To Cut Or Not To Cut?

Children’s Day is recognised in many nations around the world to honor children globally. Although many countries mark the day on different occasions, the Universal Children’s Day on Nov 20 is celebrated by the United Nations to highlight important issues affecting children.

The Universal Children’s Day dedicates in promoting the well-being and rights of the world’s children, especially those suffering the impact of poverty, discrimination and exploitation.

On the Universal Children’s Day today, I intend to explore the rights of infants who “cannot really fight back” and issues surrounding circumcision on the infants that may be perceived “protection” or “exploitation” of kids.

Dear Dr G,

I am a proud father of a newborn boy, who is now nearly six months old.

I am having a great dilemma in deciding whether to cut or not to cut for my boy.

The thing is, I never remember what it was like having foreskin as I underwent circumcision when I was six months old.

I often wonder what would life have been like with the foreskin.

I am reading conflicting data on whether men with or without foreskin make better lovers.

Can you help elaborate on the evidence? (Not that it can help much in my situation).

Now, I am a father and have to make decision for my son, I need to understand the health benefits and risks of circumcision.

The only reason why I am keen for my son to have the operation at such early stage is that I understand infants don’t feel pain and the recovery is faster.

So, what should I do?

Regards

Dave

The removal of the foreskin, although is a simple centuries-old practice, is still a controversial and hotly debated operation.

Although the benefits of HIV prevention by the removal of foreskin are well documented, the issues surrounding the differences in sexual pleasure and true impact of hygiene is not so “clear-cut”.

The moist glans of the penis can create the ideal environment for pathogens to incubate, making it susceptible to infections. This may include bacteria, fungus and sexually transmitted infections such as herpes and HIV.

Moreover, the sex partners of men with a foreskin are also recognised to have higher risks of bacterial vaginosis.

In fact, one of the treatments for boys who get recurrent urinary tract infections is actually circumcision.

Clinically, circumcision itself does not interfere with libido, erectile or ejaculatory functions.

However scientific evidence has demonstrated some loss of fine touch neuroreceptors that are highly responsive to light touches after the removal of foreskin.

Although some clinicians have advocated circumcision as the definitive treatment for premature ejaculation, in reality, such intervention plays little role in enhancing the intervals of intercourse.

It is also important to establish what sexual partners think about circumcision.

One study from Denmark showed women are twice as likely to report dissatisfaction in the bedroom with a circumcised partner, and yet other studies have reported the opposite.

I think the argument for and against the practice of circumcision can go on for many more centuries.

In light of Universal Children’s Day, it is important to highlight one myth that can no longer be disputed and must be completely clarified.

In the past, anaesthesia was not universally advocated for infants undergoing circumcisions.

The most common justifications include the argument that infants experienced minimal pain, and that the injections of the local anaesthesia itself are more painful and with terrible side effects.

Some even argue pain is inhibited during foetal life and postnatal invasive interventions must all be done shortly after birth!

On the contrary, infants experience pain! Numerous studies have outlined that infants exhibit pain and stress responses when circumcisions are carried out with no anaesthesia.

In modern medicine, while many parents may decline general anaesthesia for trivial operations, other options such as nerve blocks, EMLA numbing creams and pacifiers have been shown to be an effective alternative for pain control during surgery.

Despite the benefits and safety records of anaesthesia, many North American infants- reportedly as many as 60% of infants – undergo circumcisions without any anaesthesia.

The decision to undergo circumcision can be a dilemma for some parents.

Despite weighing out the risks and benefits of a life without a foreskin, the decision is still difficult as it impinges on culture, personal experience, religion and any preconceived ideas about its long-term effects.

One word of advice for Dave is: “When circumcision is done in a proper manner, it can only bring benefit and virtually no harm. If adults needs to have the surgery done with the protection of anaesthesia; then children deserve this equal right!”

On that note, Happy Universal Children’s Day for all the children in the world!