Tag Archives: complications of circumcision

Unspoken complications of circumcision

AAP: “Male circumcision consists of the surgical removal of some, or all, of the foreskin (or prepuce) from the penis. It is one of the most common procedures in the world. [...]Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks; [...] Male circumcision does not appear to adversely affect penile sexual function/ sensitivity or sexual satisfaction. It is imperative that those providing circumcision  are adequately trained and that both sterile techniques and  effective pain management are used. Significant acute complications are rare. [...] Parents are entitled to factually correct, nonbiased information about circumcision

AAP: “The true incidence of complications after newborn circumcision is unknown,
in part due to differing definitions  of “complication” and differing standards for determining the timing of when a complication has occurred [...] Significant acute complications are rare, occurring in approximately 1 in 500 newborn male circumcisions.
Acute complications are usually minor and most commonly involve bleeding, infection, or an imperfect amount of tissue removed.[...] Late complications of newborn circumcision
include excessive residual skin (incomplete circumcision), excessive
skin removal … ”

AAP: “Based on the data reviewed, it is difficult, if not impossible, to adequately assess the total impact of complications, because the data are scant and inconsistent regarding the  severity of complications. [...] Financial costs of care, emotional tolls, or the need for future corrective surgery (with the attendant anesthetic risks, family stress, and expense) are unknown.”

Activists monitoring social networks often encounter individual cases of complications that usually go unreported, and where evidently medical staff have done as much possible to make parents feel good regardless of the negative outcome. The previous statements mention “excessive skin removal”. While this may not sound very important because, well, “it’s just skin”, truth is penile skin has an important role in sexual life and development. And while parents are not thinking about the future sexual life of their child (except in their desire to conform to a social norm by circumcising), this excessive loss of skin results in dramatic harm to the individuals sexual life.

The skin of the penis is supposed to move during sex. In fact, it is supposed to glide over the glans, something that is almost always destroyed by circumcision. But the skin also has to be able to accommodate a normal erection. In other words, when the erectile tissue inside the penis swells with blood to make the penis enlarge and become stiff, there needs to be enough skin to accommodate its length.

When there is not enough skin, many things can happen. The penis can bend unnaturally when erect. The skin can chafe and even bleed during sex due to friction. The penis may pull surrounding skin (from the scrotum and pubic area) to make for the lack of normal penile skin, resulting in pubic hair climbing up the shaft, and potentially penetrating the individual’s sexual partner, causing bruising and tears inside. Insufficient skin can also cause part of the penis to push inward during erection (because there is nowhere else for the erectile tissue to go) causing pain during erection.

Many men who experience these complications may not seek help because they assume it’s normal, it’s what an erection feels like or looks like.

In fact, the loss of tissue due to circumcision is the reason why American supermarkets and pharmacies devote shelf space to artificial lubricants, so that men who lost too much tissue can masturbate or have sex.

In a bodybuilding forum we found one such case reported by a non-activist individual asking for advice from his peers.

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What motivates this post today is a photo found by activists today on Facebook. In that photo, a relative of a newborn reports that the baby finally left the hospital. Bleeding after circumcision was stopped, but infection is still a concern. Too much skin was removed and they are going to let it heal and follow up in two weeks, and they may use skin grafts later on.

baby1baby2

This is one of those complications that barely registers with people, one that the media doesn’t care about, one of those stories that will go unreported and unnoticed. It’s just skin. Until one day, 20 or 30 years later, baby is now an adult, and finds himself wondering why he can’t masturbate or have sex without lube. Why his skin chafes and gets sore if he tries to. Why he ends in pain if he does.

Or his girlfriend, wife, etc., wonders why she ends up with pain and burning inside her vagina after intercourse.

Oh, but it was just some extra skin, wasn’t it?

Oh, but the benefits outweigh the risks, don’t they?

I’m disgusted by the comments I see. Nobody should have to refer to a baby as a “trooper” or a “fighter” just because they allowed a doctor to harm the baby.

