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The American Urological Association: Wikify.
There are many '''issues with American urologists and the practice of male circumcision'''.
 
== Lack of experience with a normal body part ==
 
American male urologists are drawn from the general population in which the great majority of males have received a medically-unnecessary, non-therapeutic infant [[circumcision]],<ref name="laumann1997">{{REFjournal
|last=Laumann
|first=Edward O.
|init=EO
|author-link=
|last2=Masi
|first2=Christopher M.
|init2=CM
|author2-link=
|last3=Zuckerman
|first3=Ezra W.
|init3=EW
|author3-link=
|etal=no
|title=Circumcision in the United States
|journal=JAMA
|date=1997-04-02
|volume=277
|issue=13
|pages=1052-7
|url=http://www.cirp.org/library/general/laumann/
|pubmedID=9091693
|accessdate=2023-04-08
}}</ref> so most have no personal experience of the functions<ref>{{REFweb
|url=http://www.intactaus.org/information/functionsoftheforeskin/
|title=Functions of the Foreskin
|last=Helard
|first=Lou
|init=L
|author-link=
|publisher=[[Intact Australia]]
|date=2014-08-01
|accessdate=2023-04-08
}}</ref> and [[Foreskin sensitivity|sensations]] from the natural [[intact]] foreskin. American female urologists don't have male body parts so they also have no personal experience at all of the functions and sensations of the natural intact [[foreskin]].
 
This abysmal state of ignorance cannot serve the patients well. Moreover, Muller found that [[circumcised doctors]] are biased in favor of infant [[circumcision]], and may also be biased in favor of [[Adolescent and adult circumcision|adult circumcision]].<ref>{{REFjournal
|last=Muller
|first=
|init=AJ
|author-link=
|etal=no
|title=To cut or not to cut? Personal factors influence primary care physicians’ position on elective newborn circumcision
|journal=Journal of Men's Health
|date=2010-10
|volume=7
|issue=3
|pages=227-32
|url=https://www.arclaw.org/wp-content/uploads/Muller-Cut-or-not-cut-JMH-2010.pdf
|format=PDF
|accessdate=2023-04-08
}}</ref>
 
