Circumcision - have you had your ds 'done'?

[monkeygirl]

My dh wants to follow the family tradition of having ds circumcised (for non-religious reasons) but I'm not sure if I want him to go under the knife. If you've had your ds done, why and at what age? And do you think it's made a difference (ie health and hygenically-wise)?

It is not normally done in Ireland at all, unless you apply for religious reasons through your health board, which can take a very long time. I remember something in the news, African, perhaps Nigerian, baby died when circumcised by a non-medically trained person, bled to death. I personally would not do this to my son, there is absolutely no way to do it painlessly and with modern hygiene, no need!

I think to have it done so that the boy 's penis looks like his fathers is a rather strange reason. This is different to people doing it for religious reasons. If I did the former I would have to have one of my son's testicles removed! I can understand why people do it for religious reasons.

Bf has just rung me to tell me her DS2 has to be circumcised for medical reasons, he's 3 btw.

She's been told it's a day patient job and he'll recover in a couple of days, but having read through this thread I now feel sick with apprehension - so don't know how to face her. Is it really going to be that bad/painful for him?

I don't want to worry her unnecessarily, but then if I know it's going to be worse than she's anticipating how can I not warn her

Help?

Lydialemon Do you know what the problem is?
My son has a moderate hyposapdias and had a more complex op(catheter needed, reconstructive surgery) than what would be needed for say a tight foreskin or repeated urinary infections.

would not want ds to be circumcised, despite religous pressure from family (luckely they haven't seen him naked....). If done for medical reason I would want to have a GA. I saw loads (several every week)of boys few hours after the operation and they all seemed to be uncomfortable

Dh is, only because it was the done thing in his part of the UK during the late '60s. His brother, born 5 years later, is not as it had gone out of fashion by then. We were under no religious or cultural pressure to perform a circumcision should either of our children have been a boy (both girls, thank goodness after reading this thread) and if they had been boys, we would not have asked for a circumcision. In the absence of tangible proof of health benefits, and given that we do not have a religious requirement to do it, I could not have justified putting my baby through this.

I remember nicking dd1's finger when cutting her nails at 6 weeks old. She screamed the house down. It was a tiny, tiny cut and didn't bleed much at all but it obviously, really HURT!! I remember it now and still can't cut my girls' nails - dh has to do it. Hate to imagine what these wee souls feel when you slice off a part of them from one of the most sensitive areas of the human body. I won't do it if we ever end up having a boy.

maddiemo - his foreskin won't retract at all and he is constantly getting infections. He's now getting swellings due to fluid retention. My DS1 had something quite similiar, but his sorted itself out through natural 'fiddling' IYSWIM Apparently BFs DSs is too severe to correct on its own hence the surgery.

Found this on the net as a possible alternative to surgery for your friend, Lydialemon.
Question:
What is the current medical advice and evidence for the treatment of a non-retractile foreskin (phimosis) in children of age 6 years? Is circumcision indicated or not? And if so at what age?

Answer:
We found two RCTs and two clinical trials that have studied the use of topical steroids for phimosis.
The first was a prospective, randomized, double-blind RCT (1), conducted in Hong Kong and aimed to evaluate the effect of topical steroids in non-retractile foreskin.
"137 boys with non-retractile foreskin were randomized to betamethasone (n = 66) or placebo (n = 71) for 4 weeks with application of the cream twice daily. Non-responders to treatment were offered steroid treatment for a further 4 weeks. The mean pretreatment grade of the foreskin in the steroid and control groups was 5.08 +/- 0.66 and 4.97 +/- 0.70, respectively. At the 4-week follow-up, 49 of the former (74%) had a retractile foreskin (grade less than or equal to 3, mean 2.38 +/- 1.41). In contrast, only 31 of the control group (44%) had a retractile foreskin (less than or equal to 3, mean 3.55 +/- 1.55) (p < 0.001). Only 14 boys were circumcised because 43 of the remaining 57 boys had a retractile foreskin after 4 weeks of treatment. When treatment is necessary, application of topical steroid as a first line of treatment may avoid surgery in almost 90% of cases".

The second prospective, randomized, double-blind RCT (2) assessed whether it is the steroid alone or the gentle physical retraction combined that is responsible for the results of topical steroid treatment for unretractable foreskin.
"30 boys were randomized to be treated with clobetasol propionate (n = 15) or placebo (n = 15). The boys were examined 1, 2 and 6 months, respectively, after treatment. Two patients in the steroid group and one in the placebo group withdrew from the study. 10 Boys in the steroid group showed an improvement within 2 months. The remaining 3 boys had no effect and were circumcised. Histopathological examination showed lichen sclerosus et atrophicus. Seven boys in the placebo group improved. The 7 non-responders were prescribed clobetasol propionate ointment, and all 7 improved. 17 of 27 boys referred with "phimosis" were successfully treated with an ointment and gentle traction. When clobetasol propionate was given the non-responders success rate was increased to 24/27 (89%)".
The two clinical trials (3-4) conclude topical steroid treatment is an easy and safe treatment for phimosis.
One RCT (5) studied the use of local non-steroidal anti-inflammatory ointment in the treatment of phimosis.
"A total of 52 children with phimosis was included in this study. Phimosis was graded according to severity. Of the patients 32 were given locally a nonsteroidal anti-inflammatory ointment prepared in ophthalmic usage form from sterile diclofenac sodium ampules (not commercially available). The control group comprised 20 patients given sterile petrolatum ointment. Patients were seen before and after treatment, and graded according to retractibility and appearance of the foreskin. Treatment continued for 4 weeks with 3 applications daily. Of the 32 patients 24 responded to therapy and 8 remained unchanged or had insufficient improvement. Three controls responded to therapy and 17 did not. There were no side effects. Nonsteroidal anti-inflammatory ointment application for phimosis may be an alternative to surgery and steroid application".

