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Cepeda'''Posthectomy''' is the more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical [[euphemism]], ''circumcision'', is more commonly used.With reference to involuntary, non-Emiliani et altherapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a newer term that has been introduced to avoid issues associated with more traditional terms. Bollinger (2023) commentedidentifed CGC as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]].<ref name="bollinger2023">{{REFjournal |last=Bollinger |init=D |author-link=Dan Bollinger |last2= |init2= |author2-link= |url=https://kindredmedia.org/2023/02/adverse-childhood-experiences-dysfunctional-households-and-circumcision/ |title=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision. |journal=Kindred |date=2023-02-28 |volume= |issue= |pages= |accessdate=2023-03-01}}<blockquote/ref>Taking the sleve technique as an example of surgical flexibility during circumcision, to the extent that this technique is of such versatility that it allows highly variable quantities of cutaneous and subcutaneous tissue to be excised directly from Deacon & Muir (2022) have reviewed the penile body, evidence and to the extent concluded that the prepuce "there is still conceived by segments of the no medical community as "just justification for performing a small piece of skin", we are concerned circumcision prior to an age that aggressive circumcisions are intentionally or unintentionally being performed in pediatric he can assess the known risks and adult patients in the belief that "redundant" or " extra" tissue is being excisedpotential benefits, and choose to give or in the belief that "excesive sensitivitywithhold [[informed consent]] himself." is being reduced to augment ejaculatory latency time.<ref name="cepeda2023deacon2022">{{REFjournal |last=Cepeda-EmilianiDeacon |first=Matthew |init=AM |author-link=Alfonso Cepeda-Emiliani |last2=Gándara-Cortés Muir |first2=Gordon |init2=MG
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'''Posthectomy''' is a more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical The [[euphemismamputation]], ''circumcision'', is more commonly used. With reference to involuntary, non-therapeutic circumcision of children, the [[Child Genital Cutting (CGC)foreskin]] is a newer term that has been introduced very old ritual, whose exact origin cannot be verified beyond doubt. Circumcision is believed to avoid issues associated with more traditional terms. Bollinger (2023) identifed CGC as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]]have originated in east Africa near the Red Sea well before the dawn of recorded history.<ref name="bollinger2023demeo1997">{{REFjournalREFbook |last=BollingerDeMeo |initfirst=D |author-link=Dan Bollinger |last2year=1997 |init2= |author2-linktitle=The geography of sexual mutilations |url=https://kindredmediawww.academia.org/2023edu/02/adverse-childhood-experiences-dysfunctional-households-and-circumcision4212007/The_Geography_of_Male_and_Female_Genital_Mutilations |titlework=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision.Sexual Mutilations: A Human Tragedy |journaleditors=KindredGeorge C. Denniston, Marilyn Milos |dateedition=2023-02-28 |volume= |issuechapter= |pages= |location=New York |publisher=Plenum |isbn=0-306-45589-7 |quote= |accessdate=20232021-0311-0113 |note=}}</ref>Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.
Deacon & Muir (2022) have reviewed [[Image:Circumcision Sakkara 3.jpg|200px|right]] For the [[Aborigines]], the [[Australia| Australian]] natives, the evidence and concluded that "there tradition of circumcision is no medical justification for performing a circumcision prior said to go back to an age that he can assess 10,000 BC. On the known risks and potential benefitsAfrican continent, and choose the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to give or withhold [[informed consent]] himselfthe time around 3000-2000 BC."The oldest known depiction<ref name="deacon2022">{{REFjournal |last=Deacon |first=Matthew |init=M |author-link= |last2=Muir |first2=Gordon |init2=G |author2-link= |etal=no |title=What is the medical evidence on non-therapeutic child circumcision? |journal= Int J Impot Res |date=2022-01-08REFweb |url=https://wwwcommons.naturewikimedia.comorg/articleswiki/s41443-021-00502-yFile:Circumcision_Sakkara_3.jpg |pubmedIDtitle=34997197 |DOI=10File:Circumcision Sakkara 3.1038/s41443-021-00502-y jpg |accessdate=20222019-0110-3012}}</ref>is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times. In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the [[amputation]] of the [[foreskin]] is seen as the removal of an inborn piece of femininity from the boys, thus making them men.
The practice of non-therapeutic circumcision of boys has greatly declined in [[Australia]], [[Canada]], [[New Zealand]] and the [[United Kingdom]]. It has been gradually declining since 1985 in the [[United States]].===Judaism===
== Historical background ==In [[Judaism]], the tradition of [[Brit Milah| circumcision]] goes back to the [[Abrahamic covenant]] in a passage in the Book of Genesis (17:10-14). It is seen as a covenant between God and man, dating back to the patriarch Abraham. The validity of this passage is increasingly being questioned.
The {{Citation |Text=10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any [[uncircumcised]] male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” |Author=Bible |Source=Gen 17, 10-14, NIV}} According to the anthropologist and sociologist Rabbi Nissan Rubin, the [[Jewish circumcision| Jewish form of circumcision]], called ''[[Brit Milah| brit mila]]'', during the first two millennia did not include the later customary ''[[amputationperiah]] '', namely the complete scraping of the inner [[foreskin]] from the [[Glans penis|glans]]. This was only added around 135 AD, to make it almost impossible to restore the [[foreskin]] by [[stretching]], which became popular in the wake of Hellenic influence. While originally only the tip of the [[foreskin]] was cut off, ''[[periah]]'' removes the entire [[foreskin]]. In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, circumcision is a very old followed by the ''[[mohel]]'', the ritualcircumciser, whose exact origin cannot sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an infection with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of whom had to be verified beyond doubttreated in hospital. Circumcision is believed Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] claimed that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to have originated a degree just sufficient for mere reproduction. ===Christianity===Jesus was born into a Jewish family in east Africa near Israel, where [[Judaism]] was the Red Sea well before prevailing religion, so He was [[circumcised]] on the dawn of recorded historyeighth day.<ref name="demeo1997">{{REFbookREFweb |url=https://www.biblegateway.com/passage/?search=Luke+2%3A21&version=NASB |title=Gospel of Luke |last=DeMeoLuke
===Judaism===Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent [[masturbation]]. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a variety of diseases. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support for the belief that it is somehow immoral or sinful.
In Even the mere existence of a [[Judaismforeskin]]was linked to many illnesses. Among them one could find syphilis, epilepsy, paralysis of the tradition spine, bed wetting, scoliosis (spinal deformity), paralysis of [[Brit Milah| the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision]] goes back to the was [[Abrahamic covenantJohn Harvey Kellogg]] in a passage in , co-inventor of the Book of Genesis (17:10-14)corn flakes bearing his name. It is seen as a covenant between God and manIn 1888, dating back to the patriarch Abraham. The validity of this passage is increasingly being questioned.he wrote:
In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, Reasons for performing circumcision is followed range widely by the ''[[mohel]]''culture, the ritual circumciserreligion, sucking blood from the wound with his mouth. This practice is highly controversiallocation, as it can result in an infection with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] claimed that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproductionage.
In Christianity, === Medical indication ===There are no [[medical indication| medical indications]] for circumcision is practiced only in Coptic churchesof the newborn. There is no general belief that The circumcision industry offers circumcision is a requirement of Christianitythe newborn to the public because of the [[financial incentive]]. The form of circumcision adopted by the medical community essentially was equivalent to the Jewish form with ''[[periah]]'', so it inflicted the maximum injury.<ref name="hill2004">{{REFweb In a few cases |url=https://wwwwith older patients, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed.cirpIn other cases, a patient may be suffering from a severe case of [[phimosis]].org/pages/cultural/christianOverall, the actual medical necessity for circumcision is extremely rare since many conditions respond to conservative treatment.php |title=The Holy BibleAll circumcisions injure the patient by amputating the [[foreskin]] its with many protective, Circumcisionimmunological, False Prophetssensory, and Christian Parents sexual [[Foreskin#Physiological_functions|last=Hillfunctions]]. |first=George |author-link=George Hill |publisher=Circumcision Reference Library |website= |date=2004-08-29 |accessdate=2019-11-10 |format=HTML |quote=The falseness of those who advocate # '''Deformed or malformed foreskin'''. A foreskin so deformed or malformed that it does not function properly may be removed by circumcision is a recurrent theme in the New Testament. }}</ref>
Nevertheless, Christian moral notions had decisive influence on the spread of this practice# '''Traumatically injured foreskin'''. In the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent [[masturbation]]. In those days, this A foreskin so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for traumatically damaged foreskin that cannot be surgically repaired is a variety of diseases. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support valid medical reason for the belief that it is somehow immoral or sinfulcircumcision.
Even the mere existence of # '''Diseased foreskin.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, [[foreskinBalanitis#Diabetic_males| yeast infection in men with diabetes]] was linked to many illnesses. Among them one could find syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision was recurrent [[John Harvey Kelloggbalanoposthitis]], co-inventor of the corn flakes bearing his name. In 1888, he wrote:
{{Citation |Text=A remedy which is almost always successful in small boys is circumcisionIn such cases, especially when there is any degree the benefit of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as removing the brief pain attending problem foreskin may exceed the operation will have a salutary effect upon maleficial harms of tissue and function destruction. ====Arguments of prophylaxia====Though the mind, especially if it be connected with the idea practice of ritual circumcision of punishmentmales, as it may well be in some cases. In femalesboth consenting and non-consenting, the author has found existed for millenia, the application of pure carbolic acid search for "potential medical benefits" began relatively recently. {''Potential'' means to the [[clitoris]] an excellent means of allaying the abnormal excitementexist in possibility, and preventing the recurrence of the practice but not in those whose will-power has become actuality, so weakened that the patient a "''potential'' benefit" is unable to exercise entire self-controlnot a genuine proven benefit. ) |Author=[[John Harvey Kellogg]]The discussion of circumcision in the Ninth Edition of the ''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or function.<ref>{{REFweb |Sourceurl=https://www.cirp.org/library/history/encyclopaediabritannica1876/ |reftitle=<ref>{{REFbookCircumcision |last=KelloggCheyne |first=John Harvey |init=JHT. K. |author-link=John Harvey Kellogg |urlpublisher=https://archive.org/details/plainfaorold00kell/page/290Encyclopǽdia Brittanica |chapterwebsite=Treatment for Self-abuse and Its EffectsCircumcision Reference Library |titledate=Plain Facts for Old and Young1876 |locationaccessdate=Burlington, Iowa |publisher=F. Segner & Co.2019-11-10 |yearformat=1888 |pagequote=107
}}
===Islam===In [[Islam]]Initially, circumcision is also religiously founded, even though there is no mention of it was adopted in the Koran itself. According 19th century as a way to traditionstop boys and men from masturbating, the Prophet Mohammed was born without a when [[foreskinmasturbation]]. It is seen as a sign of prophets that they are born without a [[foreskin]] already. It is considered an honour was claimed to "resemble be the example of the Prophet", meaning to be [[circumcised]]cause for many diseases. In Islam, unlike [[Judaism]], there is no specific age at which As the myth that circumcision should be performed. Most circumcisions take place at ages between 6 and 10 yearsprevented masturbation became debunked, but advocates of circumcision began the range goes from birth great search to adulthoodfind the "medical benefits" of circumcision.
Reasons All claims that circumcision prevents future disease are false.<ref>{{REFweb |url=https://www.doctorsopposingcircumcision.org/for performing -professionals/alleged-medical-benefits/conclusions-and-references/ |title=Conclusions |last=Anonymous |first= |init= |publisher=Doctors Opposing Circumcision |date=2016 |accessdate=2023-10-22}}</ref> They are made to enable a physician to perform circumcision range widely by culture, religion, location, and agecollect a fee.
