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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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