The National Organisation of Restoring Men (NORM-UK) has produced clinical guidelines for phimosis (6) in which they discuss various treatment options. With regards circumcision they note:
"As with surgery, circumcision is very traumatic to a child. It is essentially irreversible and should be the treatment of last resort".
As the guidelines contain no information as to what age circumcision is recommended we contacted the Vice Chairman of NORM-UK. Through email correspondence we were given the following information.
There is a wide variability of what age a foreskin becomes fully retractable and some may not retract until puberty. There is no definitive age at which circumcision is indicated, it should always be considered as a last resort.

Can say absolutely that there were no immediate effects of after effects although, of course, things can go wrong. It never came up with DS and DH (pardon the pun!) as DS is autistic but I assumed that there would come a day when DS would say to DH why is mine different to yours? And, although that's not a problem as such, it needn't be we are different to each other and why, but maybe we are different to other people (other boys at school?) and why.......

Thanks Aloha, I'll pass it on.

DS is not. At first dh proposed the "look like me" argument as he is circumcised but I basically said they would cut on my baby's penis over my dead body. Guess I took the black and white emotional view, but that's the way I feel about it. I never knew anyone who wasn't, just didn't feel that it was a necessary thing to do and couldn't imagine putting him through something like that. It just didn't make sense to me that we would be born with something that needed to be cut off.

I'm aware that circumcision is a contentious issue but please bear with me. IMHO having a child operated in this situation is a bit like cosmetic surgery. Unless for medical or religious reasons then, personally, I would leave well alone.

Although the risks from circumcision are relatively small, in making your decision it might be worth thinking about how you would feel if your son experienced any complications. Just a thought, but if his father and grandfather had a tattoo, would you get your baby son tattooed? or would you let him decide for himself when he is grown up?

Well, for us it was not a medical or religious reason but a cultural one. Also, we cannot be fairly sure that a tattoo would have gone back through many, many generations as we can with circumcision (suppose there are cultures where tatoos go back generations, maybe Maoris?)

I couldn't do it to ds, and I should have done according to my religion.

My decision wasn't based on any scare stories, I just thought he was born with it, so why should I make the decision to remove it.

Although I did read a story once about a boy in the US who was circumsised, but the person who did it completely screwed up and cut his whole willy off! Instead of having any kind of surgery, the parents decided to bring their son up as a girl!! Horrendous thought, he obviously grew up very mixed up, and had to make the change when he was older back to being a man.

I read about that story too smellymelly - the man in question committed suicide recently

OMG.

My DS isn't but I grew up with a father and brothers who are and it was a while before I realised that some men weren't
Years ago, before we got married, DH and I were invited to a friend's son's (jewish) circumcision ... it was a bit of a 'do' with caterers and all.
I won't go into the details as I was not witness to the procedure (the women had to be in a different room) but DH was and suffice it to say that afterwards DH's words were something along the lines of, "If we have children, I will never ever EVER do that to my son ... " ...
I don't judge people's decisions to do this if they have strong religious affiliations but I agree that if there is no religious or medical reason then why do it?

regarding the randomised studies,just wandering though about the occurence of infections in both groups before/during treatment.
For "just" phimosis I would certainly not consider surgery (especially not in 3 y olds),
With recurrent infectionsI would think again (like risks of scarring after infection etc)

I'm sorry unless really necessary due to medical reasons anyone who does that to their child is sick. As for cleanliness then thats what soap was invented for ,as many of you have said why cut something off that was meant to be there. NO NO NO NO NO NO !!!!

lydialemon That does sound like a problem my friends son had. he did have a circuncision at age 4 and from what his mum told me he was very distressed and in a lot of pain. Sorry thats probably not what your friend would want to hear.

As Aloha's article said it should only be carried out as a last resort. Your friend should discuss this further with the urologist.

message withdrawn

Ghosty, not all circumcisions are done that way and I wouldn't have been happy to do it that way myself (not that they would have let me!). The little medical procedure we had carried out in a private hospital by a very experienced surgeon was not traumatic, but then we are sick

maddiemo - bit the bullet and warned my friend, she was quite glad I told her although she's quite worried now. She's a childminder and will now take a couple of weeks 'holiday' from the other kids to look after DS rather than the 2 days she had originally intended. She's going to discuss the steroid thing with her GP too.

Since the last discussion on this subject on Mumsnet the BMA have issued a statement - here

my ds has been such a little shite today thatt I'm sending him for his tomorrow