Many cultures perform The practice of finding prophylactic reasons for infant circumcision as a rite of passage into manhood. This is common started in the Middle East and amongst some indigenous African and Southeast Asian peoples. The [[United States]] and Israel are the only industrialized countries Germany in the world to have a high incidence of nineteenth century, when non-therapeutic Jewish Germans criticized the Jewish practice of infant male circumcision. The vast majority as being barbaric, Jewish doctors sprang to the defense of infant circumcisions performed in the United States are for non-religious, nonpractice by claiming health benefits.<ref name="ephron2001">{{REFbook |last=Ephron |first=John M. |init=JM |author-medical reasonslink= |year=2001 |title=Medicine and the German Jews |url=https://www. See [[History of circumcision]]cirp.org/library/history/ephron1/ |work= |editor= |edition= |volume= |chapter=6 |pages=222-33 |location=ReligiousNew Haven |publisher={{UNI|Yale University|Yale}} Press |isbn=0-300-08377-7 |quote=The circumcision of newborn boys is seen as a [[Abrahamic covenant |accessdate=2019-11-20 | divine commandment]] in note=}}</ref> And so started the [[Judaism| long tradition of Jewish faith]]. Though absent in the Koran, male doctors inventing reasons for circumcision is considered a religious requirement in [[Islam]], (and it is performed on male children of varying ages. Converts to these faiths may also choose to undergo [[Adolescent and adult circumcision| circumcision]], but it is not always requireddeceving gentile doctors).
=== Medical indication ===There are no [[medical indication| medical indications]] for circumcision of Following the newborn. The circumcision industry offers circumcision discovery of the newborn to the public because bacteria as a cause of many diseases – such as tuberculosis – the [[financial incentive]]search began for other illnesses that could be prevented by circumcision.
The form In 1870 the prominent Dr. [[Lewis Albert Sayre|Lewis A. Sayre]] of circumcision adopted by NYC’s famed Bellevue Hospital<ref>https://nypost.com/2016/12/03/bellevues-doctors-invented-the medical community essentially was equivalent -procedures-you-take-for-granted/</ref> claimed to the Jewish form cure a boy’s paralyzed legs with circumcision. Sayre''s wild advocacy of circumcision exemplified how some [[periahhttps://intaction.org/circumcision-facts-and-myths/ circumcision facts and myths]]''originated. He also claimed to cure epilepsy, mental disorders, hip-joint pain, so it inflicted & hernias with circumcision. “Genital irritations” & masturbation were deemed to be the cause of these issues. Sayre was later elected as the President of the American Medical Association. <ref>American Medical Association. Transactions of the maximum injuryAmerican Medical Association.1870;21:205–11</ref>
# '''Traumatically injured foreskin'''In the 1940s, prostate and tongue cancer as well as STDs. A foreskin so traumatically damaged foreskin [[Eugene H. Hand]] (1949) falsely explains that cannot be surgically repaired is a valid medical reason for circumcisionsomehow protects against venereal diseases and tongue cancer.<ref name="hand1949">{{REFjournal |last=Hand |first=Eugene H. |init=EH |author-link=Eugene H. Hand |url=https://pubmed.ncbi.nlm.nih.gov/18135844/ |title=Circumcision and venereal disease |journal=Archives of Dermatology and Syphilology |date=1949-09 |volume=60 |issue=3 |pages341-6 |pubmedID=18135844 |DOI=10.1001/archderm.1949.01530030037004 |accessdate=2021-10-08}}</ref>
# '''Diseased foreskinIn the 1950s it was cervical cancer.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, [[Balanitis#Diabetic_males| yeast infection in men with diabetes]], and recurrent [[balanoposthitisAbraham Ravich]](1951) invents the myth that circumcision reduces the risk of women getting cervical cancer.<ref name="ravich1951">{{Ravich1951}}</ref>
====Arguments of prophylaxia====Though In the practice of ritual circumcision of males, both consenting 1970s bladder- and non-consenting, has existed for millenia, the search for "potential medical benefits" began relatively recently. {''Potential'' means to exist in possibility, but not in actuality, so a "''potential'' benefit" is not a genuine proven benefitrectal cancer.[[Abraham Ravich]] (1971) The discussion of claims that circumcision in the Ninth Edition of the ''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or functionwould prevent bladder cancer and rectal cancer.<ref>{{REFweb |url=https://www.cirp.org/library/history/encyclopaediabritannica1876/ |title=Circumcision |last=Cheyne |first=T. K. |author-link= |publisher=Encyclopǽdia Brittanica |website=Circumcision Reference Library |date=1876 |accessdate=2019-11-10 |format= |quote=Ravich1971}}</ref>
Initially, circumcision was adopted in In the 19th century as a way to stop boys and men from masturbating1980s, when UTIs. [[masturbationThomas E. Wiswell]] was claimed to be the cause for many diseases. As the myth (1985) claims that circumcision prevented masturbation became debunked, advocates of circumcision began using a methodologically flawed report, reduces the great search to find the "medical benefits" risk of circumcision. Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensationurinary tract infections.<ref name="taylor1996wiswell1985"/> In the past, some advocates of mass circumcision have considered the [[prepuce]] to be a "mistake of nature,"<!--{{Cold and Wiswell (1995)}} REFjournal | [[Template:Cold and last=Wiswell (1995) |see more]]--> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantagesfirst=Thomas E.<ref name |init="cold-mcgrath1995">{{REFbookTE |lastauthor-link=ColdThomas E. Wiswell |firsturl=Christopherhttps://pediatrics.aappublications.org/content/75/5/901 |inittitle=CDecreased incidence of urinary tract infections in circumcised male infants |last2journal=McGrathPediatrics |first2date=KennethMay 1985 |init2volume=K75 |author2-linkissue=Ken McGrath5 |yearpages=1999901-3 |titleaccessdate=Male and female circumcision: medical2019-10-12}}</ref> [[Aaron J. Fink]] (1986), legalwith no evidence whatsoever, and ethical considerations in pediatric practiceclaims that circumcision protects against [[AIDS]] followed.<ref name="fink1986">{{REFjournal |urllast=https://www.cirp.org/library/anatomy/cold-mcgrath/Fink |workfirst=Aaron J. |editorinit=AJ |editionauthor-link=Aaron J. Fink |volumetitle=A possible explanation for heterosexual male infection with AIDS |chapterjournal=Anatomy and histology New England Journal of the penile and clitoral prepuce in primatesMedicine |pagesdate=1986-10-30 |locationvolume=New York31 |publisherissue=18 |isbnpage=03064613151167 |quoteurl=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818 |accessdateDOI=2019-10-12.1056/NEJM198610303151818 |noteaccessdate=2019-11-20
All claims that Retrospectively, circumcision prevents future was always advertised as a cure for whatever disease are falsewas in the public spotlight at the time. [[Doctors Opposing Circumcision (D.O.C.)]] (2016) state:<blockquote>These claims date originally from before the advent of evidence-based medicine, when doctors relied on the opinions of other clinicians to inform their practice, rather than on scientifically collected evidence.<refname="doc2016">{{REFweb |url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/conclusions-and-references/ |title=ConclusionsAlleged Medical Benefits |lastpublisher=Anonymous[[Doctors Opposing Circumcision (D.O.C.)]] |firstwebsite= |initdate=2016-05 |publisheraccessdate=Doctors Opposing Circumcision2019-11-20 |dateformat=2016 |accessdatequote=2023-10-22}}</ref> They </blockquote> The sheer mass of studies and publications that were released during those almost 180 years on this topic are made to enable a physician to perform the reason that even arguments that have been disproved multiple times, especially regarding infant and child circumcision and collect a fee, tenaciously persist up until today. An ever-recurring element of initiation rites found in many different cultures is the fixation upon the genitalia.
===Search for prophylactic reasons===It reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian [[Aborigines]], as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open in a [[subincision]], resulting in a partly or completely divided [[urethra]].
The practice Another known, particularly massive, intervention is the stripping of finding prophylactic reasons for infant circumcision started in Germany in the nineteenth centuryentire [[skin]] off the [[penis]]. In Indonesia, when non-Jewish Germans criticized boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the Jewish practice beginning of infant circumcision as being barbaricpuberty, Jewish doctors sprang to the defense of the religious practice by claiming health benefits.<ref name=which form little "ephron2001humps">{{REFbook |last=Ephron |first=John M. |init=JM |author-link= |year=2001 |title=Medicine and the German Jews |url=https://wwwFor many cultures it is also common to perform similar rituals on girls.cirp.org/library/history/ephron1/ |work= |editor= |edition= |volume= |chapter=6 |pages=222-33 |location=New Haven |publisher={{UNI|Yale University|Yale}} Press |isbn=0-300-08377-7 |quote= |accessdate=2019-11-20 |note=}}</ref> And so started This can range from relatively small interventions such as piercing or cutting the long tradition clitoral hood, to its complete removal and up to radical removal of Jewish doctors inventing reasons for circumcision (clitoral hood, [[clitoris]], inner and deceving gentile doctors)outer labia followed by sewing up the vagina.
Following ''The following text is taken from the discovery of bacteria as a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcision[[Circumpendium]].''
In 1870 the prominent Dr. [[Lewis Albert Sayre|Lewis A. Sayre]] of NYC’s famed Bellevue Hospital<ref>https://nypost.com/2016/12/03/bellevues-doctors-invented-the-procedures-you-take-for-granted/</ref> claimed to cure a boy’s paralyzed legs with circumcision. Sayre's wild advocacy of circumcision exemplified how some [https://intaction.org/circumcision-facts-and-myths/ circumcision facts and myths] originated. He also claimed to cure epilepsy, mental disorders, hip-joint pain, & hernias with circumcision. “Genital irritations” & masturbation were deemed to be the cause of these issues. Sayre was later elected as the President of the American Medical Association. <ref>American Medical Association. Transactions of the American Medical Association. 1870;21:205–11</ref> === Prophylactic reasons ===
In Some people claim that circumcision has prophylactic benefits. Especially in the 1920s it was penile cancerUSA those arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. At first, these were diseases where [[Abraham L. Wolbarstmasturbation]] (1926) claims that circumcision can prevent penile cancer.<ref name="wolbarst1926">{{REFjournal |last=Wolbarst |first=Abraham Lwas believed to be the cause. |init=AL |author-link=Abraham LAfter bacteria and viruses had been discovered, arguments changed, and one after another miscellaneous diseases were cited. Wolbarst |title=Is circumcision a prophylactic against penis cancer? |journal=Cancer |date=Jul 1926 |volume=3 |issue=4 |pages=301-10}}</ref>
In the 1940s* [[Phimosis]]: as mentioned earlier, prostate and tongue cancer as well as STDs. true [[Eugene H. Handphimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock et al. (19492003) falsely explains that circumcision somehow protects against venereal diseases and tongue cancer.<ref name="hand1949blalock2003">{{REFjournal |last=HandBlalock |init=HJ |last2=Vemulakonda |init2=V |firstlast3=Eugene H.Ritchey |initinit3=EHML |author-linklast4=Eugene H. HandRibbeck |urlinit4=https://pubmed.ncbi.nlm.nih.gov/18135844/M |title=Circumcision and venereal diseaseOutpatient management of [[phimosis]] Following newborn circumcision |journal=Archives of Dermatology and SyphilologyJ Urol |date=1949-092003 |volume=60169 |issue=3 |pages341-6 |pubmedIDpages=181358442332-4 |DOIurl=10.1001https://archdermwww.1949cirp.01530030037004 org/library/complications/blalock1/ |accessdate=20212019-1011-0807}}</ref> In the 1950s it was cervical cancer, 2. 9% of those circumcised develop a post-operative [[Abraham Ravichphimosis]] (1951) invents , in which the myth that circumcision reduces the risk of women getting cervical cancerscar constricts.<ref name="ravich1951">{{Ravich1951}}</ref> In the late 1960s it was neuroses. [[Morris Fishbeinintact]] (1969) calls for circumcision to prevent nervousness andpatients, the rate of course, [[masturbationphimosis]].<ref>{{Fishbein1969}}</ref> In is only 1% (see also the 1970s bladder- and rectal cancerstudy by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[Abraham Ravichphimosis]] .* Sexually Transmitted Diseases (1971STDs) claims : a vast number of studies has been conducted on the subject of transmission of STDs.* First, it has to be noted that any form of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision would prevent bladder cancer and rectal cancerfor himself.<ref>{{Ravich1971}}</ref> In * As mentioned above, the [[foreskin]] keeps the 1980s, UTIs. [[Thomas E. WiswellGlans penis|glans]] (1985) claims that circumcisionmoist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, using thereby providing a methodologically flawed report, reduces natural antibacterial screen. This explains the risk results of urinary tract infectionsseveral studies, such as Laumann et al.<ref name="wiswell1985">{{REFjournal |last=WiswellLaumann |init=EO |last2=Masi |init2=CM |last3=Zuckerman |init3=EW |title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice |journal=JAMA |date=1997 |firstvolume=Thomas E.277 |initissue=TE |authorpages=1052-link=Thomas E. Wiswell7 |url=https://pediatricswww.aappublicationscirp.org/contentlibrary/75general/5laumann/901 |titleaccessdate=Decreased incidence 2019-11-06}}</ref>, which found a higher rate of urinary tract infections infection with bacterial venereal diseases in circumcised than in intact men.* The studies by Fleiss et al. (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> According to the [[AAP]], the general sexual behaviour of the male infants- such as frequent change in partners and the use of condoms - has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournal |last=Task Force on Circumcision |first= |title=Circumcision policy statement |journal=Pediatrics |date=May 19851999 |volume=75103 |issue=53 |pages=901686-393 |url=https://www.cirp.org/library/statements/aap1999/ |accessdate=2019-1011-1215
|place=Barcelona, Spain
|source=Presented at the Fourteenth International AIDS Conference
|datefrom=2002-07-07
|dateto=2002-07-12
|place=Bangkok, Thailand
|source=Presented at the 15th International AIDS Conference
|datefrom=2004-07-11
|dateto=2004-07-16
