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Click here to return to the Articles Home Page Circumcision's comeback? Now pediatricians say the surgery may be more than cosmetic Circumcision has been controversial more than once during its 3,500-year history. Recently, an American Academy of Pediatrics' (AAP) task force reversed its earlier position that there was no valid medical rational for routine circumcision of newborns. The AAP now says the proceedure "has potential medical benefits and advantages." The AAP's more positive stand is largely based on studies by Army pediatrician Thomas Wiswell, which show that uncircumcised male infants suffer 11 times more urinary tract infections(UTI's). Researchers suspect bacteria get trapped under the foreskin and move up the urethrea to the kidneys. UTI's can be serious and may even have lifetime consequenses. The AAP also notes that circumcision virtually eliminates cancer of the penis and may reduce sexually transmitted diseases and cervical cancer in women. Not all pediatricians agree with the AAP's new positioin. Dr. Howard Snyder, associate director of urology at Children's Hospital of Philadelphia, calls circumcision "unnecessary surgury and unatural," pointing out that post-circumcision rates of infection and other complications run about 1% to 3%. Parents' reactions can be just as impassioned. Those opposed criticize circumcision for inflicting unnecessary pain; some call it "disfigurement" or even "dismemberment." One California mother is currently suing the doctor who perfomed her son's circumcision - in spite of the fact that she gave her consent in advance - on the grounds that it was done against her son's will. If you're expecting a child, how can you decide what to do? The AAP recommends talking about circumcision with your doctor before the birth, taking into consideration religion, cultural attitudes, aesthetics and social pressure. Many parents choose circumcision because of "the locker room syndrome," says George Kaplan, chief of pediatric urology at the University of California in San Diego. They don't want their sons to feel different from their fathers, brothers and friends. "If you choose to circumcise, the proceedure should be done at least 12 to 24 hours after birth, when the baby has stabilized, not in the delivery room," says arlene Eisenberg, coauther of What to Expect The First Year (Workman, $10.95). The operation does hurt, although most doctors forgo anesthetics, fearing complications, says Kaplan. The AAP states that a "dorsal penile nerve block" may be given, but only by an experienced physician, not the resident or a junior member of a surgical team. A hospital circumcision takes 15 to thirty minutes. The surgeon straps the child to a "bodyboard" and, using a clamp, makes several incisions. A less stressful alternative could be to use a mohel, or Jewish ritual circumciser. The mohel makes one excision while the child is being held by Grandpa or other family manber. The entire proceedure takes between 15 to 30 seconds. Mohel Joel Shoulson | 610-523-3393 | 1-800-700-JOEL (5635) | www.MohelJoel.com |