American urologists and the practice of male circumcision

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There are many 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,[1] so most have no personal experience of the functions[2] and sensations from the natural intact foreskin. American female urologists don't have male body parts so they also have no 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 adult circumcision.[3]

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.

A search for "circumcision" on its website produces 755 hits, so male circumcision is a major business interest of the urological industry.

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.[4] 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.
  • This statement claims that non-therapeutic circumcision is safe "when performed by an experienced operation", however infant circumcision is frequently assigned to the most junior and least-experienced operation.
  • This statement claims that circumcision prevents phimosis and paraphimosis, however these are normal developmental conditions and not diseases.
  • This statement claims that circumcision prevents 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.[5] The proper treatment for UTI is anti-microbial, not surgery.[6]
  • 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.[7]
  • This statement proposes circumcision as a treatment for phimosis and paraphimosis in boys, but makes no mention of the effectiveness of non-invasive manual stretching to relieve phimosis and paraphimosis.
  • This statement proposes circumcision as a treatment for balanoposthitis but fails to mention conservative, non-invasive, accurate diagnosis of the cause and specific appropriate treatment as a better alternative.[8]

References

  1. ↑ REFjournal Laumann, Edward O., Masi, Christopher M., Zuckerman, Ezra W.. Circumcision in the United States. JAMA. 2 April 1997; 277(13): 1052-7. PMID. Retrieved 8 April 2023.
  2. ↑ REFweb Helard, Lou (1 August 2014). Functions of the Foreskin, Intact Australia. Retrieved 8 April 2023.
  3. ↑ REFjournal Muller AJ. To cut or not to cut? Personal factors influence primary care physicians’ position on elective newborn circumcision PDF. Journal of Men's Health. October 2010; 7(3): 227-32. Retrieved 8 April 2023.
  4. ↑ REFweb Anonymous (October 2018). Circumcision, American Urological Association.. Retrieved 8 April 2023.
  5. ↑ REFjournal Fleiss P, Hodges F, Van Howe RS. Immunological functions of the human prepuce. Sex Trans Infect. October 1998; 74(5): 364-67. PMID. PMC. DOI. Retrieved 14 January 2022.
  6. ↑ REFjournal McCracken GH. Options in antimicrobial management of urinary tract infections in infants and children. Pediatr Infect Dis J. August 1989; 8(8): 552-555. Retrieved 8 April 2023.
  7. ↑ REFjournal Boyle GJ, Hill G. Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns PDF. Thompson Reuter. December 2011; 19(2): 316-34. PMID. Retrieved 30 December 2020.
  8. ↑ REFjournal Edwards S. Balanitis and balanoposthitis: a review PDF. Genitourin Med. 1996; 72: 155-9. PMID. PMC. DOI. Retrieved 9 April 2023.
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