* It can be concluded that circumcision is ineffective as a preventive measure against UTIs.* Penile and cervical cancer The [[AAFP]] (2002) states quite simply in their [https:// HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understoodwww.cirp.<ref>{{Wolbarst1932}}<org/library/statements/aafp2002/ref> Today| position paper], it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor''"Newborns experience pain during circumcision".''<ref>{{REFjournalREFweb |lasttitle=McCanceCircumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |initwebsite=DJOfficial American Academy of Family Physicians Website |last2url=Kalachehttp://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html |init2accessdate=A2011-05-02 |last3=Ashdown}}</ref> This is not a debatable fact, and yet, it is not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel [[pain]], and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule. |init3=K |etal=yesPenile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. [[EMLA]] cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb |title=Human papillomavirus types 16 and 18 in carcinomas Report 10 of the penis from BrazilCouncil on Scientific Affairs (I-99): Neonatal Circumcision |journalwebsite=Int J CancerAmerican Medical Association Official Website |dateurl=1986 |volume=37 |issue=1 |pages=55http://www.ama-assn.org/ama/no-index/about-9 |url=ama/13585.shtml |accessdate=2011-05-04}}</ref>, as well as smoking The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.<ref>{{REFjournal |last=Harish |init=K |last2=Ravi |init2=RREFweb |title=The role of tobacco in penile carcinomaWhere We Stand: Circumcision |journalpublisher=Brit J Urol[[AAP]] |date=19952011-03-23 |volumeurl=75 |issue=3 |http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages=375/Where-We-Stand-7 |url=Circumcision.aspx |accessdate=2019-10-12}}</ref>Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection. Studies have shown that there Given what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is no significant difference your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to pain during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in the risk general. One may not expect to find this kind of getting penile cancer between [[circumcised]] advice on such a website, and yet, anything less than this is a dangerously weak statement. To control [[intactpain]] men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisionssome physicians that circumcise use Tylenol, sugar,<ref>{{REFdocumentREFweb |titlequote=Position Paper on Neonatal CircumcisionTo calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room. |url=http://www.pollockclinics.com/circumcision/circumcision-guide.html |contributiontitle=Parents' Guide to Circumcision
The AAPIt has been shown that an infant's response to [[http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children websitepain]] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms can be altered for years as a consequence of analgesia that are available"''circumcision.<ref>{{REFweb |title=Where We Stand: Circumcision |publisher=[[AAP]] |date=2011-03-23 |url=http:TaddioA etal 1995}}<//www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx |accessdate=2019-10-12ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection.
Given what is known from aforementioned official documents{{Box|Boxtext=<big><b>However, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows none of the ineffectiveness of anything short above three procedures totally eliminate pain. A baby boy will still experience some pain despite any of local anesthesia, and make sure your baby is given an injectionthose analgesic procedures. This is your responsibility, because your doctor may or may not be up to date on the latest understandings Prevention of infant sensitivity to [[pain during ]] requires protecting a boy from elective neonatal non-therapeutic circumcision."'' The AAP may be holding back, however, perhaps because this would upset Only boys who are protected from the doctormedically unnecessary circumcision surgery experience no [[pain]] or [[trauma]].</b></parent power relationship, big>}}== Risks and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement.effects ==
To control [[pain]]Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects. Uberoi et al. (2022) report "some physicians that circumcise use Tylenolmen are experiencing a complex negative constellation of psychological, sugarphysical,and sexual associations that lead to significant emotional distress directed both internally and externally. The posts also reveal a discovery phenomenon wherein men discover the physical and psychological manifestations of the decisions made by others to modify their genitals."<refname ="uberoi2022">{{REFweb |quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room. |url=http://www.pollockclinics.com/circumcision/circumcision-guide.html |title=Parents' Guide to CircumcisionREFjournal |last=Uberoi
|note=Link to [[AAP]] website
}}</ref>. During procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levels, which equals a state of severe [[shock]].<ref>{{REFjournal
|last=Gunnar
|init=MR
|last2=Fisch
|init2=RO
|last3=Korsvik
|init3=S
|last4=Donhowe
|init4=JM
|title=The effects of circumcision on serum cortisol and behavior
|journal=Psychoneuroendocrinology
|date=1981
|volume=6
|issue=3
|pages=269-75
|url=https://www.cirp.org/library/pain/gunnar/
|accessdate=2019-11-26
|note=}}</ref><ref>{{REFdocumentREFweb |titleurl=Autopsy of Demetrius Mankerhttp://emedicine.medscape.com/article/1016016-overview |urltitle=Meatal Stenosis |contributionpublisher=Case 93-1711Medscape |lastaccessdate=Wetli2019-10-11}}</ref> * Shorter adult penile length was reported by Park et al. (2016) as a result of NMC (newborn male circumcision).{{Citation |firstTitle=CV |publisherText=Miami: Dade County Medical Examiner DepartmentIn conclusion, second to fourth digit ratio, flaccid penile length, and age of circumcision were significant predictive factors for erectile penile length. Furthermore, the penile lengths of the NMC group were shorter than those of the non-NMC group. |formatAuthor=Park et al. |dateSource=1993-06-23 |accessdateref=}}</ref> <ref>{{REFjournal |last=HissPark |first= |init=JJK |author-link= |last2=HorowitzDoo |first2= |init2=AAR |author2-link= |last3=KahanaKim |first3= |init3=TJH |author3-link= |last4=Park |first4= |init4=HS |author4-link= |etal=yes |title=Fatal haemorrhage following Prospective investigation of penile length with newborn male ritual circumcisionand second to fourth digit ratio. |trans-title= |language= |journal=Can Urol Assoc J Clin Forensic Med |location= |date=20002016-09 |volumeseason=7 |issuevolume=10 |pagesissue=329-410 |urlarticle=https://www.cirp.org/library/death/hiss1/ |accessdatepage=2019-11-06}}</ref><ref>{{REFdocument |titlepages=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |url=httphttps://www.circumstitionsncbi.nlm.comnih.gov/pmc/articles/PMC5028213/death-exsang.html |contributionarchived= |lastquote=Newell |firstpubmedID=TEC |publisher=Burnaby, B.C.: B.C. Coroner's Service27695583 |formatpubmedCID=5028213 |dateDOI=2004-01-1910.5489/cuaj.3590 |accessdate=20192022-1109-2604
* Post operative }}=== Sexual effects === Circumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well." The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the [[lymphoedemapenis]].* Postoperative , leaving only the uninhibited protopathic sensibility of the artificially externalized [[Infection| infectionsglans penis]]. This includes both local infections, which can The imbalance caused by not having the input from the now ablated fine-touch receptors may be treated with local therapy, and systemic infections, requiring systemic antibiotic treatmenta leading cause of the changes in sexual behavior noted in [[circumcised]] human males.<ref>{{REFconferenceREFjournal |last=DrVan Howe |init=RS |author-link=Robert S. med. HartmannVan Howe |last2=Cold |firstinit2=WolfgangCJ |urltitle=Advantages and Disadvantages of Neonatal Circumcision |placejournal=Rechtsausschuss des Bundestages [Legal Committee The Journal of the Bundestag] (German)American Medical Association |volume=277 |issue=13 |pages=1052-7 |titleurl=Stellungnahme zur Anhörung am 26http://www. November 2012 [Opinion on the hearing on 26 November 2012] (German)ncbi.nlm.nih.gov/pubmed/9218663 |quote= |pubmedID=9218663 |pubmedCID= |DOI= |date=20121997-1104-2602
* [[Wound dehiscence]], meaning the separation of the edges of the wound or the tissue after suturing.* Adhesion between the surface or rim Histology of the male circumcision scar shows [[Glans penis|glans]] with the neighbouring [[penile skinamputation]]neuromas, causing [[skin]] pockets Schwann cell proliferation and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessarythe bulbous collection of variably sized neurites.* Postoperative [[phimosisAmputation]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock et alneuromas do not mediate normal sensation and are notorious for generating pain.<ref>{{REFjournal |lastname=Blalock |init=HJ |last2=Vemulakonda |init2=V |last3=Ritchey |init3=ML |last4=Ribbeck |init4=M |title=Outpatient management of [[phimosis]] Following newborn circumcision |journal=J Urol |date=2003 |volume=169 |issue=6 |pages=2332-4 |url=https:"ColdCJ TaylorJR 1999"//www.cirp.org/library/complications/blalock1/ |accessdate=2019>Cepeda-11-26}}</ref>, the prevalence is 2Emiliani et al.9%, according to Leitch<ref>{{REFjournal |last=Leitch |init=IOW |title=Circumcision - a continuing enigma |journal=Aust Paediatr J |date=1970 |volume=6 |issue= |pages=59-65 |url=https(2023) commented://www.cirp.org/library/general/leitch1/ |accessdate=2019-12-15}}</refblockquote> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of Taking the veins. If the dorsal vein, which originates in the tip sleve technique as an example of the [[foreskin]], is cut surgical flexibility during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development extent that this technique is of knots.* Possible deformities due to circumcision include hypoplasia such versatility that it allows highly variable quantities of the [[penis]] (micro-penis) cutaneous and induratio [[penis]] plastica (skewed penis).* Medical malpractice can also not subcutaneous tissue to be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur.* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood excised directly from the wound with the mouth)penile body, there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or [[death]].<ref>{{REFweb |url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0 |title=Baby’s Death Renews Debate Over a Circumcision Ritual |last=Robbins |first=Liz |date=2012-03-07 |accessdate=2019-10-11}}</ref> === Physical late effects === * An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact extent that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out prepuce is still conceived by developing a callus layer. This reduces the sensitivity segments of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells et al.<ref>{{Sorrells etal 2007}}</ref> found medical community as "just a significant reduction small piece of sensitivity to touch for [[circumcised]] compared to [[intact]] [[penis]]es in adult males. Other studies revealed that [[circumcised]] men use condoms significantly less often than [[intact]] men, since they further limit the sexual sensitivity (see above). * Painful tension can occur when there is too little reserve [[skin]] left to support a full [[erection]]<ref name="taylor1996"/>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], we are concerned that aggressive circumcisions are intentionally or unintentionally being performed in pediatric and adult patients in the belief that "[[shower]]redundant"), others are rather short when flaccid and double or more their size during an [[erection]] ([[Blood Penis]], or "[[grower]]extra"). Especially in children's circumcision, where the [[penis]] tissue is not yet fully developedbeing excised, the amount of reserve [[skin]] needed in adulthood cannot be estimated. * Erectile dysfunction: Both the damage inflicted to the blood vessels or in the [[foreskin]] and the reduced sexual belief that "excesive sensitivity can be causes for " is being reduced erectile function with advancing age.<ref>{{REFjournal |last=Money |init=J |last2=Davison |init2=J |title=Adult penile circumcision: Erotosexual and cosmetic sequelae |journal=Journal of Sex Research |date=1983 |volume=19 |issue= |pages=289-92 |url= |accessdate=}}</ref> * Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual [[keratinization]] of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time [[circumcised]]] men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.* Vaginal dryness: Due to the loss of the natural [[gliding action]], which comes from the mobility of the [[foreskin]] and [[shaft skin]], a much increased friction between [[penis]] and [[vagina]] occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>{{FrischM LindholmM GroenbaekM 2011}}</ref><ref>{{REFjournal |last=Cortés-González |init=J |last2=Arratia-Maqueo |init2=J |last3=Gómez-Guerra |init3=L |title=Does circumcision has an effect on female's perception of sexual satisfaction? |journal=Rev Invest Clin |date=2008 |volume=60 |issue=3 |page=227 |url= |pubmedID=18807735 |accessdate=}}</ref> The prolonged augment ejaculatory latency time it takes [[circumcised]] men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to [[intact]] men - play a part in this.<ref name="ColdCJ TaylorJR 1999cepeda2023">{{ColdCJ TaylorJR 1999}}</ref><ref>{{REFjournal |last=Fink |init=KS |last2=Carson |init2=CC |last3=DeVellis |init3=RF |title=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction |journal=J Urol |date=2002 |volume=167 |issue=5 |pages=2113Cepeda-6Emiliani |urlfirst= |accessdateinit=}}</ref> * [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision. * [[Meatal stenosis]], a pathological narrowing of the opening of the [[urethra]], which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously [[circumcised]] boys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting |journal=Clin Pediatr (Phila) |note=JanAlfonso Cepeda-Feb 2006Emiliani |datelast2=2006Gándara-01Cortés |volumefirst2=45 |issueinit2=1M |pages=49author2-54 |urllink=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting |accessdatelast3=2019Otero-12-15}}</ref><ref>{{REFjournalAlén |lastfirst3=Stenram |init=A |last2=Malmfors |init2=G |last3=Okmian |init3=LM |title=Circumcision for [[phimosis]]: a followauthor3-up study |journallink=Scandinavian journal of urology and nephrology |datelast4=1986García |volumefirst4=20 |issueinit4=2H |page=89 |url= |pubmedIDauthor4-link=3749823 |accessdate=}}</ref><ref>{{REFweb |urllast5=http://emedicine.medscape.com/article/1016016Suárez-overviewQuintanilla |titlefirst5=Meatal Stenosis |publisherinit5=MedscapeJ |accessdate=2019author5-10-11}}</ref> * Shorter adult penile length was reported by Park et al. (2016) as a result of NMC (newborn male circumcision).{{Citation |Titlelink= |Textlast6=In conclusion, second to fourth digit ratio, flaccid penile length, and age of circumcision were significant predictive factors for erectile penile length. Furthermore, the penile lengths of the NMC group were shorter than those of the nonGarcía-NMC group. |Author=Park et al. |Source= |ref=<ref>{{REFjournalCaballero |lastfirst6=Park |firstinit6=T |init=JK |authorauthor6-link= |last2last7=DooGallego |first2first7= |init2init7=ARR |author2author7-link= |last3last8=Kim |first3= |init3=JH |author3García-link= |last4=ParkCaballero |first4first8= |init4init8=HSR |author4author8-link= |etal=yesno |title=Prospective investigation Immunohistological study of the density and distribution of human penile length with newborn male circumcision and second to fourth digit ratio.neural tissue: gradient hypothesis |trans-title= |language= |journal=Can Urol Assoc Int J |location=Impot Res |date=20162023-09 |season=05-02 |volume=1035 |issue=9-103
no edit summary
"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal or [[amputation]] of the [[foreskin]] (prepuce) part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the penis.<ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> When the "cutting around" is performed, the foreskin falls off, so [[amputation]] and [[mutilation]] is the result. The amputation destroys the [[Foreskin#Physiological_functions| many protective, immunological, sexual, and sensory physiological functions]] of the foreskin, so it is a very harmful and [[Pain| painful]] surgery.
