is circumcision really necessary?

[Cha]

My friend (now living in India so has asked me to research) has been told by a doctor that her 7 year old ds probably needs to be circumcised. He wets the bed, sometimes 3 times a night, and still has accidents in the day from time to time. The doctor said that he he may have continual mild urinary infections caused by a tight foreskin. The foreskin thing was picked up a few years ago by a health visitor who thought it might improve as he got older but it hasn't.
What my friend wants to know is that if her ds is circumcised, how will it affect him, his bodily image, his sex life when he gets older etc and also what the risks are.
Both my own father and my brother were circumcised (born in Africa) and I don't think either of them had any issues with it. I know that their is growing evidence that being circumcised, although not exactly preventing HIV and STDs, has been shown to reduce men's chances of getting them. But apart from that - would it be a good idea to have him done?

anyone?

You might not be getting reposnces as this has been one of the mosr 'vigerously' debated threads on MN and everyone might be too gun shy to post. If you have a search you should see some of the threads.

Opinions were polarised, lets say!

oops! Inadvertantly strayed into a minefield... But it is quite legitimate - my question - to do with health and not any religious or social reasons. But the title of my most doesn't help, I suppose. Will see how this thread runs and then maybe change the title!
Cheers for the tip.

Have a friend with a ds (3) who had to be circumcised last year due to constant urinary tract infections. Hasn't had any infections since. His infections were due to enormous amounts of medication he takes for heart problems so the circumcision must do something for that in certain cases. Friend's ds was done under general aneth and suffered pain when weeing for a quite a few days after. hth

I don't think that there was much polarisation about circumcision for medical reasons. It's circumcision for cosmetic or purely cultural reasons that gets people riled.

Anyway, from what I have read, it seems like:

1. It's debateable whether it significantly affects sex life,

2. Self-image, it doesn't make the willy appreciably smaller. And most circumcised men reckon that their is as good as any willy out there (so I don't think it would affect body image much)

If I were the parent, I'd get a 2nd opinion, but only to make sure. Presumably it has to be done under a General Anasthetic, and that is a risk in itself.

Do men in India, er, tend to see each other's members very often? I mean, would the boy be likely to do much comparing? If not, then why should it bother the boy that much?

Thanks mymama and freakyzebra. My friend (and kids) are English, she is teaching in India for a couple of years - so, no, I don't think it will be an issue for her ds growing up there (as he probably won't). However, he will probably be comparing his willy with English boys who are not generally circumcised, so yes, it might be an issue for him in the future. Though my brother certainly never had any problems with being circumcised when we came to the UK, but he was quite a self assured boy.
All the internet research I have done says that the tight foreskin thing is a big problem when the boy grows (pain, infections etc) but I cannot find anything linking it to bedwetting - which is the reason my friend went to the doctor in the first place. Does anyone know if there is a link and if so, where can we read about it?

I've never heard of a link between intact foreskin and bedwetting and I did quite a lot of research when deciding what to do with ds. I would definitely get a 2nd opinion if I were your friend. I wonder if it's more of a perceived connection in India? Will she be visiting the UK anytime soon to get an opinion there?

No - she has a contract for 2 years which started in June so she won't be home for a long time. Do you think she should have him circumcised anyway, just not expect it to cure the bedwetting?

NO, I don't think she should have him done, on the off-chance that he might have a mild UTI. If he has a UTI, they should be able to detect it (culture his urine for it). Circumcision is a painful and bruising procedures, and at this age it probably requires a general anesthetic (which carries its own risks, esp. for young children).

Why can she not see another doctor for a 2nd opinion?

TBH, 7yo is not that old to still be wetting the bed; I've heard stories of boys doing that until 8-9yo. I'm sure it's a pain, but it's not proof of infection.

One idea, if UTIs are the problem, put the boy on a mild low dose antiB for an extended period (say 1 month). If his wetting problems all go away then that would be evidence of a chronic and otherwise irresolvable infection (not that I'm convinced that circumcision would solve the UTIs, but at least it would lend evidence to this theory). If a month on a mild antiB doesn't improve anything, then I doubt the boy does have a recurring low-grade infection problem.

Well, you asked for opinions! That's what I think I'd do.

if his foreskin is particularly tight and causing problems then yes... i think it would be a good idea to have it done

BUT... i would want to be super sure that it was a problem before having the op done.

as for body image and sex life... well i don't think it woul dbe a problem at all... have had boyf's in past who were circumcised and they didn't seem to have an issue with it!

My 7 yo dd still wets the bed and I don't plan on having her circumcised!!!!! Bedwetting can also be genetic. 50% chance of child bedwetting if one parent did and 80% chance if both parents did. My dh wet until 13 so I am blaming that. Really have to say that I don't buy into the whole comparing bits as blokes are going to compare size/performance etc anyway. We don't try to match our girls up so we shouldn't do it with boys.

I've not heard of UTIs causing bed wetting. As mymama says, it's largely genetic. How late did your friend bed wet? How late did her DH/DP?

I've heard of people having great success with those alarms, for bedwetters over 6.

As others have said, I would not circumsize without a) being sure that was the problem b) ensuring there was no other way to solve the problem - I thought foreskins stretched?

Thanks for all your invaluable advice. You are confirming my suspicions that there needs to be a lot more evidence that the tight foreskin is causing the bed wetting - I think your idea, freakyzebra sounds good - a mild antiB for a month and see if the bedwetting improves. However, the tight foreskin is possibly another problem altogether - this doctor in India is not the first to notice it, it was picked up by a health visitor in the UK a while ago but my friend decided to leave it and hope the her ds fiddling would stretch it a bit. I agree that she should get a second opinion before she gets him circumcised, make sure it is really necessary.
As to the genetic bedwetting thing - not sure how long she or her ex dp bedwetted for. My dss is the same age and still regularly wets the bed as his mum did, and me and my friend have had this genetic link conversation before. I haven't seen her ds for a few months but I seem to remember him having a problem with wetting his pants in the day too, which (IMO) is a bit more unusual. Or perhaps not?

Hi Cha
I asked one of the urologists at work about this because I think ds may have a tight foreskin (though he is only 4 so maybe still growing as it were!). He said that at Great Ormond Street they now recommend trying steroid creams and gentle manipulation to relieve the tightness and then circumcision as a last resort. So maybe your friend should try and get a second opinion from someone who is prepared to do something a bit more conservative first.

Thanks, keepingmum. Yet more good advice. Will copy and paste this thread to my friend at the end of the week.

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