Notice the relative’s comment: “wish it was over for him or better yet it never happened“. Well, sad to say, but it wouldn’t have happened if it wasn’t for the circumcision. This injury was 100% preventable.

Another person says “somebody needs to answer a question about removing too much skin“. Well, they did. The AAP statement mentions the risk. Most consent forms mention the risk. They just don’t tell you how bad it really is when it happens. So parents assume that removing too much tissue is just a cosmetic problem. Not that it will involve bleeding, risk of infection (weren’t they trying to prevent infections anyway?), pain, additional surgeries… And what they don’t know yet, long term pain. During sex.

Notice the person who says one of her children had the same problem and the nurses told her that it was a “French cut” and “girls loved it“. The moment when the baby’s genitalia becomes sexualized to appease adults. This again proves that American circumcision is mostly a social fetish disguised as medicine, and that doctors and nurses will say anything to make parents feel good.

In fact, Googling “French cut circumcision” reveals that it something different. What is considered a European or French style circumcision is a low and loose circumcision, not one where excessive tissue was removed.

I’ve known many cases of men harmed in this way. Some became activists. Some have been restoring their foreskins for many years to reduce the pain.

I know a mother who had her first 3 children circumcised. She used to think the right circumcision was the one they did on her first born, the one that had a tight circumcision. Until he turned 4-5 and started expressing pain when he has erections. She is now an activist against circumcision, of course, and regrets the harm that came to her child.

Seeing this photo on Facebook today I can only think: Poor hurt baby. My heart breaks for you and all the other babies and the adults they become who were and will be harmed by this mindless unnecessary, risky and damaging surgery.

Is this harm always accidental?

A number of circumcision fetishists tend to favor “high and tight” circumcisions and often fixate on the removal of the frenulum – something which is necessarily sexual harm, given the sexual sensitivity and pleasure caused by an intact frenulum. And American doctors never mention what happens to the frenulum during circumcision – in fact the word “frenulum” is not even present on the AAP Technical Report on circumcision from 2012!

In this video, the makers of a circumcision device explain how to use their device for a tight circumcision with frenulum cauterization. In other words, to cause as much harm as possible!

One can only wonder… Why?

But they won’t answer.

 

FDA: Infant Circumcision… to detect hemophilia?

Contraindications to newborn circumcision
include significantly premature
infants, those with blood dyscrasias,
individuals who have a family history of
bleeding disorders[...]” -
AAP – Technical Report on Circumcision, 2012

A recent FDA article about treatments for hemophilia, quotes doctor Nisha Jain, M.D., chief of the Clinical Review Branch in FDA’s Office of Blood Research and Review, saying:

“Patients can be diagnosed as infants during circumcision”

Dr Nisha Jain, M.D

Dr Nisha Jain, M.D

The problem with this though is that these patients may die as a consequence of the bleeding caused by their circumcision. These deaths often go unreported. Babies are not tested for hemophilia prior to circumcision.

In March of 2013, baby Brayden Tayler Frazier was transferred to UC Davis Medical Center, Sacramento, CA, because he wouldn’t stop bleeding after his circumcision. He later went to seizures and finally died, 2 days later. His death was not reported on the media, and it was only because of activists scanning social media for circumcision-related topics, that the intactivist community learned of and followed this tragedy.

After the death, doctors and family were in denial that circumcision had anything to do with his passing. He had been sick, they argued. His initial sticks and pricks didn’t heal as quickly as normal, and yet in the face of this telltale sign, the circumcision was performed. It would be hard to deny that the massive bleeding that followed led to the catastrophic outcome.

Baby Brayden was treated with coagulants, platelets, plasma, everything to try, unsuccessfully, to save his life.

Another known victim was Ryan White (1971-1990). Again, his circumcision caused massive bleeding and so he was detected to be hemophiliac. In his case, it wasn’t the bleeding though what killed him, but the medication used to treat it;  weekly transfusions of Factor VIII,  a blood product created from pooled plasma of non-hemophiliacs, infected him with the HIV virus. He died from AIDS related complications.

