Circumcision

Illustration showing the circumcision procedure - a incision is made along one part of the foreskin, then is peeled back. The foreskin is then removed using scissors or a scalpel.

Circumcision procedure
Image by MrArifnajafov, translated (CC BY-SA 3.0)

Circumcision is the surgical removal of the foreskin (prepuce) that covers the head of the penis.

Circumcision as a religious ritual is known in many different cultures, but the idea that circumcision is normal in countries of the British Commonwealth is relatively recent.

It started only at the end of the 19th century, and appears to stem from the hygiene problems, penile infections and subsequent adult circumcisions suffered by soldiers in the Crimean wars, and to some extent in the First World War. Fathers at that time swore that they would not put their sons through such agony in adult life, and started the ritual of infant circumcision.

Today there is no medical reason to support the continuation of this ritual. Hygiene is not a problem in modern society, and it is possible for parents and children to adequately clean their penis as much as their ears or any other part of the anatomy. The majority of the medical profession can now see no advantages to the procedure.

Some men will need to be circumcised later in life, but fewer than 1% of men will need this operation for infections, tight bands, cancer or other reasons. Some of us will also need to have our appendix removed later in life, but this is not a valid reason for removing it at birth.

Cancer of the penis has been used as a good reason for circumcision. It is true that the incidence of penile cancer is higher in uncircumcised men, but it is a rare cancer that is detected at an early stage in most cases. On the other hand, the wives of circumcised men are more likely to develop cancer of the cervix.

The heterosexual spread of AIDS is reduced amongst circumcised men, but there is no change in the spread of AIDS when the sex is homosexual. This may be a reason for circumcision in Africa where AIDS is widespread, but circumcision is already a common ritual in many parts of southern and central Africa.

The procedure can be done under local anaesthetic using clamps and a scalpel, or using a device (Plastibel), which makes it technically easier for the doctor to cut off the foreskin and minimise the risk of bleeding. The procedure can be done in a doctor’s surgery, and hospitalisation is not necessary. 

There are risks associated with the procedure. Although any bleeding from the penis may appear to be adequately controlled when the child leaves the surgery, catastrophic bleeding may occur unnoticed into a nappy that night. Scarring of the penis due to infection may also occur.

Removing the foreskin may adversely affect the man in later life. The foreskin is the most sexually sensitive part of the penis, and if excess is removed, it may decrease sexual pleasure. Plastic surgeons are now able to refashion the foreskin by an operation that moves some of the skin on the penis further down the shaft.

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(Last modified: 13th Oct 2014)

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