Circumcision And High Rates Of Impotence In The US 555

1 Many older men, who have bladder or prostate gland problems, also develop difficulties with their foreskins due to their surgeon's handling, cleaning, and using instruments. Some of these patients will need circumcising. Afterwards it is often astonishing to find some who have never ever seen their glans (knob) exposed before!

2 Some older men develop cancer of the privates - about 1 in 1000 - fairly rare, but tragic if you or your son are in that small statistic. Infant circumcision gives almost 100% protection, and young adult circumcision also gives a large degree of protection.

3 Cancer of the cervix in women is due to the Human Papilloma Virus. It thrives under and on the foreskin from where it can be transmitted during intercourse. An article in the British Medical Journal in April 2002 suggested that at least 20% of cancer of the cervix would be avoided if all men were circumcised. Surely that alone makes it worth doing?

4 Protection against HIV and AIDS. Another British Medical Journal article in May 2000 suggested that circumcised men are 8 times less likely to contract the HIV virus. (It is very important here to say that the risk is still far too high and that condoms and safe love must be used - this applies also to preventing cancer of the cervix in women who have several partners.)

A BBC television programme in November 2000 showed two Ugandan tribes across the valley from one another. One practised circumcision and had very little AIDS, whereas, it was common in the other tribe, who then also started circumcising. This programme showed how the infection thrived in the lining of the foreskin, making it much easier to pbutt on.

5 As with HIV, so some protection exists against other loveually transmitted infections. Accordingly, if a condom splits or comes off, there is some protection for the couple. However, the only safe love is to stick to one partner or abstain.

6 Lots of men, and their partners, prefer the appearance of their privates after circumcision, It is odour-free, it feels cleaner, and they enjoy better love. Awareness of a good body image is a very important factor in building self confidence.

7 Balanitis is an unpleasant, often recurring, inflammation of the glans. It is quite common and can be prevented by circumcision.

8 Urinary tract infections sometimes occur in babies and can be quite serious. Circumcision in infancy makes it 10 times less likely.

mpelling medical data much of it accumulated in the past 2 decades, have conclusively shown that a boy circumcised as a newborn has multiple lifetime health advantages compared to one with an �intact� foreskin. These include protection against serious kidney infections in infancy, loveually transmitted diseases (STDs) including human immunodeficiency (HIV) infections and human papilloma virus (HPV) in young men, and invasive cancer of the privates in middle and old age. In addition, all through life uncircumcised males are more susceptible to penile infections (balanoposthitis) and a variety of skin disorders of the privates such as eczema and psoriasis, as well as more difficulty maintaining good hygiene. About 1% of boys are born with only a pinpoint opening at the tip of the foreskin (phimosis) preventing retraction, leading to painful erections, and requiring future circumcision, at a time when the procedure is more difficult, risky and costly. Further, women loveual partners of uncircumcised men with HPV infection are at significantly greater risk of developing cervical cancer.

How convincing is the scientific evidence of circumcision advantages? Overwhelming in the cases of infant kidney infections, penile cancer and local disorders, and compelling for HIV, HPV and risk of female partners of uncircumcised men with HPV infections. In the mid 1980�s, Dr. Tom Wiswell, a military pediatrician opposed to newborn circumcision, examined the United States (US) Armed Forces records of over 200,000 newborn boys and to his surprise found that uncircumcised boys were 10 to 20 times more likely to develop severe kidney infections in the first year of life. Since then a dozen published reports confirm this protective effect of circumcision against infant urinary infections and explain how these infections occur. The warm, tight, moist undersurface of the infant foreskin provides an ideal home for the harmful fecal bacteria that cause kidney infections. These bacteria (�uropathic, fimbriated E. Coli�) have tentacles which attach to the foreskin and then climb up the urinary tract to the kidney. The resultant infection leads to kidney scarring in almost half the cases, as well as body salt loss and hormonal changes in some instances. Although there is no proven long-term evidence to date of permanent kidney damage, these effects are disturbing.