That Dr. Jain thinks it’s fine to detect hemophilia on infants during circumcision is a disrespect to babies like Brayden and others who died from loss of blood and other related clotting disorders and conditions after their unnecessary and unethical circumcision.

Finally, only in the United States will doctors enable parents to risk their children’s health in the name of a social surgery. See this paper by Kuthan Kavakli et al, arguing that “Hemophilic boys (60%) and their parents (82%) have an inferiority complex because the boys are unable to be circumcised” – notice how the dissatisfaction of parents was higher (82%) than that of the boys (60%). Kavakli concludes that “circumcision is an important social problem of hemophilic patients that needs to be solved.

A social problem indeed, and rational minds wonder why not solve it with education. Maybe that is too much to ask.

 

 

NEW CIRCUMCISION “STUDY”: Complication Risks May Increase With Age – Does Medical Necessity?

“Circumcision fails to meet the commonly
accepted criteria for the justification of preventive
medical procedures in children. The cardinal
question should be not whether circumcision can
prevent disease, but how can disease best be
prevented.”
Frisch et al, Cultural Bias in the AAP’s 2012
Technical Report and Policy Statement on
Male Circumcision

Another day, another article. This time, it’s about a study by Charbel El Bcheraoui  published in JAMA Pediatrics, funded by the US Centers for Disease Control and Prevention (CDC). The study claims that “Male circumcision had a low incidence of AEs (adverse events – a euphemism for complications) overall, especially if the procedure was performed during the first year of life, but rose 10-fold to 20-fold when performed after infancy.

The question that El Bcheraoui circumvents is, however, are those circumcisions necessary? Without medical or clinical necessity, are those circumcisions ethical?

Without those considerations, this is nothing more than a sales pitch. “Circumcision! Buy now, or tomorrow it will be 20 times riskier,” El Bcheraoui seems to urge.

But, what are the chances a child will need to be circumcised later on in his lifetime?

What are the reasons a man would have to be circumcised at a later age? Do they increase with time? (Answer: No, they don’t. The majority of men who are left intact, stay that way.)

El Bcheraoui concludes that “Given the current debate about whether MC should be delayed from infancy to adulthood for autonomy reasons, our results are timely and can help physicians counsel parents about circumcising their sons” but this is nothing more than self-interested hogwash. The argument of bodily autonomy is mentioned but not expanded on. In effect, what the author is saying, without daring to say it, is that bodily autonomy can be violated in order to decrease the risk of complications; a risk the author already considers to be low.

If we were to extrapolate the reasoning behind this conclusion, it would be possible to argue that removing the breast buds from baby girls is easier, less traumatic and has less complications than waiting for breast cancer to develop and then perform mastectomies, where breast cancer is the second leading cause of cancer death in women.

The authors did not declare any conflict of interest. But of course it is not surprising that El Bcheroui is affiliated with the Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. Let’s just quickly remember that in 2009 the CDC was considering promoting universal circumcision to prevent the spread of HIV in the United States, despite pre-existing evidence (from the CDC nonetheless) that the high rates of circumcision in the United States had no effect over transmission of HIV.

It seems nowadays no circumcision article or “study” is complete without the obligatory “benefits outweigh the risks” soundbite from the 2012 AAP policy statement on circumcision. Of course, what is never mentioned is that this is only part of the statement, which is rarely ever quoted in its entirety:

“The American Academy of Pediatrics found the health benefits of newborn male circumcision outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision” - http://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Newborn-Male-Circumcision.aspx

Circumcision advocates love to quote the AAP, but they could not recommend circumcision in their last statement because, in their own words “the benefits were not great enough.” How is it lay parents are expected to analyze the same “benefits” which couldn’t convince an entire body of medical professionals, and somehow come to a more reasonable conclusion? Why are doctors expected to act on it, and why is the public purse expected to pay?

