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Circumcision

Circumcision is the surgical removal of some or all of the prepuce or foreskin (including the ridged band), a highly sensitive part of the penis. Female circumcision is a term applied to a variety of mutilations performed on female genitalia, of which only one, the removal of the clitoral hood, is comparable to male circumcision. Only the operation on males is discussed in the remainder of this article. The word circumcision comes from Latin circum (="around") and caedere (="to cut"). Another form of surgery practiced on the penis in some cultures is subincision.

Circumcision may be considered for medical reasons in a small number of cases, such as phimosis. However, the majority of circumcisions are performed for religious or cultural reasons, and when medical benefits are claimed, these are of a preventive rather than therapeutic nature; that is, the procedure is supposed to reduce certain risks later in life and not supposed to be a cure. The practice is the source of considerable controversy.

How circumcision is performed

In infants, a variety of methods are used. In the great majority of cases, there is either no anaesthetic or only a local anaesthetic. All methods have in common the tearing away of the skin covering the glans penis (these are still attached in infants), and the removal of a varying amount of skin. The extent of the removal, the precise location of the removal, and the cosmetic result all vary a great deal: some circumcised males retain a significant proportion of their nerve-rich penile skin and have an amount of mobile skin remaining on the erect penis, while others do not. In some cases the scar is small and unnoticeable; in others it is large, jagged and obvious.

An uncircumcised penis, a circumcised penis In adults, circumcision is sometimes performed under general anaesthetic. The foreskin is removed with a sharp-bladed instrument of some kind. The remaining skin is then stitched back using dissolvable stitches. The penis is then wrapped in protective bandages and a jockstrap style harness to keep it in place.

The glans, which was previously protected by the foreskin, is very sensitive; some people are prone to bleeding. After the circumcision, the pain is controllable and goes away quickly during the day. Normally there is no distress when the penis is flaccid, but the penis becomes partially or fully erect one or more times each night. Thus, for the first week or two after an adult circumcision, the patient can experience a significant amount of pain during the erection. Some patients stay in a hospital for 1-2 nights after the operation. The glans slowly becomes desensitized during the following month.

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Prevalence

Approximately one sixth of males worldwide are circumcised [1]; the vast majority for religious or cultural reasons. The United States is the only country that still practices circumcision routinely on a majority of infants for non-religious reasons.

The majority of males are circumcised in the following countries: In most of these countries the predominant religion endorses circumcision, such as Islam or Judaism.

Circumcision is now also dwindling in the United States. The rate has been steadily decreasing from near universality in the 1960s to approximately 55% today. While some states no longer pay for the procedure under Medicaid, more than 75% of the states still do.

Many medical claims have been made to justify circumcision. These included the prevention of epilepsy, penile cancer and phimosis. Circumcision advocates today claim that it reduces urinary tract infections and HIV infection, but these claims are strongly disputed and argued against.

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