== The American Urological Association ==
The [[American Urological Association]] (AUA) is the [[medical trade association ]] for the American urological industry. It has the primary function of advancing the business interests and financial well-being of its members. The AUA is considered to be a source of pro-circumcision [[bias]]. A search for "circumcision" on its website produces 755 hits, so male circumcision is a major business interest of the urological industry.
A search for "circumcision" on its website produces 755 hits, so male [[circumcision]] is a major business interest of the urological industry.
=== AUA position statement ===
 Although obstetricians, pediatricians, and family doctors obtain most of the revenue from non-therapeutic infant circumcision, the AUA has provided a promotional position statement on infant [[circumcision]].<ref>{{REFweb
|url=https://www.auanet.org/about-us/policy-and-position-statements/circumcision
|title=Circumcision
|accessdate=2023-04-08
}}</ref> There are many issues with this statement:
* This statement misleadingly uses the word "potential" to suggest the existence of "benefits" that don't actually exist except in someone's imagination.''Potential'' means to exist in possibility but not in actuality.<ref>{{REFweb |url=https://www.thefreedictionary.com/potential |title=potential |last= |first= |init= |publisher=The Free Dictonary by Farlex |date=2013 |accessdate=2023-04-13}}</ref>* This statement claims that non-therapeutic circumcision is safe "when performed by an experienced operator", however , infant circumcision is frequently assigned to the most junior and least-experienced operator.* This statement claims that circumcision prevents [[phimosis]] and [[paraphimosis]], however , these are normal developmental conditions and not diseases.* This statement claims that circumcision prevents [[Balanitis| balanoposthitis]], however , the treatment for this inflammation depends on accurate diagnosis of the cause, followed by appropriate treatment.
* This statement claims that circumcision reduces [[urinary tract infection]] (UTI) by 90 percent, but it ignores the immunological functions of the [[intact]] foreskin.<ref>{{FleissP HodgesF VanHoweRS 1998}}</ref> The proper treatment for UTI is anti-microbial, not surgery.<ref name="McCracken 1989">{{REFjournal
|last=McCracken
|accessdate=2023-04-08
}}</ref>
* This statement claims that circumcision reduces the risk of HIV infection in Africa by 60 percent, however , the RCTs on which is based have been shown to have disabling statistical faults with only a 1 percent reduction at best.<ref>{{BoyleGJ HillG 2011}}</ref>* This statement proposes [[circumcision]] as a treatment for [[phimosis]] and [[paraphimosis]] in boys, but however, makes no mention of the effectiveness of non-invasive manual [[stretching]] to relieve phimosis and paraphimosis.* This statement proposes circumcision as a treatment for [[Balanitis| balanoposthitis]] , but fails to mention conservative, non-invasive, accurate diagnosis of the cause and specific appropriate treatment as a better alternative.<ref name="edwards1996">{{REFjournal
|last=Edwards
|first=Sarah
}}</ref>
* This statement completely excludes any mention of the important protective, immunological, sexual, and sensory functions of the [[foreskin]] which might dissuade a patient or his surrogate from granting [[Informed consent| consent]] for a foreskin [[amputation]].
* This statement is completely silent on [[human rights]] and [[medical ethics ]] issues concerning the non-therapeutic excision of normal, functional body parts from a minor who is too young to grant [[Informed consent| consent]].<ref name="aap1995">{{REFjournal |last=Bioethics Committee, American Academy of Pediatrics. |first= |author-link= |etal=no |title=Informed consent, parental permission, and assent in pediatric practice |trans-title= |language= |journal=Pediatrics |location= |date=1995-02 |volume=95 |issue=2 |pages=314-7 |url=http://www.cirp.org/library/ethics/AAP/ |archived= |quote= |pubmedID=7838658 |pubmedCID= |DOI= |accessdate=2023-04-24}}</ref>
When drafting this statement, it is evident that the AUA placed the income of its members above the legal rights, health, and well-being of American boys.
}}</ref>
</blockquote>
 
== Lack of experience with a normal body part ==
 
American male urologists are part from the general population in which the great majority of males have received a medically-unnecessary, non-therapeutic infant [[circumcision]],<ref name="laumann1997">{{REFjournal
|last=Laumann
|first=Edward O.
|init=EO
|author-link=
|last2=Masi
|first2=Christopher M.
|init2=CM
|author2-link=
|last3=Zuckerman
|first3=Ezra W.
|init3=EW
|author3-link=
|etal=no
|title=Circumcision in the United States
|journal=JAMA
|date=1997-04-02
|volume=277
|issue=13
|pages=1052-7
|url=https://jamanetwork.com/journals/jama/article-abstract/414922
|pubmedID=9091693
|accessdate=2023-04-08
}}</ref> so most have no personal experience of the functions<ref>{{REFweb
|url=http://www.intactaus.org/information/functionsoftheforeskin/
|title=Functions of the Foreskin
|last=Helard
|first=Lou
|init=L
|author-link=
|publisher=[[Intact Australia]]
|date=2014-08-01
|accessdate=2023-04-08
}}</ref> and [[Foreskin sensitivity|sensations]] from the natural [[intact]] foreskin. American female urologists don't have male body parts so they also have no personal experience at all of the functions and sensations of the natural intact [[foreskin]].
 