The AAP said in their last statement that “The true incidence of complications after newborn circumcision is unknown, in part due to differing definitions of “complication” and differing standards for determining the timing of when a complication has occurred (ie, early or late)” and catastrophic injuries were excluded from the report because they were reported only as case reports, not as statistics. The statement also indicates that “Financial costs of care, emotional tolls, or the need for future corrective surgery (with the attendant anesthetic risks, family stress, and expense) are unknown.”

In the opening statements of this study, El Bcheraoui estimates that 1.4 million circumcisions are performed in medical settings annually in the United States. This appears to contradict a previous statement by none other than El Bcheraoui himself, claiming a rate of 32.5% in 2009. Perhaps he expects the 2012 AAP Policy Statement to result in the resurgence of circumcision rates.

The study reviewed the medical history of approximately 1.4 million males circumcised between 2001 and 2010, and found that approximately 4,000 infants had suffered complications, leading them to calculate a rate of complications (adverse events) of less than 0.5%

This would mean, using the data they present, that every year, between 5,600 (0.4%) to 7,000 (0.5%) infant males will suffer complications from circumcision; circumcisions that will in all likelihood be medically unnecessary.

This would not include those complications that can be minor or undetected by the parents (skin tags, skin bridges, uneven scarring) or those that will not be detected until much later (pain caused by tight erections, lack of sensitivity).

The researchers note that some complications might not have been picked up because they were reviewing claims data on problems that typically occurred within the first month following the circumcisions.

This would likely exclude meatal stenosis. High prevalence of meatal stenosis has been found in circumcised males (see here and here), possibly as consequence of ischemia (poor blood supply) to the meatus or permanent irritation of the meatus caused by friction with the diaper and resulting in scarring.

A recent ecological analysis by Ann Z. Bauer and David Kriebel found a correlation (but not causation – further studies are needed) between early exposure to paracetamol and other analgesics, and autism spectrum disorders (ASD). This took into consideration that most newborn circumcisions before 1995 used no pain relief at all, but with growing awareness of the pain of circumcision and increasing use of paracetamol, a sudden rise on the rates of male ASD occurred.  According to this analysis a change of 10% in the population circumcision rate was associated with an increase in autism/ASD prevalence of 2.01/1000 persons (95% CI: 1.68 to 2.34) ”

These findings of course would not have been included in El Bcheraoui’s paper, as this would be out of existing billing codes and administrative claims within the first month from the procedure.

So, let’s just think for a moment, if these circumcisions are not necessary, if these circumcisions are “elective,” then what is the tolerance for errors and complications? El Bcheraoui claims that a 0.5% complication rate is low. But how low is it when it means 5,600 to 7,000 babies who will suffer complications annually? And what kind of complications are we talking about?

These low rates fail to explain the increasing rates of circumcision revisions as well.

How many cases like the one of David Reimer can we afford to have before it is ethically wrong, morally wrong? How many more like Jacob Sweet?

How many MRSA infections?

How many partial or full ablations of childrens’ penises, like that baby in Memphis and that other baby in Pittsburgh last year?

How many infections with Herpes?

How many deaths?

Catastrophic complications, rare or not, mean destroyed lives. Not numbers. And to destroy lives of innocent babies in the name of “religious, ethical and cultural beliefs” is simply not right. Because there is no medical indication for surgery in healthy, non-consenting minors, any complications above zero is ethically unconscionable.

Zimbabwe: Clinic cuts off boy’s little manhood during circumcision

12-year-old Bulawayo boy’s penis was cut off during circumcision. Although the boy was under local anaesthetic, he screamed as blood gushed out of his organ. The boy was admitted at the United Bulawayo Hospitals (UBH) where the cut off organ has been sewn back on. A source at UBH said while he was in stable condition, it was too early to know if his penis would be normal again. Population Services International (PSI) spokesperson Paidamoyo Magaya was unreachable for comment. PSI sponsors the circumcision drive in Zimbabwe.

Complete article: http://www.crazynews24.com/news/4856-clinic-cuts-off-boy-s-little-manhood-during-circumcision.html