Risks Associated with Circumcision
Circumcision is the most often performed surgical procedure in the world. Every year millions of boys and men are circumcised - according to the "Circlist" website: 15 million circumcisions take place per year, each taking about 20 minutes, that means that approximately 500 males are being circumcised right while you are reading this. Quite impressive numbers.
If carried out by a properly trained professional under hygienic conditions it is almost 100% safe. As a matter of fact, far more people die because they haven’t been circumcised than because they have been. In a nutshell, it is much safer to have your child circumcised than not to have it done.
The major disadvantage associated with circumcision stems from the fact that like all surgical procedures it carries some ihnerent riks. The two main risks are bleeding and infection of the wound site. Both are minor risks can be minimized by ensuring that the procedure is done under hygienic condidtions by an experienced medical practitioner. Hygienic issues should not be a factor in developed countries (like the US), the only remaining issue would be to ensure that the circumcision is done by someone who knows what he/she is doing. This could mean having the pediatrician do it, or a urologist (e.g. if done on an outpatient basis). It should be relatively easy and straightforward for parents to check this and ensure that they discuss the procedure beforehand with their doctor.
- Excessive bleeding: Occurs in 1 in 1000 - treated with pressure or locally-acting agents, but 1 in 4000 may require a ligature and 1 in 20,000 need a blood transfusion because they have a previously unrecognized bleeding disorder. Haemophilia in the family is of course a contra-indication for circumcision.
- Infection: Local infections occur in 1 in 100-1,000 and are easily treated with local antibiotics. Systemic infections may appear in 1 in 4,000 and require intravenous or intramuscular injection of antibiotics.
- Subsequent surgery: Needed for 1 in 1,000 because of skin bridges, or removal of too much or too little foreskin. Repair of injury to penis or glans required for 1 in 15,000. Loss of entire penis: 1 in 1,000,0000, and is avoidable by ensuring the practitioner performing the procedure is competent. Injuries (rare) can be repaired  and in the infinitely remote instance of loss of the penis it can be re-attached surgically .
- Local anaesthetic: The only risk is when the type of anaesthetic used is a dorsal penile nerve block, with 1 in 4 having a small bruise at the injection site. This will disappear.
- Death: The records show that between 1954 and 1989, during which time 50,000,000 circumcisions were performed in the USA, there were only 3 fatalities. It should also be noted that during the same period there were 11,000 deaths from penile cancer, a disease which essentially only occurs in uncircumcised men.
It is important to consider these statistics in context. If the circumcision is performed carefully by an experienced operator, the procedure is totally safe - as a matter of fact it is one of the safest around.
Risks that have been quoted in medical literature include:
- Meatitis: normally found in infants when the meatus gets inflamed due to diaper rash, which makes passing water painful. Treatment is usually easy and swift, while in extreme cases scarring may occur. Very rarely the opening might need stretching. The risks of meatitus can be almost eliminated by proper hygiene (e.g. frequent diaper changes).
- Loss of sensitivity: there are some men who complain that circumcision leads to a loss of sensitivity of the penis due to the fact that the glans becomes thicker and the absence of the foreskin. There is, however, no scientific evidence that circumcision reduces the sensitivity during intercourse. Even though there are several thousand men who have tried to restore their foreskins (e.g. by stretching) and mourn the loss of their foreskins, there are thousands of men who decided to have themselves circumcised as adults because they were, amongst others, unhappy about the way they experienced intercourse with a foreskin. It should be remembered that there are several million men in North America who were circumcised as infants and who are perfectly happy about their status.
- Pain: regarding the issue of pain experienced by the infant during the procedure, the AAP states: In summary, analgesia is safe and effective in reducing the procedural pain associated with circumcision and, therefore, adequate analgesia should be provided if neonatal circumcision is performed." Medical results have furthermore shown that local anesthetics (administered by injection), when properly administered, completely do away with the pain other than the needle sticks and the infiltration of the anesthetic.
A detailed summary of the risks and benefits based on medical facts can be found in the flyer Circumcision Risk-Benefit Analysis. As the conclusion states: benefits exceed risks by a factor 100 to 1.
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