Changes

Jump to navigation Jump to search

Pain

1,937 bytes added, 00:45, 29 November 2020
Add adult section.
}}</ref>
Taddio & colleagues (1995)(1997) studied the effect of neonatal circumcision on the behavior of boys after surgery and at the time of vaccination. It was found that circumcised boys had a higher pain response at time of vaccination sixth six months later as compared with intact boys,<ref name="taddio"1995">{{REFjournal
|last=Taddio
|init=A
</blockquote>
John Rhinehart, M. D., (1999) a clinical psychiatrist, reported finding numerous cases of PTSD in his adult male patients pursuant to infant circumcision.<ref>{{REFjournal
|last=Rhinehart
|init=J
}}</ref>
Surgical operation on infants without anesthesia continued for well over a century, at least until 1987, when the [[American Academy of Pediatrics]] was forced to issue a CYA statement that called for the use of anesthesia.<refname="poland1987">{{REFjournal
|last=Poland
|first=Ronald L.
====Finding an ethical way to do painful non-therapeutic circumcision====
The finacially and psychologically vested circumcision industry suddenly found itself in a predicament. It was now suddenly proven beyond the any shadow of a doubt that newborn baby boys can feel intense pain. Medical ethics and the standard of care now required necessitated pain relief, however it is dangerous to give general anesthesia to neonates. Wallerstein (1985) had proposed that routine (non-therapeutic) circumcision of baby boys be eliminated just as routine tonsillectomy and adenoidectomy previously had been eliminated,<ref name="wallerstein1985">{{REFjournal
|last=Wallerstein
|first=Edward
|DOI=
|accessdate=2020-11-15
}}</ref> however this clearly would not dofor the avid pro-circumcision lobby. No circumcision equals no fee for surgery. The take financial gain from discontinuing non-therapeutic circumcision is just too high to discard. Bollinger (2012) estimated that the total annual cost of non-therapeutic circumcision to Americans is $3,647,000,000.<ref>{{REFweb
|url=https://www.academia.edu/6442587/High_Cost_of_Circumcision_3_6_Billion_Annually
|archived=
|format=PDF
|quote=
}}</ref> The avaricious American circumcision industry is simply not willing to give that lucrative income up, so a way to make non-therapeutic circumcisions in infancy acceptable had to be found.
Three methods were proposed:
|author6-link=
|etal=no
|title=Post-circumcision analgesia--a analgesia—a prospective evaluation of subcutaneous ring block of the penis
|journal=Anesthesiology
|location=
|DOI=10.1097/00000542-198709000-00019
|accessdate=2020-11-18
}}</ref> Ring block is considered the most effective analgesic procedure for neonatal non-therapeutic circumcision. Infant boys feel less pain and suffer less trauma than with the other two pain reduction procedures.<ref name="lander1997" /> <ref name="stang1997">{{REFjournal
|last=Stang
|first=Howard J.
}}</ref>
The standard of care now requires analgesia if elective neonatal non-therapeutic circumcision is to be carried out. <ref name="poland1987" /> <ref name="aap1999">{{REFjournal |last=Lannon |init=CM |first=Carole M. |author-link= |last2=Bailey |init2=AGD |first2=Ann Geryl Doll |author2-link= |last3=Fleischman |init3=AR |first3=Alan R. |author3-link= |last4=Kaplan |init4=G |first4=George |author4-link= |etal=yes |title=Circumcision policy statement |trans-title= |language=English |journal=Pediatrics |location= |date=1999-09 |volume=103 |issue=3 |pages=687-93 |url=http://www.cirp.org/library/statements/aap1999/ |archived= |quote= |pubmedID=22926180 |pubmedCID= |DOI=10.1016/j.juro.2013.06.094 |accessdate=2020-11-19}}</ref>
<b>None However, none of the above three procedures described above totally eliminate pain. A baby boy will still experience some pain with 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 feel experience no pain or trauma.</b>
==Attitudes and practices regarding analgesia for newborn circumcision==
</blockquote>
The [[American Academy of Pediatrics]] convened a new task force on circumcision under the chair of Carole M. Lannon, M. D. That task force reversed the position previously taken under [[Edgar J. Schoen]]. It clearly stated that non-therapeutic infant circumcision is "not essential to the child’s current well-being." It provided an extensive discussion of procedural analgesia and said, quite strongly, that, if a circumcision is done, procedural analgesia should be provided.<ref>{{REFjournal |lastname=Lannon |init=CM |first=Carole M. |author-link= |last2=Bailey |init2=AGD |first2=Ann Geryl Doll |author2-link= |last3=Fleischman |init3=AR |first3=Alan R. |author3-link= |last4=Kaplan |init4=G |first4=George |author4-link= |etal=yes |title=Circumcision policy statement |trans-title= |language=English |journal=Pediatrics |location= |date=1999-09 |volume=103 |issue=3 |pages=687-93 |url=http://www.cirp.org/library/statements/"aap1999" / |archived= |quote= |pubmedID=22926180 |pubmedCID= |DOI=10.1016/j.juro.2013.06.094 |accessdate=2020-11-19}}</ref>
Kraft (2003) reported that "many health care practitioners routinely perform this procedure without the use of any or with inadequate or ineffective analgesia and anesthesia."<ref name="kraft2003">{{REFjournal
<youtube>SLhEoOQhsVw</youtube>
 
==Adolescent and adult circumcision==
 
Adolescent and adult circumcision are usually carried out under total anesthesia, either by nerve block or by general anesthesia, so the pain of the surgery is not usually a concern. That does not mean that the operation is pain free. It is not.
 
The recovery period for adolescent and adult circumcision is usually placed at six weeks. During that period of time, many patients experience pain when they they have involuntary nocturnal erections and the erection tightens the residual skin and pulls at the incision and suture.<ref>{{REFjournal
|last=Dai
|init=
|first=A-Juan
|author-link=
|last2=Li
|init2=
|first2=Miao
|author2-link=
|last3=Wang
|init3=
|first3=Li-Li
|author3-link=
|last4=Wang
|init4=
|first4=Xiao-Hua
|author4-link=
|last5=Huang
|init5=Yu-Hua
|first5=
|author5-link=
|last6=
|init6=
|first6=
|author6-link=
|last7=
|init7=
|first7=
|author7-link=
|last8=
|init8=
|first8=
|author8-link=
|last9=
|init9=
|first9=
|author9-link=
|etal=yes
|title=Improvement of Erection Related Incision Pain in Circumcision Patients using Interrupted Rapid Eye Movement Sleep: A Randomized Controlled Study
|trans-title=
|language=English
|journal=Urol J
|location=
|date=2018
|volume=15
|issue=3
|pages=126-31
|url=https://journals.sbmu.ac.ir/urolj/index.php/uj/article/view/3981
|archived=
|quote=
|pubmedID=29308579
|pubmedCID=
|DOI=10.22037/uj.v0i0.3981
|accessdate=2020-11-28
}}</ref> In a few cases, the erections may cause [[wound dehiscence]] which requires additional surgery to re-close the surgical wound.
{{SEEALSO}}
15,548
edits

Navigation menu