Tuesday, May 19, 2009

To Circumcise or not?

There continues to be debate about whether to circumcise your baby boys or not. The latest literature continues to support the "ayes". Your obstetrician is traditionally the doctor who does the circumcision, not your pediatrician. Done the day after birth or the day of discharge from the hospital. They use a local block, by the way, so your baby feels no pain and he is given tylenol afterwards for pain when the anesthesia wears off. The penis heals well, usually before the cord falls off, and the trick to caring for it is to keep the top of the penis "wet" by using vaseline ( from a tube ) with a guaze square on top, with every diaper change. So back to the controvery....

Historically, there is evidence of circumcision dating back to the Egyptians as evidenced by a bas relief dated to around 2500 BCE. Jews have circumcised since the biblical era as evidence of the covenant with Abraham and God. Muslims circumcise for the same reason. Now in the common era, circumcision is done for a variety of reasons including, social ( it's what's done in your circle and you want your baby to "look" like his dad ) and cultural, religious and of course, medical.

The "nays"
It is mutilation
It is painful ( see above )
It is sexual abuse
It is not necessary

The "ayes"
It reduces the risk of transmission of sexuallly transmitted diseases like: human papillomavirus ( warts and abnormal pap smears ), human immunodefieciency virus ( HIV/AIDS ) and herpes simplex virus ( herpes ). The World Health Organization has recommended that male circumcision be part of a comprehensive HIV prevention program to reduce the epidemic.
There is a lower rate of urinary tract infection
There is a lower rate of penile cancers
There is a lower rate of maetitis
There is a lower rate of balanitis
There is a lower rate of phimosis
There is a lower rate of balanoposthitis
There is a lower rate of dermatosis
Women who's partners are circumcised have lower rates of HPV infection, cervical cancer, genital ulcers, trichomonas ( sexually tansmitted diseases like syphyllis and gonorrhea don't seem to be statistically reduced with circumcision ) and bacterial vaginosis

Mother's of newborns are worried about bathing their infants in general. water the right temperature? room warm enough? What to do about the cord? slippery baby. towel within reach. Add to that, making sure that you pull that foreskin back enough to clean under there. It's scary and the baby cries and then you go visit the pediatrician who tells you that you haven't been aggressive enough.

So, to circumcise or not? Another one of those responsibilities that we face as parents. You must decide.