Pain: Difference between revisions
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# Before circumcision surgery can commence, the surgeon must first forcibly separate these two highly innervated body parts in an exquisitely painful procedure by forcing a blunt probe between the two parts to destroy, rip and tear the [[synechia]] apart.<ref>{{REFjournal | # Before circumcision surgery can commence, the surgeon must first forcibly separate these two highly innervated body parts in an exquisitely painful procedure by forcing a blunt probe between the two parts to destroy, rip and tear the [[synechia]] apart.<ref name="bellini2022 /><ref>{{REFjournal | ||
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# Next, in another painful step, a [[dorsal slit]] must be cut in the foreskin, so that a special clamp can be installed. | # Next, in another painful step, a [[dorsal slit]] must be cut in the foreskin, so that a special clamp can be installed.<ref name="bellini2022 /> | ||
# The foreskin is erogenous tissue,<ref>{{REFjournal | # The foreskin is erogenous tissue,<ref>{{REFjournal | ||
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}}</ref> Nervous tissue requires a large blood supply, so the foreskin is richly vascularized with many blood vessels,<ref name="fleiss-hodges-vanhowe1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> therefore the foreskin must be crushed with one of several special clamps in yet another painful step before the circumcision can be carried out.<ref>{{REFjournal | }}</ref> Nervous tissue requires a large blood supply, so the foreskin is richly vascularized with many blood vessels,<ref name="fleiss-hodges-vanhowe1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> therefore the foreskin must be crushed with one of several special clamps in yet another painful step before the circumcision can be carried out.<ref name="bellini2022 /><ref>{{REFjournal | ||
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# Finally, in another, painful step, the foreskin must be cut away. | # Finally, in another, painful step, the foreskin must be cut away.<ref name="bellini2022 /> | ||
Lander et al. (1997) conducted a comparison neonatal non-therapeutic circumcision without anesthesia (current practice in 1997), ring block, dorsal penile nerve block, and a topical eutectic mixture of local anesthetics ([[EMLA]]).<ref name="lander1997">{{REFjournal | Lander et al. (1997) conducted a comparison neonatal non-therapeutic circumcision without anesthesia (current practice in 1997), ring block, dorsal penile nerve block, and a topical eutectic mixture of local anesthetics ([[EMLA]]).<ref name="lander1997">{{REFjournal | ||
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{{Box|Boxtext=<big><b>However, none of the above three procedures totally eliminate pain. A baby boy will still experience some pain and [[trauma]] despite any of those analgesic procedures. Prevention of pain requires protecting a boy from elective neonatal non-therapeutic circumcision. Only boys who are protected from the medically unnecessary circumcision surgery experience no pain or [[trauma]].</b></big>}} | {{Box|Boxtext=<big><b>However, none of the above three procedures totally eliminate pain. A baby boy will still experience some pain and [[trauma]] despite any of those analgesic procedures.<ref name="bellini2022 /> Prevention of pain requires protecting a boy from elective neonatal non-therapeutic circumcision. Only boys who are protected from the medically unnecessary circumcision surgery experience no pain or [[trauma]].</b></big>}} | ||
Wallerstein (1985)<ref>{{REFjournal | Wallerstein (1985)<ref>{{REFjournal | ||
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}}</ref> have suggested that it would be better to abandon the practice of non-therapeutic infant circumcision because of the pain associated with it. | }}</ref> have suggested that it would be better to abandon the practice of non-therapeutic infant circumcision because of the pain associated with it. | ||
The ''Daily Mail'' (2021) reported the pain stress of non-therapeutic neonatal circumcision increases the risk of SIDS, and that the incidence of Sudden Infant Death Syndrome (SIDS) is lower where baby boys are not circumcised.<ref name="thompson2021">{{REFnews | The ''Daily Mail'' (2021) reported the pain stress of non-therapeutic neonatal circumcision increases the risk of SIDS, and that the incidence of Sudden Infant Death Syndrome (SIDS) is lower where baby boys are not [[circumcised]].<ref name="thompson2021">{{REFnews | ||
|title=Circumcising newborn boys increases their risk of cot death due to the stress of the procedure - and could explain why it is more common in boys than girls, study finds | |title=Circumcising newborn boys increases their risk of cot death due to the stress of the procedure - and could explain why it is more common in boys than girls, study finds | ||
|url=https://www.dailymail.co.uk/health/article-5998771/Circumcising-newborn-boys-increases-risk-cot-death-stress-procedure.html | |url=https://www.dailymail.co.uk/health/article-5998771/Circumcising-newborn-boys-increases-risk-cot-death-stress-procedure.html | ||
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==Standard of care== | ==Standard of care== | ||
It is now clear that boys are born with healthy | It is now clear that boys are born with a healthy [[foreskin]] without evidence of disease. Therefore there are no indications for infant [[circumcision]], which is a non-therapeutic and medically-unnecessary surgical operation.<ref name="cps1996">{{REFjournal | ||
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}}</ref> so the pain of the surgery is not usually a concern. That does not mean that the operation is pain free. It is not. | }}</ref> so the pain of the surgery is not usually a concern. That does not mean that the operation is pain free. It is not pain free.<ref name="bellini2022 /> | ||
* There is, of course, post-surgical pain, which may be relieved by a potent oral analgesic. One should have a two-week supply of analgesic medicine. | * There is, of course, post-surgical pain, which may be relieved by a potent oral analgesic. One should have a two-week supply of analgesic medicine. | ||