Neonatal circumcision is totally unnecessary, and there is no current role for preventative or prophylactic neonatal circumcision.
Unfortunately, 70-80% of neonatal circumcisions are performed by obstetricians, who can neither manage their complications (2-5% incidence) nor obtain proper informed consent (defined as outlining risks and benefits of a procedure, as well as alternatives - including nothing) for neonatal circumcision.
Currently, the American Congress of Obstetricians and Gynecologists (ACOG) have no parameters for training (learning and performing neonatal circumcision, managing complications) of residents, who then go out and continue this practice.
In my practice, as a pediatric urologist, I manage the complications of neonatal circumcision. For example, in a two year period, I was referred over 275 newborns and toddlers with complications of neonatal circumcision. None of these were ‘revisions’ because of appearance, which I do not do. 45% required corrective surgery (minor as well as major, especially for amputative injury), whereupon some could be treated locally without surgery.
Complications of this unnecessary procedure are often not reported, but of 300 pediatric urologists in this country who have practices similar to mine... well, one can do the math to understand the scope of this problem, let alone to understand the adverse cost-benefit aspect of complications (>$750,000) in this unfortunate group of infants and young children.
Fortunately, neonatal circumcision is on the decline as parents become educated, but the complications still continue.
Until the time that the United States falls in step with the rest of the planet who does not submit newborns to neonatal circumcision, ACOG should assure that the training of obstetricians to perform this procedure is adequate, particularly in avoiding and managing complications of a procedure that is unnecessary, and that obstetricians learn to obtain proper informed consent from parents who have no idea of the problems that can ensue from infant circumcision.
Related Reading:
The Perils of Plastibell: A Mythical 'No Cutting - No Risk' Method:
http://www.drmomma.org/2010/05/the-perils-of-plastibell-circumcision.html
Intact vs. Circumcised Outcome Statistics:
http://www.drmomma.org/2010/01/cut-vs-intact-outcome-statistics.html
Repeat Circumcision: Lessons Learned From the Mother of a Botched Baby:
http://www.savingsons.org/2013/05/repeat-circumcision-lessons-learned.html
Circumcision's Complications: What Could Go Wrong?
http://www.examiner.com/article/circumcision-s-complications-what-could-go-wrong
Death From Circumcision:
http://www.drmomma.org/2010/05/death-from-circumcision.html
Massive Infection Takes Over Body Post-circumcision:
http://www.drmomma.org/2009/11/massive-infection-takes-over-body-after.html
Medical Benefits of Infant Circumcision and Statements from National Health Organizations Around the World:
http://www.drmomma.org/2013/05/the-medical-benefits-of-infant.html
In my opinion, the only American doctor with a rich understanding of how RIC can go wrong, and honest enough to put his understanding into print, in language any educated parent can understand. Dr Gibbons is a hero of mine, and I am deeply grateful for his honesty.
ReplyDeleteI was cut, now I can't orgasm after a life of poor sex. So much for hygiene!
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