Not to be included in your generality of urologic opinions, I would like to voice an opinion re: circumcision of the neonate and or pediatric male.
As an Ivy-League trained specialist in urologic surgery, from a Christian-based , not Jewish-based school, it was never part of our teaching curriculum to "automatically' circumcise or to assume that each male born child required circumcision, nor are we trained to "lead" parents into thinking that this needs to be performed prior to discharge.
In most hospitals in America ( I assume this without factual knowledge), the first person that comes into contact with the new born parent(s) is the pediatrician and/or labor and delivery nurse personnel. They are trained to ask the parents if they would choose to have their child circumcised before they bring their son home. The decision does not end here as it must be agreed upon and or advocated by the performing doctor, whether the pediatrician, obstetrician, or urologist.
In my professional experience the overwhelming factors that drive a parent to have the procedure performed in the hospital are: 1) "I want my son to look like his father," 2) religious affiliation 3) to save the child from having the circumcision performed at another time (pediatrician's office).
I must admit that my own personal philosophy on the wisdom of circumcision, as a surgeon myself, have transitioned over the years. This modification in my logic stems from not only access to unbiased publications but also from my own inner thinking about the wisdom of the procedure. I must state affirmatively that this change in my thought process does not stem from anecdotal experiences from patients complaining as adults or certainly even from that pool of patients who had circumcision performed as adults and were disenchanted with their sexual experiences thereafter. This is stated as such simply, because, after 33 years of surgical experience I would be very hard-pressed to recall a single occasion that a patient complained to me that he was unhappy after he had made the decision to be "cut." This also includes patients who were circumcised at birth and I consult with in my adult clinic. I have never heard voiced from these patients that they have a concern over their sexual experiences after "comparing notes" with their uncircumcised friend.
I want to state also, in contradiction to previous posts, that I see many female partners of my patients. Never once in over thirty-three years of surgery have I heard even a single complaint that, compared to other partners historically, that they admit a level of diminished sexual fulfillment now with their "cut" sexual partner.
The rationale, as I have stated in much earlier blogs on this site to perform circumsion as an adult are: Failure after repeated conservative attempts to rectify phimosis (very tight entrapment of the preputial skin over the penile head), chronic lacerations (cuts of the foreskin) after sexual activity hampering the pleasure of the experience, and most commonly inability to maintain proper hygienic care of the tight foreskin due to inability to retract and or administer proper cleansing of the penis, resulting in chronic infection which requires multiple return visits to the MD or health care practitioner, and/or frequent circulation of this infection to their sexual partner(s) which sets up an ever-ending vicious cycle of disease. It is not uncommon for a gynecologist to recommend to the partner of their patient to seek a surgical opinion after multiple attempts at ameliorating the condition fails with conservative treatment.
Finally, the wisdom of propagating religious myths re: need for circumcision I believe is slowly changing to the conservative side.
I must also admit that my comments are not universally shared nor represent the majority of health care providers, but represent those of my opinion.
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Not to be included in your generality of urologic opinions, I would like to voice an opinion re: circumcision of the neonate and or pediatric male.
As an Ivy-League trained specialist in urologic surgery, from a Christian-based , not Jewish-based school, it was never part of our teaching curriculum to "automatically' circumcise or to assume that each male born child required circumcision, nor are we trained to "lead" parents into thinking that this needs to be performed prior to discharge.
In most hospitals in America ( I assume this without factual knowledge), the first person that comes into contact with the new born parent(s) is the pediatrician and/or labor and delivery nurse personnel. They are trained to ask the parents if they would choose to have their child circumcised before they bring their son home. The decision does not end here as it must be agreed upon and or advocated by the performing doctor, whether the pediatrician, obstetrician, or urologist.
In my professional experience the overwhelming factors that drive a parent to have the procedure performed in the hospital are: 1) "I want my son to look like his father," 2) religious affiliation 3) to save the child from having the circumcision performed at another time (pediatrician's office).
I must admit that my own personal philosophy on the wisdom of circumcision, as a surgeon myself, have transitioned over the years. This modification in my logic stems from not only access to unbiased publications but also from my own inner thinking about the wisdom of the procedure. I must state affirmatively that this change in my thought process does not stem from anecdotal experiences from patients complaining as adults or certainly even from that pool of patients who had circumcision performed as adults and were disenchanted with their sexual experiences thereafter. This is stated as such simply, because, after 33 years of surgical experience I would be very hard-pressed to recall a single occasion that a patient complained to me that he was unhappy after he had made the decision to be "cut." This also includes patients who were circumcised at birth and I consult with in my adult clinic. I have never heard voiced from these patients that they have a concern over their sexual experiences after "comparing notes" with their uncircumcised friend.
I want to state also, in contradiction to previous posts, that I see many female partners of my patients. Never once in over thirty-three years of surgery have I heard even a single complaint that, compared to other partners historically, that they admit a level of diminished sexual fulfillment now with their "cut" sexual partner.
The rationale, as I have stated in much earlier blogs on this site to perform circumsion as an adult are: Failure after repeated conservative attempts to rectify phimosis (very tight entrapment of the preputial skin over the penile head), chronic lacerations (cuts of the foreskin) after sexual activity hampering the pleasure of the experience, and most commonly inability to maintain proper hygienic care of the tight foreskin due to inability to retract and or administer proper cleansing of the penis, resulting in chronic infection which requires multiple return visits to the MD or health care practitioner, and/or frequent circulation of this infection to their sexual partner(s) which sets up an ever-ending vicious cycle of disease. It is not uncommon for a gynecologist to recommend to the partner of their patient to seek a surgical opinion after multiple attempts at ameliorating the condition fails with conservative treatment.
Finally, the wisdom of propagating religious myths re: need for circumcision I believe is slowly changing to the conservative side.
I must also admit that my comments are not universally shared nor represent the majority of health care providers, but represent those of my opinion.
February 23, 2011 - 6:02amThis Comment
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