CANOE, March 4, 2002.


Circumcision, the unkindest cut

By DR. GIFFORD-JONES -- Special to C-Health

GIFFORD-JONES When I researched this column on circumcision, my initial reaction was "wow." I thought the topic would be as easy to write about as rolling off a log, but it took hours. I hadn't realized the male foreskin had triggered so many medical articles and so much controversy. Now I'm convinced that most families make a decision on circumcision without knowing much about this procedure. The question is, has male circumcision increased the sale of Viagra?

For some families the decision is easy. They believe circumcision should be performed for religious as well as for sound medical reasons. But if that's not the case, what should you do? A good start is a lesson on anatomy and its sexual implications.

First, the foreskin doesn't cover just a small surface of the penis. The skin removed by circumcision measures from three to five inches in length. That's about half of the total skin of the penis. Besides, inside the foreskin, there's a band of tissue that moves in and out like an accordion. This gliding motion triggers sexual reflexes and contributes to sexual pleasure.

So shouldn't sensible babies cry out to parents , "you had better think twice before removing such a significant portion of my anatomy. And have you ever considered how this will affect my sex life?" Some might even add in these litigating times, "do it and I'll sue you for a million."

Due to the recent research of Dr. John Taylor, male babies now have even greater grounds for being upset. Taylor is a retired pathologist in Winnipeg, Man. In 1996, he and his colleagues published a report describing anatomically 21 foreskins in the British Journal Of Urology.

In effect, Taylor claimed medical textbooks of anatomy have neglected the foreskin for hundreds of years. In Gray's Anatomy, the bible of anatomy, there's just one sentence about the foreskin. But Taylor and his colleagues found a "ridged band," 1.25 centimetres (half an inch) in width, that runs around the inside tip of the foreskin never before mentioned.

A detailed microscopic examination of the foreskin revealed it's not merely a piece of skin. Rather, it's loaded with blood vessels and nerves. Remove it and you also amputate a large part of the sexual portion of the penis. That in itself should warrant a class action suit by millions of males!

Erectile dysfunction (ER) is due to several causes. But I wonder how much Viagra is being sold today because of too much snipping of the foreskin?

So why is circumcision being done? One lame argument claims it prevents cancer of the penis, an extremely rare problem. But you don't amputate breasts to prevent cancer of the breast!

Studies do show that circumcision decreases the number of urinary tract infections during the first year of life. But is this a valid reason for amputation that may decrease the pleasures of sex for 75 years?

What about complications from the procedure? Luckily, they're rare but there have been some terribly botched jobs. Some have resulted in severe injuries to the penis and urethra (the tube that carries urine through the penis). Other babies have suffered from infections and hemorrhage.

So, if you don't have religious views about circumcision, what is the best decision? The Canadian Paediatric Society believes that circumcision of newborns should not be a routine procedure.

The Council on Scientific Affairs of The American Medical Association has reached the same conclusion.

Due to the updated anatomy lesson from Dr. Taylor, saying "thanks but no thanks" to circumcision seems to be a logical conclusion. Surely, nature put the foreskin there for a valid reason and it's rarely prudent to disagree with nature.

As Dr. Taylor remarks, "The value of the actual foreskin is often put at zero. But parents should put a value on it because it's a structure in its own right."

I'm sure some readers will argue, "I've enjoyed good sex for years and I was circumcised." Maybe so, but they could also be living in a fool's paradise. Have they considered how much better sex would have been without the snipping!

And what about the babies' pain? I've heard too many screaming babies not to know it's a painful procedure. As Dr. Margaret Somerville, a lawyer and ethicist at McGill University says, "People have a fundamental human right not to have pain intentionally inflicted on them." Shouldn't that human right include babies?

[CIRP Note: Dr. Gifford-Jones writes a medical column that appears in numerous newspapers across Canada.]

Cite as:
(File prepared 16 March 2002)