|author2-link=
|etal=no
|title=Immunohistological study of What is the density and distribution of human penile neural tissue: gradient hypothesis |transmedical evidence on non-title=therapeutic child circumcision?
|journal= Int J Impot Res
|date=20232022-0501-02 |volume=35 |issue=3 |article= |page= |pages=286-30508 |url=https://www.nature.com/articles/s41443-022021-0056100502-9 |archived= |quote=y |pubmedID=35501394 |pubmedCID=34997197 |DOI=10.1038/s41443-022021-0056100502-9 y |accessdate=20232022-1101-2330}}</ref></blockquote>The un-anesthetized and un-sedated newborn infant is restrained by being strapped to a special plastic board called the [[circumstraint]]. The procedure is most often an elective, practice of non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons circumcision of boys has greatly declined in violation of the child's [[human rightsAustralia]] to , [[physical integrityCanada]], but in older patients may be rarely indicated for therapeutic reasons. It is a radical treatment option for pathological [[phimosisNew Zealand]], refractory and the [[balanoposthitisUnited Kingdom]] and chronic . It has been gradually declining since 1985 in the [[urinary tract infectionUnited States]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health. == Historical background ==
|first=
|author-linkpublisher=NASB |yearwebsite=1997Bible Gateway |titledate=The geography of sexual mutilations |urlaccessdate=https://www.academia.edu/4212007/The_Geography_of_Male_and_Female_Genital_Mutilations |work=Sexual Mutilations: A Human Tragedy |editors=George C. Denniston, Marilyn Milos |edition= |volume= |chapter= |pages= |location=New York |publisher=Plenum |isbn=02019-30611-45589-710 |quoteformat= |accessdate=2021-11-13 |notequote=And when eight days had passed, before His circumcision, His name was then called Jesus, the name given by the angel before He was conceived in the womb.}}</ref> Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.
The first Christians had been born Jewish, so a question arose whether one must be [[Image:Circumcision Sakkara 3.jpg|200px|rightcircumcised]] For to be a Christian. When Christian leaders met at the [[AboriginesCouncil at Jerusalem]], in the [[Australia| Australian]] natives, the tradition of circumcision is said First Century to go back decide what was required to 10be a Christian,000 BC. On a letter was written to explain the African continentrequirements, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of but circumcision date back to was omitted from the time around 3000-2000 BCrequirements. The oldest known depiction<ref>{{REFweb |url=https://commonswww.wikimediabiblegateway.orgcom/wikipassage/File:Circumcision_Sakkara_3.jpg?search=Acts+15%3A1-30&version=NASB |title=FileActs 15:Circumcision Sakkara 3.jpg1-30 |last=Luke |first= |accessdate=2019-11-10-12}}</ref> is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times.
In many cultures Christianity, circumcision is practiced only in the Coptic denomination. There is no general belief that circumcision during puberty serves as is a rite requirement of passageChristianity.<ref name="hill2004">{{REFweb |url=https://www.cirp.org/pages/cultural/christian.php |title=The Holy Bible, bringing adolescents into the community. As with other painful or humiliating initiation ritesCircumcision, False Prophets, proof of courage and mastering Christian Parents |last=Hill |first=George |author-link=George Hill |publisher=Circumcision Reference Library |website= |date=2004-08-29 |accessdate=2019-11-10 |format=HTML |quote=The falseness of critical situations are the key motivations. From some African tribes it those who advocate circumcision is also known that the [[amputation]] of the [[foreskin]] is seen as a recurrent theme in the removal of an inborn piece of femininity from the boys, thus making them menNew Testament.}}</ref>
{{Citation
|Text=10 This A remedy which is almost always successful in small boys is circumcision, especially when there is my covenant with you and your descendants after youany degree of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcisionmind, and especially if it will be connected with the sign idea of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must punishment, as it may well be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspringsome cases. 13 Whether born in your household or bought with your moneyIn females, they must be circumcised. My covenant in your flesh is the author has found the application of pure carbolic acid to be an everlasting covenant. 14 Any the [[uncircumcisedclitoris]] malean excellent means of allaying the abnormal excitement, who has not been circumcised and preventing the recurrence of the practice in the flesh, those whose will be cut off from his people; he -power has broken my covenantbecome so weakened that the patient is unable to exercise entire self-control.” |Author=Bible[[John Harvey Kellogg]] |Source=Gen 17, 10 |ref=<ref>{{REFbook |last=Kellogg |first=John Harvey |init=JH |author-link=John Harvey Kellogg |url=https://archive.org/details/plainfaorold00kell/page/290 |chapter=Treatment for Self-14abuse and Its Effects |title=Plain Facts for Old and Young |location=Burlington, NIVIowa |publisher=F. Segner & Co. |year=1888 |page=107}}</ref>}} According to the anthropologist and sociologist Rabbi Nissan Rubin, the ===Islam===In [[Jewish circumcision| Jewish form of circumcisionIslam]], called ''[[Brit Milah| brit mila]]''circumcision is also religiously founded, during even though there is no mention of it in the first two millennia did not include Koran itself. According to tradition, the later customary ''Prophet Mohammed was born without a [[periahforeskin]]'', namely the complete scraping . It is seen as a sign of the inner prophets that they are born without a [[foreskin]] from already. It is considered an honour to "resemble the example of the Prophet", meaning to be [[Glans penis|glanscircumcised]]. This was only added around 135 ADIn Islam, to make it almost impossible to restore the [[foreskin]] by unlike [[stretchingJudaism]], there is no specific age at which became popular in the wake of Hellenic influencecircumcision should be performed. While originally only the tip of the [[foreskin]] was cut offMost circumcisions take place at ages between 6 and 10 years, ''[[periah]]'' removes but the entire [[foreskin]]range goes from birth to adulthood. == Rationale ==
===ChristianityCultural===Jesus was born Many cultures perform circumcision as a rite of passage into a Jewish family manhood. This is common in Israel, where the Middle East and amongst some indigenous African and Southeast Asian peoples. The [[JudaismUnited States]] was and Israel are the prevailing religion, so He was [[circumcised]] on only industrialized countries in the eighth day.<ref>{{REFweb |url=https://www.biblegatewayworld to have a high incidence of non-therapeutic infant male circumcision.com/passage/?search=Luke+2%3A21&version=NASB |title=Gospel The vast majority of Luke |last=Luke |first= |publisher=NASB |website=Bible Gateway |date= |accessdate=2019infant circumcisions performed in the United States are for non-11religious, non-10 |format= |quote=And when eight days had passed, before His medical reasons. See [[History of circumcision, His name was then called Jesus, the name given by the angel before He was conceived in the womb]].}}</ref>
===Religious===The first Christians had been born Jewish, so circumcision of newborn boys is seen as a question arose whether one must be [[circumcisedAbrahamic covenant| divine commandment]] to be a Christian. When Christian leaders met at in the [[Council at JerusalemJudaism| Jewish faith]] . Though absent in the First Century to decide what was required to be Koran, male circumcision is considered a Christianreligious requirement in [[Islam]], a letter was written and it is performed on male children of varying ages. Converts to these faiths may also choose to explain the requirementsundergo [[Adolescent and adult circumcision| circumcision]], but circumcision was omitted from the requirements.<ref>{{REFweb |url=https://wwwit is not always required.biblegateway.com/passage/?search=Acts+15%3A1-30&version=NASB |title=Acts 15:1-30 |last=Luke |first= |accessdate=2019-11-10}}</ref>
}}</ref>
Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref name="taylor1996"/> In the past, some advocates of mass circumcision have considered the [[prepuce]] to be a "mistake of nature,"<!--{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]--> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantages.<ref name= Rationale "cold-mcgrath1995">{{REFbook |last=Cold |first=Christopher |init=C |last2=McGrath |first2=Kenneth |init2=K |author2-link=Ken McGrath |year=1999 |title=Male and female circumcision: medical, legal, and ethical considerations in pediatric practice |url=https://www.cirp.org/library/anatomy/cold-mcgrath/ |work= |editor= |edition= |volume= |chapter=Anatomy and histology of the penile and clitoral prepuce in primates |pages= |location=New York |publisher= |isbn=0306461315 |quote= |accessdate=2019-10-12 |note=}}</ref>
===CulturalSearch for prophylactic reasons===
In a few cases with older patients, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failedthe 1920s it was penile cancer. In other cases, a patient may be suffering from a severe case of [[phimosisAbraham L. Wolbarst]]. Overall, the actual medical necessity for (1926) claims that circumcision is extremely rare since many conditions respond to conservative treatmentcan prevent penile cancer. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions<ref name="wolbarst1926">{{REFjournal |last=Wolbarst | functions]]first=Abraham L. |init=AL |author-link=Abraham L. Wolbarst# '''Deformed or malformed foreskin'''. A foreskin so deformed or malformed that it does not function properly may be removed by |title=Is circumcision.a prophylactic against penis cancer? |journal=Cancer |date=Jul 1926 |volume=3 |issue=4 |pages=301-10}}</ref>
In such casesthe late 1960s it was neuroses. [[Morris Fishbein]] (1969) calls for circumcision to prevent nervousness and, the benefit of removing the problem foreskin may exceed the maleficial harms of tissue and function destructioncourse, [[masturbation]].<ref>{{Fishbein1969}}</ref>
}}</ref>
}}</ref>
* [[HIV]] / [[AIDS]]: in the recent past, the argument that circumcision could help to contain the spread of [[HIV]] has been stated numerous times.