All studies on invasive penile cancer from 1930 to the present have shown that this devastating malignancy is almost entirely limited to uncircumcised men. In 1932 it was reported from what is now the Sloan Kettering Insbreastute, that of 120 men with penile cancer none were circumcised; all subsequent studies have confirmed this overwhelming preponderance. In Kaiser Permanente Northern California Region (KP), a large health maintenance organization (HMO), recently published studies found that uncircumcised males are about 22 times more likely to get invasive penile cancer and 10 times more likely to get infant kidney infections as are circumcised males (Schoen, Pediatrics 2000).

In the case of HIV, reports published in the late 1980�s in two of the world�s leading medical journals, the New England Journal of Medicine and Lancet, found that uncircumcised men in Africa had about four times the risk of acquiring the virus following loveual exposure. In the ensuing 14 years this observation on the protective effect of circumcision against HIV has been repeated in over 30 separate series, including all 8 prospective studies (looking forward from exposure, rather than backwards from diagnosis). Further, the likely reasons for the role of the foreskin in the spread of HIV have been clarified. In addition to the risk of the virus entering through foreskin tears, it has been found that the foreskin is rich in special cells, Langerhans cells, which trap and normally help kill invading infectious organisms. But in the case of HIV the trapped virus is not destroyed but binds to these special cells and is introduced into the body.

As for HPV penile infections and cervical cancer, in 2002 a report in the New England Journal of Medicine reviewed over 1900 loveual partners from 7 different studies in 5 countries. It was found that uncircumcised men were 3 times more likely to develop penile HPV infection as were circumcised men and female partners of the uncircumcised men were at significantly greater risk of developing cervical cancer.

During World War II, particularly during the North African desert campaign, the combination of sand and lack of hygienic conditions proved disastrous to uncircumcised men. The loss of these soldiers to active duty in combat areas resulted in prophylactic circumcision being performed on many recruits at training centers. A World War II medical report from the U.S. Army referred to the �enormous man-hour loss from disease peculiar to the uncircumcised man,� and stated that �hospital admission from paraphimosis, phimosis, balanitis and condyloma accuminata during 1942 � 1945 totaled 146,793. Had these patients been circumcised before induction, this total would probably have been close to zero�. A similar though less well-documented loss to active duty occurred in uncircumcised servicemen in Operation Desert Storm during the Gulf War.

If the evidence favoring circumcision is so strong, why is the public given contradictory and misleading information? The reasons are twofold. Probably most important is the lack of interest and objectivity of organized medicine, particularly the American Academy of Pediatrics. The second source of misrepresentation is by the activist, lay anti-circumcision groups, which dominate the media and the Internet and concentrate on anecdotes, testimonials and undocumented opinions.

asons many parents choose circumcision

Research studies indicate that there are good medical reasons why your son should be circumcised. These include:

* Circumcision substantially reduces an infant�s chances of getting a urinary tract infection (UTI) during the first year of his life. Although the rate of urinary tract infections for infants is not very high (around love %), UTI�s are becoming increasingly difficult to treat (see here for a discussion). * Cancer of the privates - that effects love men in a thousand - is essentially eliminated in circumcised males. * Research shows that males who are circumcised have a lower risk of getting loveually transmitted diseases (STDs). In addition, partners of circumcised males are less likely to contract privatesl infections (e.g. yeast infections). * Circumcision eliminates foreskin infections that occur throughout childhood. * Circumcision prevents phimosis, a narrow opening that makes it impossible to retract the foreskin at a later age. * Genital hygiene is easier after circumcision. * Circumcision virtually eliminates the accumulation of smegma.

References

1. E.J. Schoen et al., Report of the Task Force on Circumcision Pediatrics 1989; 84: 388-391

2. Canadian Medical buttociation Journal; March 1996: 154 (6)