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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
|last=Anonymous
|publisher=[[American Urological Association]]
|date=2018-10
|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 operateroperator", 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.
</blockquote>
== Issues Lack of experience with care of intact males 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 [[IntactiWikicircumcision]] is aware ,<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 a steady flow the functions<ref>{{REFweb |url=http://www.intactaus.org/information/functionsoftheforeskin/ |title=Functions of inquiries the Foreskin |last=Helard |first=Lou |init=L |author-link= |publisher=[[Intact Australia]] |date=2014-08-01 |accessdate=2023-04-08}}</ref> and complaints [[Foreskin sensitivity|sensations]] from the natural [[foreskinnedintact]] males who have consulted unnamed urologists for one reason or anotherforeskin. It appears that some American female urologists omit information on conservative, 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 preserving treatment and immediately recommend circumcision]].
The inquiries usually seek to validate information provided to This abysmal state of ignorance cannot serve the patient by the urologistpatients well. Patients with a narrow foreskin may be told Moreover, Muller (2010) found that well proven [[stretchingcircumcised doctors]] to generate are biased in favor of infant [[tissue expansioncircumcision]] won't work, so they will have to receive a 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 treat noncut? 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-retractile foreskin32 |url=https://www.arclaw.org/wp-content/uploads/Muller-Cut-or-not-cut-JMH-2010.pdf |format=PDF |accessdate=2023-04-08}}</ref>
Reports suggest that some urologists tend to omit information on the nature and function == Issues with care of the adult intact males ==The AUA does not have a published policy or position statement regarding [[foreskin]] from discussions with [[intactadolescent and adult circumcision| adolescent or adult circumcision]] patients.
The [[IntactiWiki]] is aware of a steady flow of inquiries and complaints usually are about efforts by the urologist to get a healthy patient to grant consent from [[foreskinned]] males who have consulted various unnamed urologists for a circumcisionone reason or another. 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/omit information/functionsoftheforeskin/ function]on conservative foreskin preserving treatment, and lifelong harm to the patientimmediately 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 [[Intactstretching]] males who consult a urologist should receive any recommendation for to generate [[Adolescent_and_adult_circumcision| adult circumcisiontissue expansion]] with extreme caution. Doing onewon's own research is advised t work, so one does not become one of the they will have to receive a [[regret menAdolescent and adult circumcision|circumcision]]to treat non-retractile foreskin.
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 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.
 
According to Spend On Health, a surgeon would get about $625.00 for an adult circumcision that takes about one hour to perform. The total cost can run as high as $6,110.00. Spend On Health advises that insurance may not 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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