*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, circumcision status does not make a difference.
*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of [[HIV]], which in return renders circumcision unnecessary
* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>{{REFjournal
|last=Hooykaas
|init=C
|last2=van der Velde
|init2=FW
|last3=van der Linden
|init3=MM
|etal=yes
|title=The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals
|journal=Genitourin Med
|date=1991
|volume=67
|issue=5
|pages=378-83
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1194736/pdf/genitmed00041-0022.pdf
|accessdate=2019-11-15
}}</ref><ref>{{REFjournal
|last=Michael
|init=RT
|last2=Wadsworth
|init2=J
|last3=Feinleib
|init3=J
|etal=yes
|title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison
|journal=Am J Public Health
|date=1998
|volume=88
|issue=5
|pages=749-54
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508929/pdf/amjph00017-0039.pdf
|accessdate=2019-11-15
}}</ref><ref>{{REFjournal
|last=Laumann
|init=EO
|last2=Masi
|init2=CM
|last3=Zuckerman
|init3=EW
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
|journal=JAMA
|date=1997
|volume=277
|issue=
|pages=1052-7
|url=https://www.cirp.org/library/general/laumann/
|accessdate=2019-11-06
}}</ref>
* Two studies that have been published in early 2007<ref>{{RCT Gray et al 2007}}</ref><ref>{{RCT Bailey et al 2007}}</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of [[HIV]] from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been [[circumcised]] for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{BoyleGJ HillG 2011}}</ref>
The fact that the USA has both the highest rate of [[Aaron J. Finkcircumcised]] males in the western world, as well as the highest [[HIV]] (1986)infection rate, with no evidence whatsoevermakes the studies look dubious. Besides that, claims several other studies concluded that circumcision protects against does not have a significant impact on the risk of infection with [[AIDSHIV]] followed.<ref name="fink1986">{{REFjournal |last=FinkGrosskurth |firstinit=H |last2=Mosha |init2=Aaron J.F |initlast3=AJTodd |author-linkinit3=Aaron J. Fink |etal=yes |title=A possible explanation for heterosexual male infection with AIDScommunity trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results |journal=New England Journal of MedicineAIDS |date=1986-10-301995 |volume=319 |issue=188 |pagepages=1167927-34 |url=https://wwwinsights.nejmovid.orgcom/aids/doiaids/full1995/10.105608/NEJM198610303151818 |DOI=10.1056000/NEJM198610303151818 |accessdate=2019community-11trial-20}}</ref> Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[Doctors Opposing Circumcision (D.O.C.)]] (2016) state:<blockquote>These claims date originally from before the advent of evidenceimpact-based medicine, when doctors relied on the opinions of other clinicians to inform their practice, rather than on scientifically collected evidence.<ref name="doc2016">{{REFweb |url=https://www.doctorsopposingcircumcision.org/forimproved-professionalssexually/alleged-medical-benefits15/ |title=Alleged Medical Benefits |publisher=[[Doctors Opposing Circumcision (D.O.C.)]] |website= |date=2016-0500002030 |accessdate=2019-11-20 |format= |quote=15}}</ref></blockquote> The sheer mass of studies and publications that were released during those almost 180 years on this topic are the reason that even arguments that have been disproved multiple times, especially regarding infant and child circumcision, tenaciously persist up until today. An ever-recurring element of initiation rites found in many different cultures is the fixation upon the genitalia. It reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian [[Aborigines]], as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open in a [[subincision]], resulting in a partly or completely divided [[urethra]]. Another known, particularly massive, intervention is the stripping of the entire [[skin]] off the [[penis]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the beginning of puberty, which form little "humps". For many cultures it is also common to perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the clitoral hood, to its complete removal and up to radical removal of clitoral hood, [[clitoris]], inner and outer labia followed by sewing up the vagina. ''The following text is taken from the [[Circumpendium]].'' === Prophylactic reasons === Some people claim that circumcision has prophylactic benefits. Especially in the USA those arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. At first, these were diseases where [[masturbation]] was believed to be the cause. After bacteria and viruses had been discovered, arguments changed, and one after another miscellaneous diseases were cited. * [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock et al. (2003)<ref name="blalock2003">{{REFjournal |last=BlalockBarongo |init=HJLR |last2=VemulakondaBorgdorff |init2=VMW |last3=RitcheyMosha |init3=ML |last4=RibbeckFF |init4etal=Myes |title=Outpatient management The epidemiology of [[phimosis]] Following newborn circumcisionHIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania |journal=J UrolAIDS |date=20031992 |volume=1696 |issue=612 |pages=23321521-48 |url=https://www.cirp.org/library/complications/blalock1/ |accessdate=2019-11-07}}</ref>, 2.9% of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constricts. In [[intact]] patients, the rate of [[phimosis]] is only 1% (see also the study by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[phimosis]].* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.* First, it has to be noted that any form of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision for himself.* As mentioned above, the [[foreskin]] keeps the [[Glans penis|glans]] moist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, thereby providing a natural antibacterial screen. This explains the results of several studies, such as Laumann et al.<ref>{{REFjournalREFconference |last=LaumannChangedia SM, Gilada IS |init=EO |last2=Masi |init2first=CM |last3=Zuckerman |init3=EW |title=Circumcision Role of male circumcision in HIV transmission insignificant in the United States: prevalence, prophylactic effects, and sexual practiceconjugal relationship (abstract no. ThPeC7420) |journalurl=JAMA |dateplace=1997Barcelona, Spain |volumesource=277Presented at the Fourteenth International AIDS Conference |issuedatefrom=2002-07-07 |pagesdateto=10522002-07-7 |url=https://www.cirp.org/library/general/laumann/12 |accessdate=2019-11-06}}</ref>, which found a higher rate of infection with bacterial venereal diseases in circumcised than in intact men.* The studies by Fleiss et al. (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> According to the [[AAP]], the general sexual behaviour of the male - such as frequent change in partners and the use of condoms - has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournalREFconference |last=Task Force on CircumcisionConnolly CA, Shishana O, Simbayi L, Colvin M
|first=
|title=Circumcision policy statementHIV and circumcision in South Africa (Abstract No. MoPeC3491) |journalurl=Pediatrics |dateplace=1999Bangkok, Thailand |volumesource=103Presented at the 15th International AIDS Conference |issuedatefrom=32004-07-11 |pagesdateto=6862004-9307-16 |accessdate=}}</ref><ref>{{REFconference |last=Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA |first= |title=Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861) |url=https://wwwapps.cirpdtic.orgmil/dtic/librarytr/statementsfulltext/aap1999u2/a458066.pdf |place=Bangkok, Thailand |source=Presented at the 15th International AIDS Conference |datefrom=2004-07-11 |dateto=2004-07-16
|accessdate=2019-11-15
}}</ref>
* [[HIV]] / [[AIDS]]Urinary tract infections (UTI): in the recent past, the argument that circumcision could help to contain the spread of a [[HIVUTI]] has been stated numerous times.*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse can be effectively treated with that preventive measureantibiotics, circumcision status does not make a difference.*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women this was also proven by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of [[HIV]], which in return renders circumcision unnecessary* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivitystudies.<ref>{{REFjournal |last=HooykaasMcCracken |init=C |last2=van der Velde |init2=FW |last3=van der Linden |init3=MM |etal=yesG |title=The importance Options in antimicrobial management of ethnicity as a risk factor for STDs urinary tract infections in infants and sexual behaviour among heterosexualschildren |journal=Genitourin MedPediatr Infect Dis J |date=19911989 |volume=678 |issue=58 |pages=378552-835 |url=https://www.ncbicirp.nlm.nih.govorg/pmclibrary/articlesdisease/PMC1194736UTI/pdfmccracken/genitmed00041-0022.pdf |accessdate=2019-11-1519
}}</ref><ref>{{REFjournal
|last=MichaelLarcombe |init=RTJ |title=Urinary tract infection in children |journal=BMJ |date=1999 |volume=319 |issue= |last2pages=1173-5 |url= |accessdate=Wadsworth}}</ref> A Swedish study<ref>{{REFjournal |init2last=JMårild |last3init=FeinleibS |init3last2=JJodal |etalinit2=yesU |title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparisonIncidence rate of first–time symptomatic urinary tract infection in children under 6 years of age |journal=Am J Public HealthActa Paediatr
|date=1998
|volume=8887
|issue=5
|pages=749549-5452 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508929/pdf/amjph00017-0039.pdf |accessdate=2019-11-15}}</ref>found that, during the first 6 years of life, the incidence of UTIs in boys was 1.8%, but in girls was 6.6%. UTIs are less common in boys after the first year of life. Mueller et al. <ref>{{REFjournal |last=LaumannMueller |init=EOER |last2=MasiSteinhardt |init2=CMG |last3=ZuckermanNaseer |init3=EWS |title=Circumcision The incidence of genitourinary abnormalities in the United States: prevalence, prophylactic effects, [[circumcised]] and sexual practice[[uncircumcised]] boys presenting with an initial urinary tract infection by 6 months of age |journal=JAMAPediatrics
|date=1997
|volume=277100 (Supplement)
|issue=
|pagespage=1052-7580 |url=https://www.cirp.org/library/general/laumann/ |accessdate=2019-11-06}}</ref>* Two studies that have been published in early 2007<ref>{{RCT Gray et al 2007}}</ref><ref>{{RCT Bailey et al 2007}}</ref>, which investigated the effectiveness of circumcision as did not find a means of reducing the spread of [[HIV]] from infected women to heterosexual men significant difference in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been UTI rates between [[circumcised]] for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{BoyleGJ HillG 2011}}</ref> The fact that the USA has both the highest rate of [[circumcisedintact]] males in the western world, as well as the highest [[HIV]] infection rate, makes the studies look dubiousboys with normal urinary tract anatomy. Besides that, several other * Other studies concluded suggest that circumcision does not have is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from Israel showed a significant impact strong correlation between ritual circumcision on the risk 8th day of infection with [[HIV]]life and postoperative UTI.<ref>{{REFjournal |last=GrosskurthMenahem |init=H |last2=Mosha |init2=F |last3=Todd |init3=J |etal=yesS |title=A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural TanzaniaComplications arising from ritual circumcision: 2. Baseline survey resultspathogenesis and possible prevention |journal=AIDSIsr J Med Sci |date=19951981 |volume=917 |issue=81 |pages=92745-348 |url=https://insights.ovid.com/aids/aids/1995/08/000/community-trial-impact-improved-sexually/15/00002030 |accessdate=2019-11-15}}</ref><ref>{{REFjournal |last=BarongoCohen |init=LRHA |last2=BorgdorffDrucker |init2=MWMM |last3=MoshaVainer |init3=FFS
|etal=yes
|title=The epidemiology of HIV-1 Postcircumcision urinary tract infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania |journal=AIDSClin Pediatr
|date=1992
|volume=631 |issue=126 |pages=1521322-84
|url=
|accessdate=
}}</ref><ref>{{REFconferenceREFjournal |last=Changedia SM, Gilada ISGoldman |firstinit=M |last2=Barr |init2=J |last3=Bistritzer |init3=T |last4=Aladjem |init4=M |title=Role of male Urinary tract infection following ritual Jewish circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420) |journal=Isr J Med Sci |date=1996 |volume=32 |issue= |pages=1098-1102
|url=
|accessdate=
}}</ref>* It can be concluded that circumcision is ineffective as a preventive measure against UTIs.* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understood.<ref>{{REFconferenceWolbarst1932}}</ref> Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal |last=Connolly CA, Shishana O, Simbayi L, Colvin MMcCance |init=DJ |last2=Kalache |init2=A |last3=Ashdown |init3=K |firstetal=yes |title=HIV Human papillomavirus types 16 and circumcision 18 in South Africa (Abstract No. MoPeC3491)carcinomas of the penis from Brazil |journal=Int J Cancer |date=1986 |volume=37 |issue=1 |pages=55-9
|url=
|accessdate=
}}</ref>, as well as smoking<ref>{{REFconferenceREFjournal |last=Thomas AGHarish |init=K |last2=Ravi |init2=R |title=The role of tobacco in penile carcinoma |journal=Brit J Urol |date=1995 |volume=75 |issue=3 |pages=375-7 |url= |accessdate=}}</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between [[circumcised]] and [[intact]] men. To prevent a single case of penile cancer, Bakhireva LN, Brodine SK, Shaffer RAit would statistically take 600 to 900 circumcisions<ref>{{REFdocument |title=Position Paper on Neonatal Circumcision |url= |contribution= |last=
