Difference between revisions of "Adolescent and adult circumcision"

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[[Category:Circumcision]]
 
[[Category:Circumcision]]

Revision as of 10:46, 21 December 2020

Construction Site

This article is work in progress and not yet part of the free encyclopedia IntactiWiki.

 

Adolescent and adult circumcision is rare when compared to the millions upon millions of medically-unnecessary, non-therapeutic circumcisions of boys that are carried out in Islamic nations, Israel, the United States, and elsewhere.

Reasons for circumcision

All circumcisions are injurious because they amputate a multi-functional body part, but in some cases the benefit obtained by removing a deformed, diseased, or damaged foreskin may be of more value than the lost foreskin.

  • Deformed foreskins — The common type of deformed foreskin is the narrow non-retractable foreskin of phimosis. Circumcision is the traditional treatment for phimosis, however circumcision is less performed today because newer conservative treatments are now available that preserve the foreskin and its many useful functions.
  • Damaged foreskins — This is includes any type of physical trauma and injury which is beyond surgical repair. Zipper injury usually does not require circumcision.[2] [3]

Some adult males may seek non-therapeutic circumcision because of a conversion to Judaism or Islam. Others may simply want a circumcision because they like the physical appearance, to fit into a society where most men are circumcised, or for some personal whim.[4]

A word to intact teens

Boys are born with a foreskin that is non-retractable for reasons of protection. The inner surface is fused with the glans penis by a synechia (similar to a fingernail that is glued to the nail bed of the finger). Also the tip of the foreskin is too narrow to retract. As a boy gets older, the synechia disintegrates and releases the foreskin and the foreskin gets wider as a boy ages, so the foreskin gradually becomes retractable. Some boys go through puberty but find that their foreskin is still to narrow to permit retraction. The traditional way of addressing this issue was to consult a urologist and get a circumcision, however we now understand that in the vast majority of cases, manual stretching over a few months will widen the foreskin by tissue expansion, make the foreskin retractable and eliminate the need for a destructive circumcision.

Methods of adult circumcision

Dorsal slit

Dorsal slit is a cut on the top of the foreskin to open it. This allows the foreskin to fall below the shaft of the penis. Dorsal slit does not cut around and does not remove tissue, so it is not a true circumcision. Dorsal slit is a first step in the circumcision of a phimotic foreskin by the sleeve technique.[4]

Sleeve technique

Holman & Stuessi (1999) said patients should be advised of alternatives to circumcision.

They reported the indications for adult circumcision are uncommon. The most common is phimosis.

They recommended dorsal penile nerve block or ring block local anesthesia for the pain of circumcision surgery.

Informed consent must be obtained. They stated:

Specifically, the patient should be told about the risks of bleeding, hematoma formation, infection, inadvertent damage to the glans, removal of too much or too little skin, aesthetically unpleasing results and a change of sensation during intercourse. The patient should also be informed that, during the postoperative period, erections can cause pain and disruption of the suture line that may require replacement of the sutures. Full recovery following circumcision generally requires four to six weeks of abstinence from all genital stimulation and sexual activity.[4]

Shang ring

Rite of passage

In some cultures, circumcision is viewed as a rite of passage, and a male may not be considered a privileged adult until he has undergone circumcision.

Aborigines

The indigeous people of Australia, the Aborigines, have variously practiced subincision and circumcision on adolescents and adults since before the first contact with Europeans.

Ulwaluko

Traditional Circumcision and Initiation into Manhood (ulwaluko) is an ancient initiation ritual practiced by the amaXhosa of the Eastern Cape. The ritual is traditionally intended as a teaching institution to prepare boys for the responsibilities of manhood. The principles that lie at the very core of the ritual are respect for self (including self control and integrity), respect for family (not to bring shame to them), and respect for community (to protect them from harm).

Every single initiation season the media writes about complications accompanying the ritual of Traditional Circumcision and Initiation into Manhood (ulwaluko). The magnitude of these complications is horrific, from 1995 till 2014, 919 boys have lost their lives in the mountains and hills of the Eastern Cape. Many others were mutilated or even lost their manhood.

See also

External links