This abysmal state of ignorance cannot serve the patients well. Moreover, Muller (2010) found that [[circumcised doctors]] are biased in favor of infant [[circumcision]], and may also be biased in favor of [[Adolescent and adult circumcision|adult circumcision]].<ref>{{REFjournal
|last=Muller
|first=
|init=AJ
|author-link=
|etal=no
|title=To cut or not to cut? Personal factors influence primary care physicians’ position on elective newborn circumcision
|journal=Journal of Men's Health
|date=2010-10
|volume=7
|issue=3
|pages=227-32
|url=https://www.arclaw.org/wp-content/uploads/Muller-Cut-or-not-cut-JMH-2010.pdf
|format=PDF
|accessdate=2023-04-08
}}</ref>
== Issues with care of adult intact males ==
The AUA does not have a published policy or position statement regarding [[adolescent and adult circumcision| adolescent or adult circumcision]].
[[IntactiWiki]] is aware of a steady flow of inquiries and complaints from [[foreskinned]] males who have consulted various unnamed urologists for one reason or another. It appears that some urologists omit information on conservative, foreskin preserving treatment , and immediately recommend circumcision.
The inquiries usually seek to validate information provided to the patient by the urologist. Patients with a narrow foreskin may be told that well -proven [[stretching]] to generate [[tissue expansion]] won't work, so they will have to receive a [[Adolescent and adult circumcision|circumcision]] to treat non-retractile foreskin.
Reports The nature and function of the [[foreskin]] (prepuce) and its essential role in normal sexual intercourse has been known for many years,<ref name="cold1999">{{REFjournal |last=Cold |first= |init=CJ |author-link=Christopher J. Cold |last2=Taylor |first2= |init2=JR |author2-link=John R. Taylor |etal=no |title=The prepuce |trans-title= |language= |journal=BJU Int |location= |date=1999-01 |volume=83 Suppl 1 |issue= |article= |page= |pages=34-44 |url=http://artemide.bioeng.washington.edu/InformationIsPower/cold-taylor-prepuce_bju_1999_83_34-44.pdf |archived= |quote=The prepuce is primary, erogenous tissue necessary for normal sexual function. |pubmedID=10349413 |pubmedCID= |DOI=10.1046/j.1464-410x.1999.0830s1034.x |format=PDF |accessdate=2023-04-13}}</ref> yet reports suggest that some urologists tend to omit information on the nature and function of the [[foreskin]] from discussions with [[intact]] patients.
The complaints usually are about efforts by the urologist eager to get a healthy patient to grant consent for a an [[adult circumcision]]. It appears that some urologists try to enhance the revenue from their practice by doing more circumcisions, regardless of the [[trauma]], loss of [http://www.intactaus.org/information/functionsoftheforeskin/ function], and lifelong harm to the patient.
[[Intact]] males who consult According to Spend On Health, a urologist should receive any recommendation surgeon would get about $625.00 for [[Adolescent_and_adult_circumcision| an adult circumcision]] with extreme cautionthat takes about one hour to perform. The total cost can run as high as $6,110.00. Doing one's own research is advised so one does Spend On Health advises that insurance may not become one of the [[regret men]]cover adult circumcision.<ref>{{REFweb |url=https://spendonhealth.com/circumcision-cost/ |title=Average Cost Of Circumcision |last=Anonymous |first= |init= |publisher=Spend On Health |date=2023 |accessdate=2023-04-12}}</ref>
Masood et al. (2005) advised that urologists are informing men incorrectly. The authors said:
<blockquote>
"… we suggest that before circumcision, men should be warned of the long-term consequences (penile sensations and effect on erectile function) as well as be talked through the more traditional subjects (peri-operative complications)."<ref name="masood2005">{{REFjournal
|last=Masood
|init=S
|etal=yes
|title=Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly?
|journal=Urol Int
|date=2005
|volume=75
|issue=1
|pages=62-6
|url=http://www.cirp.org/library/sex_function/masood1/
|pubmedID=16037710
|pubmedCID=
|DOI=10.1159/000085930
|accessdate=2023-04-20
}}</ref>
</blockquote>
[[Intact]] males who consult a urologist should receive any recommendation for [[Adolescent_and_adult_circumcision| adolescent or adult circumcision]] with extreme caution. Doing one's own research is advised so one does not become another [[regret men| regret man]].
{{SEEALSO}}
* [[Adult circumcision]]
* [[Bias]]
* [[Circumcised doctors]]
* [[Financial incentive]]
* [[Phimosis]]
* [[Regret men]]
* [[Stretching]]
* [[Tissue expansion]]
{{REF}}
 
[[Category:Education]]
[[Category:Physicians]]
[[Category:Medical society]]
[[Category:USA]]
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