|first=
|titlepublisher=Prevalence American Academy of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population Family Physicians (Abstract no. TuPeC4861Leawood, Kansas) |url=https://apps.dtic.mil/dtic/tr/fulltext/u2/a458066.pdf |placeformat=Bangkok, Thailand |sourcedate=Presented at the 15th International AIDS Conference |datefrom=2004-07-11 |dateto=20042002-0702-1614 |accessdate=2019-11-15}}</ref>. The influence of circumcision on the infection risk of the female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the cervix. In conclusion, circumcision does not provide any proven benefits in preventive medicine. == Non-medical indications for circumcision == Apart from the [[medical indication]] of pathological phimosis, there also are other reasons for circumcision. === Aesthetic reasons ===* Urinary tract infections (UTI): The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an [[intact]] or a [[UTIcircumcised]] [[penis]] can is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about the risks and possible later complications before embarking on an aesthetically motivated circumcision, to decide whether the appearance will justify such bodily modification. It should be effectively treated with antibioticsnoted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the shaft of the [[penis]]. In addition, there frequently a a color change at the circumcision scar which results in a two-tone appearance. Since this was also proven modification and its possible late effects will be the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by studiesthe person to be [[circumcised]] himself, once he has reached the necessary age and level of maturity to make that decision.<ref>{{REFjournalThis should normally be the case when adulthood is reached. |last=McCracken==Financial reasons=== |init=G In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment|title=Options in antimicrobial management third-party payers]] without question of necessity. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of urinary tract infections in infants and childrensimply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]]. |journal=== Moral reasons ===Pediatr Infect Dis J |date=1989 |volume=8With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire [[penile skin]], the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]]. |issue=8 In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of mental diseases, caused by the thinking of immoral thoughts! More on that can be found in the chapter "[[Circumcision#Historical_background|pages=552Historical background]]". Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, circumcision for moral reasons - which would only affect boys too young to give [[informed consent]] -5is no longer justifiable nowadays. |url=== Hygiene reasons ===https://www ''Hygiene'' refers to health and only secondarily to cleanliness.cirp.org/library/disease/UTI/mccracken/ One should note that the human foreskin is endowed by nature with [[Foreskin#Immunological_functions|accessdateimmunological functions]] that serve to protect the human body from disease.<ref name=2019"fleiss-11hodges-19}}<vanhowe1998"/ref>The glans penis receives blood through the frenular artery.<ref>{{REFjournal |last=LarcombePersad |init=JR |titleauthor-link=Urinary tract infection in children |journallast2=BMJSharma |dateinit2=1999S |volumeauthor2-link=319 |issuelast3=McTavish |pagesinit3=1173-5J |urlauthor3-link= |accessdateetal=}}</ref> A Swedish study<ref>{{REFjournalyes |lasttitle=MårildClinical presentation and pathophysiology of meatal stenosis following circumcision |initjournal=SBrit J Urol |last2date=Jodal1995 |init2volume=U75 |titleissue=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age1 |journalpages=Acta Paediatr91-3 |dateurl=1998https://www.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1995.tb07242.x |volumequote=87 |issuepubmedID=57850308 |pagespubmedCID=549-52 |urlDOI=10.1111/j.1464-410x.1995.tb07242.x |accessdate=2019-11-26}}</ref> found that, during These facts are generally overlooked in arguments for alleged hygienic benefits of circumcision. A common reason stated for circumcision is the first 6 years assumption of life, hygienic benefits. This argument has to be viewed in the incidence context of UTIs the environment the person in question grows up in boys was 1.8%It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, but pose a serious problem. The situation in disaster areas or refugee camps in girls was 6the so-called third world keep reminding us of that.6%. UTIs are less common In western industrial nations, however, this problem does not exist, in boys after view of the first year availability of lifeclean water for daily personal hygiene. Mueller et alIf the cleaning of the genitals is performed on a daily basis - and that may be assumed - no pathogens can accumulate under the [[foreskin]]. <ref>{{REFjournal Cleaning of the [[Glans penis|glans]] and the area underneath the [[foreskin]] is easy - they are simply [[Preputial_sac#Washing|last=Muellerwashed along with the rest of the body]], just like the areas between the toes. |init=ER In small boys, where the [[foreskin]] cannot be retracted yet, cleaning is not necessary, since the [[Synechia|last2=Steinhardt membrane]] that fuses the [[foreskin]] to the [[Glans penis|init2=G glans]] prevents the accumulation of micro-organisms. The so-called "[[Ballooning of the foreskin|last3=Naseerballooning]]", where the [[foreskin]] inflates during urination, is not a serious problem. |init3=S |title=The incidence opening of genitourinary abnormalities the [[foreskin]] in small boys is often quite narrow and serves as a one-way valve, allowing the [[circumcisedurine]] to flow out, but preventing entry of microbes, for example from a dirty diaper. As long as the child is able to pass water, everything works as nature intended. But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of easier cleaning of a circumcised [[uncircumcisedpenis]] boys presenting are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an initial urinary tract [[infection by 6 months ]] of the wound. This also applies to the treatment of common complications like post-operative [[bleeding]]. The benefit of easier cleaning must be balanced against the risk of promoting serious infections - among others [[HIV]] - during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of agetheir circumcision. |journal=Pediatrics= Circumcision methods == The [[Circumcision methods]] are discussed in a separate article. |date=1997 |volume=100 (Supplement) |issue= |page=580 |urlPain = |accessdate=}}</ref> did In the past, advocates of circumcision claimed that a newborn child's nerve system was not find yet fully developed, and that as a significant difference in UTI rates between result, the child felt no [[circumcisedpain]] and during the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel [[intactpain]] boys with normal urinary tract anatomy.* Other studies suggest that circumcision is , and more likely to raise acutely than to lower the generally low risk of acquiring UTI: multiple studies from Israel showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTIadults.<refname="anand-hickey1987">{{REFjournal |last=MenahemAnand |initfirst=S |titleauthor-link=Complications arising from ritual circumcision: pathogenesis and possible prevention |journal=Isr J Med Sci |date=1981 |volumelast2=17Hickey |issuefirst2=1 |pages=45author2-8 |urllink= |accessdateetal=}}</ref><ref>{{REFjournalno |lasttitle=CohenPain and its effects in the human neonate and fetus |inittrans-title=HA |last2language=Drucker |init2journal=MMNew Engl J Med |last3location=Vainer |init3date=S1987-11-19 |etalvolume=yes317 |titleissue=Postcircumcision urinary tract infection21 |journalpages=Clin Pediatr1321-9 |dateurl=1992https://www.cirp.org/library/pain/anand/ |volumequote=31 |issuepubmedID=63317037 |pagespubmedCID=322-4 |urlDOI= |accessdate=2019-11-08}}</ref>This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants. The [https://www.cirp.org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is considerable evidence that newborns who are [[circumcised]] without analgesia experience pain and physiologic stress"''. Furthermore, the pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening of the clamp"''.<ref>{{REFjournal |last=Goldman |init=M |last2=Barr |init2=J |last3=Bistritzer |init3=T |last4first=Aladjem |init4=M |title=Urinary tract infection following ritual Jewish circumcisionAmerican Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision |journal=Isr J Med SciPediatrics |date=19961999-03 |volume=32103 |issue=3 |pages=1098686-110293 |url=https://pediatrics.aappublications.org/content/103/3/686#sec-9 |accessdate=2019-11-26 |note=Statement Reaffirmed Sept. 1, 2005
}}</ref>
|last=
|first=
|publisher=American Academy of Family Physicians (Leawood, Kansas) |formatdate= |dateaccessdate=20022011-0204-14 |accessdate=08}}</ref>. The influence of <ref>{{REFweb |quote=During the circumcision , your son will receive sugar pacifiers to suck on the infection risk of the female partner with cervical cancer has been refuted several times as wellwhich reduce his pain perceptions. |url=http://www. HPV vaccination is an effective measure against carcinoma of the cervixpollockclinics. In conclusion, com/circumcision/circumcision does not provide any proven benefits in preventive medicine-before.html = |title= Non-medical indications for circumcision == Apart from Before the [[medical indication]] of pathological phimosis, there also are other reasons for circumcision.Circumcision |last= |first= |publisher= |date= Aesthetic reasons ==2011-04-08 |accessdate=2011-04-08 The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an [[intact]] or a [[circumcised]] [[penis]] is more appealing. Since }}</ref> a circumcision cannot be undonetopical cream, it is essential to be fully informed about the risks and possible later complications before embarking on an aesthetically motivated circumcision<ref>{{REFweb |quote=Then in our office, he will have topical anesthetic applied to decide whether the appearance will justify such bodily modificationhis penis. It should be noted that every |url=http://www.pollockclinics.com/circumcision operation leaves a life-long [[/circumcision scar]] that encircles the shaft of the [[penis]]. In addition, there frequently a a color change at the circumcision scar which results in a two-tone appearancebefore.html Since this modification and its possible late effects will be |title=Before the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by the person to be [[circumcised]] himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reached.Circumcision |last= |first= |publisher= |date=Financial reasons=== In the United States, payment for non2011-therapeutic circumcision is made by most [[third04-party payment08 | thirdaccessdate=2011-party payers]] without question of necessity. Doctors frequently perform medically04-unnecessary, non-therapeutic circumcision of infants 08}}</ref> and children simply to collect /or a local anaesthetic injection called a fee for the surgical operationdorsal penile ring block. The only beneficiary of such surgery is the [[Financial Incentive<ref>{{REFweb | bank account of the medical doctor]]. === Moral reasons ==quote= With the [[foreskin]]We use extensive pain control methods including Tylenol, circumcision removes approximately 70% of the sensitive tissue of the [[penis]]a sugar solution (to reduce pain perceptions), lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire [[penile skin]]a topical freezing cream, the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]]a local anesthetic injection. In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of mental diseases, caused by the thinking of immoral thoughts! More on that can be found in the chapter "[[Circumcision#Historical_background |Historical background]]"url=http://www. Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual developmentpollockclinics. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, com/circumcision/circumcision for moral reasons - which would only affect boys too young to give [[informed consent]] - is no longer justifiable nowadaysguide.html |title=Parents' Guide to Circumcision |last= |first= |publisher= Hygiene reasons = |date= |accessdate=2011-04-08 ''Hygiene'' refers }}</ref> Topical anaesthetic only serves to health and only secondarily numb the area to cleanliness. One should note lessen the pain of the injection, but studies have shown that the human foreskin a dorsal penile ring block is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect not always effective in stopping the human body from diseasepain of circumcision.<ref name="fleiss-hodges-vanhowe1998Journal of Perinatology April/May 2002"/> The glans penis receives blood through the frenular artery.<ref>{{REFjournal |last=PersadTaeusch |first=H. William |init=RHW |author-linklast2=Martinez |last2first2=SharmaAlma M. |init2=AM |last3=Partridge |first3=J. Colin |init3=JC |last4=Sniderman |first4=Susan |init4=S |author2last5=Armstrong-link=Wells |last3first5=McTavishJennifer |init3init5=J |author3last6=Fuentes-link=Afflick |etalfirst6=yesElena |titleinit6=Clinical presentation and pathophysiology of meatal stenosis following circumcisionE |journaltitle=Brit J UrolPain During Mogen or Plastibell Circumcision |datejournal=1995Journal of Perinatology |volume=7522 |issue=13 |pages=91214-38 |url=httpshttp://www.onlinelibrary.wileynature.com/doijp/journal/v22/absn3/10.1111full/j.1464-410X.1995.tb072427210653a.xhtml |quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure. |pubmedID=7850308
