Re: Circumcision: A Barbaric Practice (by J. Steven Svoboda)

From: thumper1@netcom.com (Tom Stempler)
Subject: Re: Circumcision: A Barbaric Practice (by J. Steven Svoboda)
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Date: Thu, 28 Dec 1995 01:16:22 GMT
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Corrections:

Dr. Spock unfortunately is no longer with us.  Maybe that's one reason
we haven't stopped RIC (Routine Infant Circumcision) yet.

In referring to respected anti-cut medical people the word should have
been "note" instead of "not".

To Patrick Malka for his statement:

>You are hereby labelled a raving lunatic to whom I no longer listen ...

I was really beginning to wonder about his perspective as I was
reading his reply. I do want to thank him for clearing up the matter
so explicitly for me, however.

He did make one reference that might confuse some, who were not too
amused by his remarks to miss it.

FORESKIN RESTORATION

Although foreskin restoration ( or uncircumcising--I use the terms
interchangeably to refer to bringing back the penile forefold
(foreskin) to cover the glans) has and can be accomplished by surgical
means, the current preferred procedures using "skin expansion
techniques" (similar to the idea of how Africans increase the size of
their lips with plates) are non-surgical.

For some background on foreskin restoration on the net see:

http://www.tde.com/~derrickt/restore-faq.html     (and  links)

It should be pointed out that although the term "foreskin restoration"
is used here. Many of the techniques can be used to loosen and
increase the amount of shaft skin for many men without taking the
procedures to the final end of covering the glans. 

I have not taken any surveys myself but I believe Bigelow estimates
that upwards of  20% of all circs performed on babies (more difficult
to perform well since the penis is not fully formed on an infant) are
unsatisfactory from the perspective of the person circumcised. For
example, from a medical viewpoint, twisting of the raphe (seam running
between testes and  up underside of penis) is a perfectly "acceptable"
outcome of circ (may occur if more skin is taken from one side than
the other). However, if it's your penis it may not be so "acceptable".

The term EFL (effective foreskin length) is basically the amount of
coverage of the glans that is possible in an erect state by stretching
the skin and measuring. 

In the cases of many of the men in the internet support group for
foreskin restoration most report a negative EFL before they begin
restoring. This indicates that there is not enought skin to accomodate
a normal erection, without stretching skin.

Although I and many others believe RIC is wrong (it's his body) or
prudent (he may grow up to resent their making that decision for him)
for parents to make the circ decision for their baby boy, the fact is
that many parents will continue to do this.

SOME SUGGESTIONS FOR PARENTS WHO WILL CIRCUMCISE

 If some parents and some doctors are going to continue it, at least
they could do a better job of it. 

To repeat the suggestions:

1. Use a plastic surgeon. Although more expensive than a Pediatrician
or an OB/GYN, we're talking about your son's genitals here. The
medical profession is generally agreed amongst themselves Plastic
Surgeons do the
best job. Next come Urologists.

2. Don't make the decision in the pressure of "The  New Car
Showroom-The Hospital". Take him home and try him out. They'll still
be there to do it when you're ready to bring him back. He should be
anesthestized if you're at all concerned about the cruelty aspects of
the pain. (Current thinking even by the AAP is that infants experience
and are affected by pain) And the older he is the less risk of death
from anesthesia (often the riskiest aspect of a surgical procedure)

3. Consider the Dorsal Slit Procedure only. He will look circumcised,
the glans will be exposed, and all of the supposed hygiene benefits
will apply.
No tissue is being removed. There are a number of "luckier' men around
who think they were circumcised, but received this procedure, and
don't understand  all the fuss about circ. 

One would have to suspect that those least likely to notice any
problems with their circ are those who had little or no tissue
removed.

4. Unless you're a radical jewish rabbi with a viewpoint a la  second
century AD  (afraid that he might someday want to uncircumcise himself
and blend in with the Gentiles), there is no reason to take a lot of
skin. Some circumcisions remove as much as 80% of the skin system of
the penis.  Try to have as little tissue taken as possible. Discuss it
ahead of time with the doctor and make sure he understands your
feelings.

Note: There are  cases for which RIC should definitely not be
performed.  For example, the natural lengh of the foreskin varies
amongst males the same as the lengh of any other parts of the body.
There are some males (usually runs in families)  who have so little
skin that they should NOT be circumcised.  This is difficult to
determine in the infant and such men have been routinely circumcised.

The results of a circumcision in such a male often results in a
condition called "scrotal penile tethering". Scrotal skin is drawn
far onto the underside of the penis.

Another result of excessive skin taken in  circ is abdominal skin and
hair being  drawn onto the shaft.

"TOO TIGHT" CIRCUMCISIONS

Some American men have found that in the typical "American
circumcision," they are left with too little skin.

 (see http://theorem.math.rochester.edu/nocirc/anat/garcia.html)

Erections may not be comfortable (excessive tightness). Taping
techniques often can he used to ameliorate this problem.

The point is that generally this is something some men are not willing
to discuss even with their family doctor.  (Given that men who have
tried to get medical help for these problems have been referred to
psychiatrists--it's not considered "pschologically healthy" to express
dissatisfaction with ones circumcision). I guess you can't blame the
doctors, it doesn't help their statistics any if they have to
acknowledge less than satisfactory circs.

The techniques for skin expansion are rather simple to do in private
and don't _require_ more than some type of tape (elastic tape works
very well--e.g. J&J Elasticon, however surgical tape like 3M Micropore
will work too).

see:  http://www.tde.com/~derrickt/restore-faq.html  and
http://www.eskimo.com/~gburlin/restore/

For a thorough discussion of circumcision, foreskin restoration see: The Joy of Uncircumcising, by Dr. Jim Bigelow. Reviewed in the Journal of the American Medical Association:

[The book] is based on three premises: that infant circumcision is performed without consent; that circumcision diminishes penile sensation and therefore reduces sexual enjoyment; and that techniques of prepucial reconstruction can restore lost sensitivity to the glans penis...As Dr. Bigelow forcefully points out, there is little evidence that early circumcision confers any health gain to the individual in the longer term.

Tom Stempler

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