it can translate into a bad recommendation. Which can hurt you down the road. Not always, but sometimes.

 

[DrBowtie]

So women shouldn't have their breasts replaced with implants after a radical mastectomy? There is more to the well being of a patient than just physical well-being. I wish those in our field would understand that, that a person is more than just a machine that needs to be brought into physical homeostasis only. The benefits do not outweigh the use of an outdated medical procedure. If they did, the AMA and other medical organizations would encourage them.

You should also note the official position of the AAP:
The medical benefit doesn't recommend routine circumcision for all male newborns. The AAP leaves the decision up to parents.

If it really was harming them wouldn't they be totally against it?

I'm all for breast reconstruction and I can also tell you how immature high schoolers are. Case in point a kid on the football team had the nickname "hoodie" which alluded to his foreskin. Probably wasn't the best for his psyche.

 

[Doula-2-OB]

Case in point a kid on the football team had the nickname "hoodie" which alluded to his foreskin. Probably wasn't the best for his psyche.

With the steady decrease in circumcision this argument doesn't work. I'm not at all concerned for my sons who will go to school and see the penises of boys who are cut and those who are not, and around here, the intact boys might outnumber the cut ones. The tables turn! Cut boys might get teased about their 'baldies'. LMAO

 

[45408]

Hey, it'd add up to hours and hours I'm sure. I hadn't thought of shampooing that way before, maybe I'll have to consider it. Although since not washing my hair won't increase my wife's chances of getting cancer maybe I'll just stop washing it and get some dreads. Anyway, that part was more of a joke. The more serious part of my comment is the preventative qualities it has. One of my nephews isn't snipped and he's had a few problems with it despite my sister teaching him about it. Little kids just don't always remember to wash everywhere very well. "Don't forget to wash behind your ears and under your foreskin." So why not snip it off in the name of preventative medicine?

Cut their ears off too

 

[UMP]

I'm all for breast reconstruction and I can also tell you how immature high schoolers are. Case in point a kid on the football team had the nickname "hoodie" which alluded to his foreskin. Probably wasn't the best for his psyche.

It really depends on where in the US you grew up... no offence BB, but you don't seem like you grew up in a very "diverse" environment... in the west almost 3/4's of boys are now left uncirc'd and on the east coast about 2/3's... the only areas where circ'ing kids is more common than not is in the plains and the south. But I'm sure they find quite a lot more things than just hooded penises "weird" around there 🙄

 

[Law2Doc]

It really depends on where in the US you grew up... no offence BB, but you don't seem like you grew up in a very "diverse" environment... in the west almost 3/4's of boys are now left uncirc'd and on the east coast about 2/3's... the only areas where circ'ing kids is more common than not is in the plains and the south. But I'm sure they find quite a lot more things than just hooded penises "weird" around there 🙄

There's no way those fractions are correct.

 

[rotatores]

Originally Posted by UMP
It really depends on where in the US you grew up... no offence BB, but you don't seem like you grew up in a very "diverse" environment... in the west almost 3/4's of boys are now left uncirc'd and on the east coast about 2/3's... the only areas where circ'ing kids is more common than not is in the plains and the south. But I'm sure they find quite a lot more things than just hooded penises "weird" around there

Absolutely not true...In the US, circs are still mainstream.

Rotatores
PGY-1 Pediatrics

 

[UMP]

Absolutely not true...In the US, circs are still mainstream.

Rotatores
PGY-1 Pediatrics

again, depends on where you are located... midwest and south, mainstream... east and west coast, it's not... I guess altogether its about 50-50 now, that's clearly not going to make a kid feel isolated

 

[rotatores]

Originally Posted by UMP
again, depends on where you are located... midwest and south, mainstream... east and west coast, it's not... I guess altogether its about 50-50 now, that's clearly not going to make a kid feel isolated

You're just making these numbers up...and you're still wrong. Try doing a pubmed search.

rotatores

 

[rotatores]

Here's an article in Pediatrics A Comparison of the Mogen and Gomco Clamps etc... by Kurtis et al. 1999

According to this article 69.6% of males (in the US) are circ'd in the northeast, 64.7% in the south, 34% in the west and 80.1% in the midwest.

rotatores

 

[Law2Doc]

Here's an article in Pediatrics A Comparison of the Mogen and Gomco Clamps etc... by Kurtis et al. 1999

According to this article 69.6% of males (in the US) are circ'd in the northeast, 64.7% in the south, 34% in the west and 80.1% in the midwest.

rotatores

It's actually even higher than those figures because a lot of religious circumcisions are done outside of the hospital and will not have been included in medical statistics.

 

[rotatores]

Originally Posted by Law2Doc
It's actually even higher than those figures because a lot of religious circumcisions are done outside of the hospital and will not have been included in medical statistics.

Good point!

 

[UMP]

fine, 50% was a bit high, and it's not 70 it's 60% ...

http://www.cdc.gov/nchs/data/series/sr_13/sr13_158.pdf

table 44 page 58...

and the amount of boys that are done outside of the hospitals would be less than 1%... jews and muslims only make up 3-4% of the population and i doubt that all of them are traditional enough to have a 'bris'... my northeast data was way off, i guess i remembered things incorrectly

 

[rotatores]

Read the fine print....I'll help you. Table 44 on page 58: Infants born in non-Federal hospitals etc...