|pubmedCID=
|DOI=10.1111 |note=April/j.1464May 2002 |date=2002-410x.1995.tb07242.x04 |accessdate=20192011-1104-2608}}</ref> These facts are generally overlooked in arguments for alleged hygienic benefits of circumcision. A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed in the context of the environment the person in question grows up in. It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problem. The situation in disaster areas or refugee camps in the so-called third world keep reminding us of that. In western industrial nations, however, this problem does not exist, in view of the availability of clean water for daily personal hygiene. If the cleaning of the genitals is performed on a daily basis - and that may be assumed - no pathogens can accumulate under the [[foreskin]]. Cleaning of the [[Glans penis|glans]] and the area underneath the [[foreskin]] is easy - they are simply [[Preputial_sac#Washing| washed along with the rest of the body]], just like the areas between the toes. In small boys, where the [[foreskin]] cannot be retracted yet, cleaning is not necessary, since the [[Synechia| membrane]] that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "[[Ballooning of the foreskin| ballooning]]", where the [[foreskin]] inflates during urination, is not a serious problem. The opening of the [[foreskin]] in small boys is often quite narrow and serves as a one-way valve, allowing the [[urine]] to flow out, but preventing entry of microbes, for example from a dirty diaper. As long as the child is able to pass water, everything works as nature intended. But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of easier cleaning of a circumcised [[penis]] are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an [[infection]] of the wound. This also applies to the treatment of common complications like post-operative [[bleeding]]. The benefit of easier cleaning must be balanced against the risk of promoting serious infections - among others [[HIV]] - during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcision. == Circumcision methods == The [[Circumcision methods]] are discussed in a separate article. == Pain ==In the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the child felt no [[pain]] during the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel [[pain]], and more acutely than adults.<ref name="anand-hickey1987Clinical Pediatrics August 1986">{{REFjournal |last=AnandWilliamson |first=Paul S. |author-linkinit=PS |last2=HickeyEvans |first2=Nolan Donovan |author2-linkinit2= |etal=noND |title=Pain and its effects in the human neonate and fetus |trans-title= |language=Neonatal Cortisol Response to Circumcision with Anesthesia |journal=New Engl J Med |location= |date=1987-11-19Clinical Pediatrics |volume=31725 |issue=218 |pages=1321412-96 |url=httpshttp://wwwcpj.cirpsagepub.orgcom/librarycontent/pain25/anand8/412.abstract |quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine. |pubmedID=3317037
|pubmedCID=
|DOI=
|date=1986-08 |accessdate=20192011-1104-08}}</ref> This has led American health associations to recommend doctors take measures During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain of ",<ref>{{REFweb |quote=During the circumcision in infants, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. The [https |url=http://www.cirppollockclinics.orgcom/library/statements/aap1999circumcision/circumcision-before.html |AAP title=Before the Circumcision Policy Statement] (1999) states quite clearly that ''"There is considerable evidence that newborns who are [[circumcised]] without analgesia experience pain and physiologic stress"''. Furthermore, the pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening of the clamp"''.<ref>{{REFjournal
|last=
|first=
|titlepublisher= |date=2011-04-08 |accessdate=American Academy 2011-04-08}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of Pediatrics: Circumcision Policy Statement; Task Force on Circumcisionpain in the child.<ref name="Lancet, The 2010-10-09">{{REFjournal |last=Slater |first=Rebeccah |init=R |first2=Laura |init2=L |last2=Cornelissen |first3=Lorenzo |init3=L |last3=Fabrizi |first4=Debbie |init4=D |last4=Patten |first5=Jan |init5=J |last5=Yoxen |first6=Alan |journalinit6=PediatricsA |datelast6=1999-03Worley |volumefirst7=103Stewart |issueinit7=3S |pageslast7=686-93Boyd |urlfirst8=https://pediatrics.aappublications.org/content/103/3/686#sec-9Judith |accessdateinit8=2019-11-26J |notelast8=Statement Reaffirmed Sept. 1, 2005Meek}}</ref> |first9=Maria |init9=MThe [[AAFP]] (2002) states quite simply in their [https://www.cirp.org/library/statements/aafp2002/ | position paper], ''"Newborns experience pain during circumcision"last9=Prof.''<ref>{{REFwebFitzgerald |title=CircumcisionOral sucrose as an analgesic drug for procedural pain in newborn infants: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmeda randomised controlled trial |journal=The Lancet |volume=376 |issue=9748 |websitepages=Official American Academy of Family Physicians Website1225-32 |url=http://www.aafpthelancet.orgcom/onlinejournals/enlancet/homearticle/clinical/clinicalrecs/childrenPIIS0140-6736%2810%2961303-7/circumcision.htmlfulltext |accessdatequote=2011-05-02}}</ref> This is Our data suggest that oral sucrose does not a debatable factsignificantly affect activity in neonatal brain or spinal cord nociceptive circuits, and yet, it is therefore might not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel [[pain]], and may have performed countless circumcisions with this ideaan effective analgesic drug. Usage of anesthesia for infant circumcision is still by no means the rule. Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 The ability of the Council on Scientific Affairs], the AMA states ''"When the decision is made sucrose to proceed with circumcision, local anesthesia reduce clinical observational scores after noxious events in newborn infants should not be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. [[EMLA]] cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk interpreted as pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia"relief. The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb |titlepubmedID= |pubmedCID=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision |websiteDOI=American Medical Association Official Website |urldate=http://www.ama2010-assn.org/ama/no-index/about10-ama/13585.shtml09 |accessdate=2011-0504-0408}}</ref>Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.
|first=
|publisherinit=M |dateauthor-link= |accessdatelast2=2011-04-08}}</ref><ref>{{REFwebAbdulcadir |quotefirst2=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |urlinit2=http://www.pollockclinics.com/circumcision/circumcision-before.htmlJ |titleauthor2-link=Before the Circumcision |lastlast3=Ohi |firstfirst3= |publisherinit3=DA |dateauthor3-link=2011-04-08 |accessdatelast4=2011-04-08}}</ref> a topical cream,<ref>{{REFwebSantiago |quotefirst4=Then in our office, he will have topical anesthetic applied to his penis. |urlinit4=http://www.pollockclinics.com/circumcision/circumcision-before.htmlJE |titleauthor4-link=Before the Circumcision |lastlast5= |firstfirst5= |publisherinit5= |date=2011author5-04-08 |accessdatelink=2011-04-08}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |quotelast6=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection. |urlfirst6=http://www.pollockclinics.com/circumcision/circumcision-guide.html |titleinit6=Parents' Guide to Circumcision |lastauthor6-link= |firstlast7= |publisherfirst7= |dateinit7= |accessdate=2011author7-04-08}}</ref> Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcision.<ref namelink="Journal of Perinatology April/May 2002">{{REFjournal |lastlast8=Taeusch |firstfirst8=H. William |initinit8=HW |last2author8-link=Martinez |first2last9=Alma M. |init2first9=AM |last3init9=Partridge |first3author9-link=J. Colin |init3etal=JCyes |last4title=SnidermanPotentially under-recognized late-stage physical and psychosexual complications of non-therapeutic neonatal penile circumcision: a qualitative and quantitative analysis of self-reports from an online community forum |first4trans-title=Susan |init4language=S |last5journal=Armstrong-WellsInt J Impot Res |first5location=Jennifer |init5date=J |last6=Fuentes2022-10-Afflick23 |first6volume=Elena |init6issue=E |titlearticle=Pain During Mogen or Plastibell Circumcision |journalpage=Journal of Perinatology |volume=22 |issue=3 |pages=214-8 |url=httphttps://www.nature.com/jparticles/journal/v22/n3/full/7210653a.htmls41443-022-00619-8 |archived= |quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure. |pubmedID=36274189
|pubmedCID=
|DOI= |note=April10.1038/May 2002 |date=2002s41443-022-00619-048 |accessdate=20112023-0401-08}}</ref>=== Possible operative and postoperative complications === Circumcision is surgery. Surgical complications of circumcision generally may be classified as [[Bleeding| hemorrhage]], [[infection]], or surgical misadventure up to and including loss of the penis and [[death]].<ref name="deacon2022" /><ref name="Clinical Pediatrics August 1986williams-kapilla1993">{{REFjournal |last=WilliamsonWilliams |firstinit=Paul S.N |initauthor-link=PS |last2=EvansKapilla |first2init2=Nolan DonovanL |init2author2-link= |etal=no |title=NDComplications of circumcision |trans-title=Neonatal Cortisol Response to Circumcision with Anesthesia |language= |journal=Clinical PediatricsBrit J Surg |location= |date=1993-10 |volume=2580 |issue=810 |pages=4121231-6 |url=httphttps://cpjwww.sagepubcirp.comorg/contentlibrary/25complications/8williams-kapila/412.abstract |quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine. |pubmedID=8242285
|pubmedCID=
|DOI= |date=1986-0810.1002/bjs.1800801005 |accessdate=20112019-0411-0827}}</ref> During circumcision * Intolerance or allergic reactions to the narcotics used.* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]], the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, somp physicians give children sugar pacifiers is only likely to be used in emergencies. A surgical operation without proper [[pain]] control can lead to "reduce the perception development of a specific pain",memory<ref>{{REFweb |quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinicsspiegel.comde/circumcisionspiegel/vorab/circumcisionexperte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-before849534.html |title=Before Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-title=Children's pain expert warns: Ritual circumcision changes the Circumcisionbrain of children |language=German |last=Prof. Dr. med. Boris Zernikow
|first=
|publisher=Spiegel Online |website= |date=20112012-0408-0812 |accessdate=20112019-0410-0811 |format= |quote=}}</ref> but in at least one study. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, data shows that giving sugar to a child doesn't help to reduce their pain threshold was lower and the perception risk of chronic pain in the childincreased.Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref name="Lancet, The 2010-10-09">{{REFjournal |last=SlaterGarry |init=T |title=Circumcision: a survey of fees and practices |journal=OBG Management |date=1994 |firstvolume=RebeccahOctober |initissue=R |first2pages=Laura34-6 |init2url=L |last2accessdate=}}</ref><ref>{{REFjournal |last=CornelissenHoward |first3init=LorenzoCR |init3last2=LHoward |last3init2=FabriziFM |first4last3=DebbieGarfunkel |init4init3=DLC |last4=Pattende Blieck |first5init4=JanEA |init5last5=JWeitzman |last5init5=YoxenM |first6title=AlanNeonatal circumcision and pain relief: current training practices |init6journal=APediatrics |last6date=Worley1998 |first7volume=Stewart101 |init7issue=S |last7pages=Boyd423-8 |first8url=Judith |init8accessdate=J}}</ref><ref>{{REFjournal |last8last=MeekStang |first9init=MariaHJ |init9last2=MSnellman |last9init2=Prof. FitzgeraldLW |title=Oral sucrose as an analgesic drug for procedural pain Circumcision practice patterns in newborn infants: a randomised controlled trialthe United States |journal=The LancetPediatrics |date=1998 |volume=376101 |issue=9748e5 |pages=1225-32 |url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext |quoteaccessdate= |note=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuitsLink to [[AAP]] website}}</ref>. During procedures which take several minutes, and therefore might not be an effective analgesic drug. The ability babies tend to fall into a state of sucrose to reduce clinical observational scores after noxious events stupor, which in newborn infants should not be the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain relief.Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levels, which equals a state of severe [[shock]].<ref>{{REFjournal |pubmedIDlast=Gunnar |pubmedCIDinit=MR |DOIlast2=Fisch |init2=RO |last3=Korsvik |init3=S |last4=Donhowe |init4=JM |title=The effects of circumcision on serum cortisol and behavior |journal=Psychoneuroendocrinology |date=20101981 |volume=6 |issue=3 |pages=269-10-0975 |url=https://www.cirp.org/library/pain/gunnar/ |accessdate=20112019-0411-0826}}</ref> Post-operative * Postoperative wound pain and , in the pain the child must endure during recovery is hardly, if ever, addressed by professionals. It has been shown that an infantcase of children's response to [[pain]] can be altered for years as a consequence circumcisions conceivably worsened by the forceful breaking of circumcisionthe preputial adhesions.<ref>{{TaddioA etal 1995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> {{Box|Boxtext=<big><b>However, none * Postoperative pain from the exposure of the above three procedures totally eliminate sensitive glans penis to clothing. This pain. A baby boy will still experience endure for several weeks or even longer in some pain despite any of those analgesic procedurescases. Prevention of * Postoperative [[painbleeding]] requires protecting a boy from elective neonatal non-therapeutic circumcisionof the wound. Only boys who This can have severe consequences especially for very young infants, if they are protected from the medically unnecessary circumcision surgery experience no [[pain]] or [[trauma]]not treated promptly.</b></big>}}== Risks and effects == Just like tonsil or appendix surgery, circumcision Their blood volume is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks only about 85 ml per kilogram of complications and late effects. Uberoi et al. (2022) report "some men are experiencing a complex negative constellation of psychological, physicalbody weight, and sexual associations that even moderate blood loss can lead to significant emotional distress directed both internally hypovolaemia, hypovolaemic [[shock]] and externallyeven death. The posts also reveal a discovery phenomenon wherein men discover the physical and psychological manifestations of the decisions made by others to modify their genitals."<ref name ="uberoi2022">{{REFjournalREFbook |last=Uberoi
