Being Conscious Of Your Own Circumcision, Ctd

Readers continue to provide the best MGM conversation out there:

This is in response to this reader. The condition that worries the dads is called phimosis. Until my mid-twenties, I couldn’t see more than a dime-sized area of my glans when I pulled back my foreskin. I didn’t even realize my foreskin was supposed to retract until I stumbled upon information about the condition online.

I recommend the dads look at the archives of this forum. It contains many first-hand accounts of successfully overcoming phimosis with stretching exercises. After stretching my foreskin twice per day for a year, I was able to fully retract my foreskin when flaccid. My sensitivity decreased, but that was necessary. I was overly-sensitive, and now I’m able to retract to wash my glans every shower with soap and water, which any healthy uncircumcised man will tell you is simple and necessary. I don’t stretch now, years later, and my frenulum is still a bit tight when erect, but I was amazed by the improvement.

The forum is sometimes antagonistic to doctors, with the allegation that American doctors are too willing to circumcise in phimosis cases because they don’t know any better. Some extreme phimosis cases may need circumcision, but I recommend the dads do extensive research of their own before subjecting their son to a scalpel.

Another reader is pretty antagonistic toward American doctors:

America just doesn’t know how to deal with foreskins.  We didn’t circumcise my son and his foreskin didn’t retract by age 5.  We were told that it should by age 3, and the cure for a non-retracting foreskin was circumcision.  No other advice was offered in England or America.

Then we moved to Bulgaria.

The doctor said we should pull the foreskin back to the point of gentle tension every day in the bath.  Now, it’s a bit awkward for a mother to be handling her son’s penis, so I tried to get my son to do this himself, with so-so results.  Not many months later, my son got an infection in his foreskin, from sloughed off skin cells trapped under the foreskin. He didn’t tell me in time, because he was an accident-prone kid and his solution to avoiding the doctor was to ignore the infection until he had a fever and was walking funny.

I checked on the web, consulted my home medical books, and called my American insurance company’s hotline.  All the advice was to lop off that useless (and, it was hinted, disgusting) foreskin.  But we were in Bulgaria, so we went to a Bulgarian hospital.  The doctor was built like a weight lifter and had odd English. I explained my husband’s preference was to try to save the foreskin, if possible, expecting to be told it wasn’t.  The doctor was absolutely horrified at the barbaric notion that anyone would consider removing a part of a man’s or a boy’s penis, especially for a trivial problem like a nonretracting foreskin with a treatable infection.

He forced the foreskin back, disinfected the infection, slathered antibiotic cream and told us to keep putting the cream on and that the foreskin now retracted. The procedure took under 5 minutes, cost $60 (10$ fee, 50$ tip) and solved the problem.  That was years ago.  My son remains intact.

I think it’s the cultural value that foreskins are useless at best and otherwise potential for disgusting reservoirs for grunge that makes the American and English solution to be lop it off at the slightest hint of any problem – and better yet, before there’s a problem.

And back Stateside:

I have been reading your circumcision thread and thought your readers may want a perspective from a female pediatrician who actually performs circumcisions on a regular basis.

My patient base is semi-rural, mostly white, blue collar, in the heart of Appalachia. They feel that their newborn sons are not “normal” if they are not clipped, and in fact that is sometimes the only question they ask when their son is just born – “Will he be circumcised?” Typically my partners and I will do a circumcision before the child leaves the hospital, but it can be done with local anesthesia up to two months of age in an office setting. There are different types of circumcision procedures that can be done and different doctors are trained on different procedures, but the basic principle is the same: the foreskin is loosened from the glans, a dorsal slit is performed and the foreskin is either placed in a clamp, or tied off around a plastic ring. There are pluses and minuses to each procedure, but it is mostly doctor preference regarding which one is done. And as I said, local anesthesia is given.

As part of my practice, I want my patients’ parents to make the right decision, and so I typically perform a thorough explanation of the risks and benefits of the procedure. But I do get frustrated that despite letting them know they don’t need the procedure, the parents feel it must be done.

Reading your readers stories, I am sad and a little disappointed because although I was not involved in these cases, I feel like the medical field have let them down.  And I think the reason is because the majority of males in the US are circumcised, and that creates a bias and a misunderstanding of the true nature of the foreskin and the male sex organs. If you only see circumcised boys, you may not really know when the foreskin should protract, and you would view something that is completely normal as abnormal just because it is different.

First off, ALL males are born with a natural phimosis. With time the phimosis loosens. This can vary, but there is a key ingredient needed and that is TESTOSTERONE. That is why the doctors of the various readers gave them steroid cream, but that is just not as effective as your own production of testosterone. Now some mothers with uncircumcised boys are aggressive with “cleaning”  and that traction will loosen the foreskin. Some boys are more playful, and that too will loosen foreskin, but a boy of age 3, 5, 7, 8 – even sometimes 14 – has very little testosterone flowing, so it is needed to mature the the male sex organ to function like it should. (As a side note, we recommend not pulling the foreskin down to clean, as that may cause it to rip from the glans but stick, swell and potentially cause loss of blood to the glans, which is bad.) Once the testosterone is flowing, the adolescent maleusually provides enough friction that any minor tightness will also loosen.

Obviously there are some exceptions to this rule, and a circumcision may need to be performed for medical reasons, but that is the exception. I would highly question any physician who tells you a prepubertal boy needs a circumcision if they are urinating with no problems. I also feel very sorry for the man that had a circumcision as an adult with just a local anesthetic that is cruel. No child or adolescent would get a circumcision out of the newborn period without general anesthesia, so why would we do that to an adult?

One more thing: I am surprised that nobody has mentioned circumcisions that had complications. Commonly I see penile adhesions where the foreskin has reattached itself to the glans of the penis, sometimes making it appear as though the child has never been circumcised.  Unfortunately I actually had a mother re-circumcise her son due to this very issue, despite my explaining that this was completely unnecessary, as the boy was two and thus had no testosterone, and that it will get better with time. Unfortunately she became obsessed with it and insisted it be done. I will never forget that boy. (Interestingly enough, prepubertal girls have a similar condition in which the labia minor fuse together, because there is no estrogen blocking the opening of the vagina and even the urethra, but of course we would never perform procedures to separate that.)

So that’s my two cents, for what it’s worth. I found you a few years ago and have thoroughly enjoyed reading your blog.

And we never cease to enjoy these incredible contributions from readers. Update from another:

(Interestingly enough, prepubertal girls have a similar condition in which the labia minor fuse together, because there is no estrogen blocking the opening of the vagina and even the urethra, but of course we would never perform procedures to separate that.)

Actually, this is exactly what my daughter’s pediatrician recommended when she was less than a year old; we were told to put estrogen cream on it (don’t worry if your infant develops breasts, that’ll be temporary … never mind the people freaking out about exposing their children to tiny amounts of estrogenic compounds in BPA plastics and possible links to the obesity epidemic). And if that didn’t work, we were told surgery might be necessary. Thank god for the Internet. The problem went away on its own at about 18 months. Never caused any trouble.