If you account for all the federal hospitals I can assure you its higher. After working in the newborn nursery I would say that about 80% of our male patients get circ'd (this is at a military hospital).
.
rotatores

 

[SanDiegoSOD]

I refuse to go a gyn rotation as a third year. 😉

 

[DrBowtie]

It really depends on where in the US you grew up... no offence BB, but you don't seem like you grew up in a very "diverse" environment... in the west almost 3/4's of boys are now left uncirc'd and on the east coast about 2/3's... the only areas where circ'ing kids is more common than not is in the plains and the south. But I'm sure they find quite a lot more things than just hooded penises "weird" around there 🙄

I grew up in the Midwest:

According to the National Center for Health Statistics in Washington, D.C., the latest figures on circumcision for the four basic regions of the U.S. as of 1994 (the latest reported date) are:

Northeast 69.6%
Midwest 80.1%
South 64.7%
West 34.2%

Average for entire U.S. is 62.7%

 

[docolive]

I refuse to do pap smears. I believe the vagina is the house of the female spirit and I am morally opposed to disturbing the sanctity of the vessel.

teeheeteehee

 

[UMP]

where are you located ?

 

[docolive]

where are you located ?

Is this in reference to the pap smear (aka cervix) or people above?

 

[docolive]

I grew up in the Midwest:

According to the National Center for Health Statistics in Washington, D.C., the latest figures on circumcision for the four basic regions of the U.S. as of 1994 (the latest reported date) are:

Northeast 69.6%
Midwest 80.1%
I think we know where all m'jewish boyfriends are hangin' out. j/k

 

[rotatores]

where are you located ?

This is my observation from varioius military hospitals...from the east coast to the west.

I'm not saying that my observations are absolute...but I do think it would increase the numbers you stated. But overall...the number of circs nationally is decreasing...and will likely be back in the 50s (like you mentioned) shortly.

Me personally...I hate doing circs (pediatricians do circs in the military). I would also like to see the numbers drop. The more education given to new parents about the pros and cons the quicker these stats will change.

rotatores

 

[willow18]

I say this is the fastest growing thread I have ever seen on SDN.

 

[Brickhouse]

I can't believe you guys are still all in here talking about dick. I mean really.

 

[Law2Doc]

I grew up in the Midwest:

According to the National Center for Health Statistics in Washington, D.C., the latest figures on circumcision for the four basic regions of the U.S. as of 1994 (the latest reported date) are:

Northeast 69.6%
Midwest 80.1%
I think we know where all m'jewish boyfriends are hangin' out. j/k

Actually, these numbers are going to be exclusive of your jewish boyfriends, since, as I noted above, religious circumcisions generally take place outside of the hospital and probably aren't even included in these statistics. There's thus probably a decent percentage swing upwards in the Northeast numbers.

 

[DrBowtie]

I can't believe you guys are still all in here talking about dick. I mean really.

Lots of future urologists here.

 

[Law2Doc]

I say this is the fastest growing thread I have ever seen on SDN.

I guess it hits close to home for some.

 

[Dr.Acula]

I say this is the fastest growing thread I have ever seen on SDN.

Damn you willow! You beat me by 8 minutes...

Also, someone should add a poll (pun definitly intended) 😀

 

[UMP]

alright, i've said all I could say in the last page... I'm unsubscribing from this thread... I'm not gonna do them, my kids are not going to get them (although my fiancee is jewish, so I might have to run that by her 😛 ), and I didn't have one... and I love it 😀

 

[Firebird]

Quote:
Originally Posted by LifetimeDoc
Please stop unnecessarily mutilating young male babies over dubious procedures, especially since it's irreversible (at least without huge expense) and something the child has no choice in.



I always said that same thing about babies with pierced ears - what if the kid doesn't want holes in its ears.

Better yet, why don't we just abandon all our children, leave them to fend for their own, just to make sure that we, as parents, don't influence them into believing or feeling one way or another. I mean come on, it's not the parents' job to raise their child!

 

[rotatores]

Originally Posted by UMP
alright, i've said all I could say in the last page... I'm unsubscribing from this thread... I'm not gonna do them, my kids are not going to get them (although my fiancee is jewish, so I might have to run that by her ), and I didn't have one... and I love it

Too much info...but thanks for sharing! 😉

 

[Brickhouse]

You were last seen hiking up Mt. Ego.
-Dr. Niles Crane

you're funny

 

[Law2Doc]

alright, i've said all I could say in the last page... I'm unsubscribing from this thread... I'm not gonna do them, my kids are not going to get them (although my fiancee is jewish, so I might have to run that by her 😛 ), and I didn't have one... and I love it 😀

If you are uncut, you have to have noticed you are in the distinct minority -- hard to imagine you think the percentage is 50% or better.
At any rate, I suspect your inlaws are going to lobby your wife for your kids' circumcision ceremonies -- better hope you have girls or there may be future family turmoil. 😀 Good luck!

 

[Dr. Giggles]

Some important points seem to have been lost in the fray:

1. Male circumcision is (pretty much) irreversible, unlike shaving. While most guys hate shaving several times a week, I doubt they'd want to undergo a procedure that precludes them from ever growing a beard.

2. Cervical Cancer: What if the kid turns out to be gay? And besides, that's between him and his SO. Would anyone want their mom and dad making decisions on their behalf on whether to use condoms?

3. As another poster mentioned, a baby isn't going to be having sexual intercourse and thereby picking up and spreading STD's. Why not at least wait until the kid becomes a sexually active adult and decide for himself?

4. Penile Cancer: The overall risk is about 1 in 100,000 according to the About article, but that article doesn't provide the quantitative differences in risk for circumcised and uncircumcised males. I doubt that the difference, if it really exists, is high enough to justify risking a lifetime of reduced sexual stimulation and possible irritation. And again, this is something a child can decide for himself, as I doubt penile cancer is a significant worry among teenagers and toddlers.

The pros of circumcision, at least before a kid becomes sexually active and a mature independent thinker, seem essentially nonexistent to me, apart from the inconvenience of cleaning, which literally takes less than 10 seconds a day. That's something any caring parent should be willing to put up with. The cons on the other hand are enormous.