|first=
|inityear=M2000 |author-linktitle=Paediatric Handbook |last2url=Abdulcadir |first2work= |init2editors=Smart J, Nolan T. |author2-linkedition=6 |last3volume=Ohi |first3chapter= |init3page=DA82 |author3-linklocation= {{AUSC|last4=SantiagoVIC}}, Australia |first4publisher=Blackwell Science Asia |init4isbn=JE |author4-linkquote= |last5accessdate= |first5note= |init5=}}</ref><ref>{{REFdocument |author5-linktitle=Autopsy of Demetrius Manker |last6url= |first6contribution=Case 93-1711 |init6last=Wetli |author6-linkfirst=CV |last7publisher=Miami: Dade County Medical Examiner Department |first7format= |init7date= |author71993-06-link=23 |last8accessdate= |first8=}}</ref> <ref>{{REFjournal |init8last=Hiss |author8-linkinit=J |last9last2=Horowitz |first9init2=A |init9last3=Kahana |author9-link= |etalinit3=yesT |title=Potentially under-recognized late-stage physical and psychosexual complications of non-therapeutic neonatal penile Fatal haemorrhage following male ritual circumcision: a qualitative and quantitative analysis of self-reports from an online community forum |trans-title= |language= |journal=Int J Impot Res |location=Clin Forensic Med |date=2022-10-232000 |volume=7
|issue=
|articlepages=32-4 |pageurl=https://www.cirp.org/library/death/hiss1/ |pagesaccessdate=2019-11-06}}</ref><ref>{{REFdocument |title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |url=httpshttp://www.naturecircumstitions.com/articles/s41443death-022-00619-8exsang.html |archivedcontribution= |quotelast=Newell |pubmedIDfirst=36274189TEC |pubmedCIDpublisher=Burnaby, B.C.: B.C. Coroner's Service |format= |DOIdate=10.1038/s414432004-02201-00619-819 |accessdate=20232019-0111-0826
}}</ref>
* Post operative [[lymphoedema]].* Postoperative [[Infection| infections]]. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference |last=Dr. med. Hartmann |first=Wolfgang |url= |place= Possible operative and postoperative complications Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=2012-11-26 |accessdate=}}</ref>Circumcision is surgery* [[Wound dehiscence]], meaning the separation of the edges of the wound or the tissue after suturing. Surgical complications * Adhesion between the surface or rim of circumcision generally may be classified as the [[BleedingGlans penis| hemorrhageglans]] with the neighbouring [[penile skin]], causing [[infectionskin]]pockets and bridges, or surgical misadventure up to and including loss of the penis and as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.* Postoperative [[deathphimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock et al.<ref name="deacon2022" /><ref name="williams-kapilla1993">{{REFjournal |last=WilliamsBlalock |init=N |author-link=HJ |last2=KapillaVemulakonda |init2=LV |author2-linklast3=Ritchey |etalinit3=noML |titlelast4=Complications of circumcisionRibbeck |trans-titleinit4=M |languagetitle=Outpatient management of [[phimosis]] Following newborn circumcision |journal=Brit J Surg |location=Urol |date=1993-102003 |volume=80169 |issue=106 |pages=12312332-64 |url=https://www.cirp.org/library/complications/williamsblalock1/ |accessdate=2019-11-kapila26}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |last=Leitch |init=IOW |title=Circumcision - a continuing enigma |journal=Aust Paediatr J |quotedate=1970 |pubmedIDvolume=6 |issue=8242285 |pubmedCIDpages=59-65 |DOIurl=10https://www.cirp.1002org/library/general/leitch1/bjs.1800801005 |accessdate=2019-1112-2715}}</ref>5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Intolerance or allergic reactions to Knot formation of the narcotics usedveins.* Especially in newborns, where If the bodily pain reduction mechanisms are not yet fully developeddorsal vein, local anaesthesia is often insufficient for the operation. Even which originates in conjunction with regional anaesthesia of the dorsal nerve tip of the [[penisforeskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the rate development of failure knots.* Possible deformities due to provide sufficient anaesthetic even for experienced anaesthetists is still 5circumcision include hypoplasia of the [[penis]] (micro-10%penis) and induratio [[penis]] plastica (skewed penis). The general anaesthesia that would * Medical malpractice can also not be needed for newbornsruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, [[necrosis]], gangrene, howeverischaemia, poses significant risks for the childkeloid formation, andcirculatory problems may also occur.* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), therefore, there is only likely to be used in emergencies. A surgical operation without proper a risk of infection with [[painherpes]] control simplex type 1, which can lead to the development of a specific pain memorybrain damage or [[death]].<ref>{{REFweb |url=http://www.spiegelnytimes.decom/spiegel2012/vorab03/experte08/nyregion/infants-warntdeath-rituellerenews-beschneidungdebate-veraendertover-dasa-gehirn-der-kindercircumcision-a-849534ritual.html |title?_r=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder0 |trans-title=Children's pain expert warns: Baby’s Death Renews Debate Over a Circumcision Ritual circumcision changes the brain of children |language=German |last=Prof. Dr. med. Boris ZernikowRobbins |first= |publisher=Spiegel Online |website=Liz |date=2012-0803-1207 |accessdate=2019-10-11 |format= |quote=}}</ref> === Physical late effects === * An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. In unsedated This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and partially sedated infants increased secretion of the stress hormone cortisol could be observed touch receptors, which account for months after the operationmajor part of male sexual sensation. OverallIf the [[foreskin]] is removed, their pain threshold was lower they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the risk sensitivity of chronic pain increasedthe remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells et al. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournalSorrells etal 2007}}</ref> found a significant reduction of sensitivity to touch for [[circumcised]] compared to [[intact]] [[penis]]es in adult males. Other studies revealed that [[circumcised]] men use condoms significantly less often than [[intact]] men, since they further limit the sexual sensitivity (see above). |last=Garry |init* Painful tension can occur when there is too little reserve [[skin]] left to support a full [[erection]]<ref name=T |title=Circumcision: a survey "taylor1996"/>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of fees their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and practicesdouble or more their size during an [[erection]] ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve [[skin]] needed in adulthood cannot be estimated. |journal=OBG Management |date=1994 |volume=October |issue= |pages=34-6 |url= |accessdate=}}</ref>* Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal |last=HowardMoney |init=CRJ |last2=HowardDavison |init2=FM |last3=Garfunkel |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=MJ |title=Neonatal Adult penile circumcision : Erotosexual and pain relief: current training practicescosmetic sequelae |journal=PediatricsJournal of Sex Research |date=19981983 |volume=10119
|issue=
|pages=423289-892
|url=
|accessdate=
}}</ref> * Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual [[keratinization]] of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time [[circumcised]]] men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.* Vaginal dryness: Due to the loss of the natural [[gliding action]], which comes from the mobility of the [[foreskin]] and [[shaft skin]], a much increased friction between [[penis]] and [[vagina]] occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>{{FrischM LindholmM GroenbaekM 2011}}</ref><ref>{{REFjournal |last=StangCortés-González |init=HJJ |last2=SnellmanArratia-Maqueo |init2=LWJ |last3=Gómez-Guerra |init3=L |title=Does circumcision has an effect on female's perception of sexual satisfaction? |journal=Rev Invest Clin |date=2008 |volume=60 |issue=3 |page=227 |url= |pubmedID=18807735 |accessdate=}}</ref> The prolonged time it takes [[circumcised]] men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to [[intact]] men - play a part in this.<ref name="ColdCJ TaylorJR 1999">{{ColdCJ TaylorJR 1999}}</ref><ref>{{REFjournal |last=Fink |init=KS |last2=Carson |init2=CC |last3=DeVellis |init3=RF |title=Adult Circumcision practice patterns in the United StatesOutcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction |journal=PediatricsJ Urol |date=19982002 |volume=101167 |issue=e55 |pages=2113-6
|url=
|accessdate=
}}</ref>
* Postoperative wound pain, in the case [[Lymphoedema]] of children's circumcisions conceivably worsened by the forceful breaking penis is a normal and expected complication of the preputial adhesionsmale circumcision. * Postoperative pain from [[Meatal stenosis]], a pathological narrowing of the exposure opening of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in some cases.* Postoperative [[bleedingurethra]] of the wound. This can have severe consequences especially for very young infants, if they are not treated promptlywhich mostly occurs in infancy and early childhood. Their blood volume It is only about 85 ml per kilogram one of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously [[shockcircumcised]] and even deathboys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting |journal=Clin Pediatr (Phila) |note=Jan-Feb 2006 |date=2006-01 |volume=45 |issue=1 |pages=49-54 |url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting |accessdate=2019-12-15}}</ref><ref>{{REFbookREFjournal |last=Stenram |firstinit=A |yearlast2=2000Malmfors |init2=G |last3=Okmian |init3=L |title=Paediatric HandbookCircumcision for [[phimosis]]: a follow-up study |journal=Scandinavian journal of urology and nephrology |date=1986 |volume=20 |issue=2 |page=89
|url=
|work= |editors=Smart J, Nolan T. |edition=6 |volume= |chapter= |page=82 |location={{AUSC|VIC}}, Australia |publisher=Blackwell Science Asia |isbn= |quotepubmedID=3749823
|accessdate=
}}</ref>
|accessdate=
}}</ref>
|article=
|page=
|pages=286-305 |url=https://www.ncbinature.nlm.nih.gov/pmccom/articles/PMC5028213/s41443-022-00561-9
|archived=
|quote=
|pubmedID=27695583 |pubmedCID=5028213 |DOI=10.5489/cuaj.3590 |accessdate=2022-09-04}}</ref>}}=== Sexual effects === Circumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well." The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the [[penis]], leaving only the uninhibited protopathic sensibility of the artificially externalized [[glans penis]]. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in [[circumcised]] human males.<ref>{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |last2=Cold |init2=CJ |title=Advantages and Disadvantages of Neonatal Circumcision |journal=The Journal of the American Medical Association |volume=277 |issue=13 |pages=1052-7 |url=http://www.ncbi.nlm.nih.gov/pubmed/9218663 |quote= |pubmedID=921866335501394
|pubmedCID=
|DOI= |date=199710.1038/s41443-022-0400561-029 |accessdate=2023-11-23
}}</ref>
</blockquote>Histology of The un-anesthetized and un-sedated newborn infant is restrained by being strapped to a special plastic board called the male circumcision scar shows [[amputationcircumstraint]] neuromas. The procedure is most often an elective, Schwann cell proliferation non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation of the bulbous collection of variably sized neuriteschild's [[human rights]] to [[physical integrity]], but in older patients may be rarely indicated for therapeutic reasons. It is a radical treatment option for pathological [[Amputationphimosis]], refractory [[balanoposthitis]] neuromas do not mediate normal sensation and are notorious for generating painchronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health.<ref name="ColdCJ TaylorJR 1999"/>
See [[Sexual effects of circumcision]] for more information.