Circumcision: it’s not medically necessary

Press, 11 September 1986, Page 16

Circumcision: it’s not medically necessary

by

MAVIS AIREY

Although it is less fashionable now than it was when today’s parents were children, a lot of parents still assume that circumcision is just a matter of course for boy babies. In fact, no medical grounds exist for doing it to the newborn, according to a Christchurch pediatrician, John Barry. Circumcision is the surgical removal of most of the foreskin covering the glans penis. In the newborn baby it is performed by an obstetrician; in older children and adults, it is done by a surgeon. Parents give a variety of reasons for wanting the operation to be performed, among them cleanliness, social convention, and family or religious tradition. Another argument is the risk of penile cancer. From a medical point of view, Dr Barry feels that a lot of parental concern is misplaced. “Sometimes mothers complain that they can’t clean the baby’s penis because the foreskin won’t retract, but it should

be understood that it is normal for the foreskin not to be retractable in the first two or three years of life. “Similarly, it is normal for there to be a white discharge, called smegma, as the union between the

prepuce and the glans is broken down. Many mothers think it is dirty and unhygienic, but it is not,” he insists. “All that is necessary to keep the penis clean is to gently wipe the tip that is visible.”

Retracting the foreskin forcibly is not just unnecessary, it can do considerable harm, he maintains. Bleeding, infection, and scarring can result, stopping the foreskin from retracting naturally and causing painful erections in later life. That would then be a medical reason for circumcision, Dr Barry says. Once the foreskin is retractable, cleanliness is just a matter of common sense, he maintains, and should not be turned into a fetish. The only time when he would accept hygiene as a grounds for circumcision would be if someone went off to live in a hot sandy place, like a desert. Similarly, the risk of penile cancer is very low in a place like Christchurch compared with hotter countries, Dr Barry believes. Another cause of parental concern is the apparent smallness of the opening of the baby’s foreskin, but this is generally only a problem if the opening is so small that

urine is not able to pass properly. Usually, the size of the opening increases sufficiently with age to retract normally, but if it remains so small that erections are painful, or that the foreskin, once retracted, will not go back, this would be a reason for circumcision, Dr Barry says. Parents sometimes voice the view that it is better to have their child circumcised as a baby, to avoid the possibility of pain and trauma later on, but Dr Barry does not agree with this view. “It is a painful procedure done without anaesthetic in a new baby. In infants, children, and adults, it is done under general anaesthetic. Circumcision can be done at any age, provided the person is fit enough.” The fear of possible complications arising from being uncircumcised

he dismisses as “a nebulous fear,” and points to the possible complications of the operation itself. “Most are undertaken without complications," he admits, “but in a new baby the chance of haemorrhaging does exist, and there is the possibility of taking too little skin off, or — worse — too much. Amputation has happened, although it’s unlikely. “I would never say to a parent, ‘No don’t have it done.’ But you should look at it this way. Circumcision is an operation done on a non-consenting person (if you’re talking about a baby) at the request of someone usually without medical qualifications (if it’s the parents.” A chilling thought. If any parent is concerned about their child, he recommends going to the family doctor so that specialist opinion can be sought. Do you have a subject you would like discussed in this column? If so, please write to Mavis Airey, Parents’ Survival Guide, “The Press,” Home and People Page, Private Bag, Christchurch.