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Male Circumcision - Is It Necessary?


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A few years ago, the surgery department of a certain hospital in manila condemned the practice of non therapeutic circumcision, like "operation tule". Circumcision was only limited to correct certain medical conditions like recurrent urinary tract infection due to phimosis (abnormally small opening of the foreskin).

JUST CURIOUS IS IT STILL POSSIBLE TO CIRCUMCISE AT ADULT AGE OF 40

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JUST CURIOUS IS IT STILL POSSIBLE TO CIRCUMCISE AT ADULT AGE OF 40

 

Yes it is still possible. There is not cut off age for the procedure. What is important is the indication (reason) and that the patient has been fully informed of the risks and benefits of the procedure.

 

The oldest I've done was a 34 year old, request ng wife niya.

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My eldest son, who just turned 9 y/o, is not circumcised unlike my younger son, 8 y/o. Since he was my first born and I was inexperience at motherhood, I didn't think I can handle taking care of his belly button and circumcision at the same time. So I decided to just have it done when he's about 5. The doctor's told me they would have to put him under general anesthesia and with his asthma there are some risks involved.

So hanggang ngayon hindi pa siya tule. For hygienic reasons, I want him circumcise but I'm afraid of the risk. He hasn't had an asthma attack in about 4 to 5 years. Maybe next summer when my hubby is home so he can help me.

 

IMHO:

The best time for circumcision is when the foreskin has already separated from the bulb. Normally, that is about 13 to 15 years old, it is also at that age where in the surgeon can also make the most precise idea of how much foreskin is to be removed, totally eliminating the chances for a second circumcision later in life. Another advantage is that the boy is already responsible enough to take care of the affected area. If you didn't wait for the foreskin to separate from the bulb by itself, the child will experience extreme pain the moment the anesthesia wears off.

 

To: exal

According to the surgeon who worked on my child & a dermatologist, it is possible for a 40 year old to be circumcised. But at that age, you would need more time for recovery.

Edited by johnlove
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  • 1 month later...
  • 4 months later...

i heard that circumcision is been done using laser nowadays, is this true? painless and can recover very fast, few hours lang no more pain. but may question is, will the skin be properly removed? will it grow back again? hope someone can englihten me. thank you very much

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  • 2 weeks later...

Circumcision is Relatively necessary. It is not ABSOLUTE.

 

If you will ask the Fellows of the Philippine College of Surgeons especially their pediatric surgeons, they discourage circumcision at birth.

 

The child should also be given the chance to decide for himself whether he like to be circumcised or not.

 

In Columbia Univerisity Medical Center (New York Prysbyterian Hospitals Affiliate) where I chance to visit, the doctors advocate circumcision in the pre-teen years because according to them, the smegma (kupal) increases the chance of having penile cancer.

 

Based on my readings, pre-teen circumcision is effective. But if the procedure was done already in the adult years, it has very little protective advantage.

 

Penile wart viruses tends to be higher in uncircumcised males thereby increasing the chance of penile cancer and cervical cancer in her partner.

 

 

 

But if you will ask some surgeons in Ospital ng Maynila, some or most of them do not advocate circumcision.

 

 

 

My final say: circumcision must be done in the pre-teen years!

 

Roel Tolentino,MD,FPCS,FPSGS,FPSO,FMOSP (MBA Student)

General Surgeon-Surgical Oncologist

SLMC,MCM

http://health.groups.yahoo.com/group/Dr_Ro...entino_Website/

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i heard that circumcision is been done using laser nowadays, is this true? painless and can recover very fast, few hours lang no more pain. but may question is, will the skin be properly removed? will it grow back again? hope someone can englihten me. thank you very much

 

 

 

LASER? That is a big JOKE. We don't use laser but cautery machine.

 

The pain that should be felt by the patient is the initial infiltration of local anesthesia. it must not be painful. if i forsee that i will have a diff time during the surgery, i do it in the OR under sedation.

 

recovery is about 5 days. but the "kamatis" is unavoidable unless the patient had a german cut which i don't do because i don't want to remove a very sensitive skin. although the german cut look is better.

 

removed skin will never go back again.

 

 

 

i prefer the dorsal slit. kahit may lambi. it adds to the bulk of the penis when erect!

 

Roel Tolentino,MD,FPCS,FPSGS,FPSO,FMOSP (MBA Student)

General Surgeon-Surgical Oncologist

SLMC,MCM

http://health.groups.yahoo.com/group/Dr_Ro...entino_Website/

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  • 2 weeks later...
How would you know if a doctor specializes in circumcision? Is circumcision something that any doctor in the field of 'General Surgery' can do?

 

AFAIK circumcision is not a specialization, every medical intern learn how to do the procedure during their rotation in surgery. Of course, every General Surgeon knows how to do it.

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  • 4 months later...

There is controversy surrounding circumcision. Advocates for circumcision argue, for example, that it provides important health advantages which outweigh the risks, has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physician, and is best performed during the neonatal period. Opponents of circumcision argue, for example, that it is a practice which has historically been, and continues to be, defended through the use of various myths; that it interferes with normal sexual function; is extremely painful; and when performed on infants and children violates the individual's human rights.

 

The American Medical Association stated in 1999: "Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice."

 

The World Health Organization (WHO; 2007), the Joint United Nations Programme on HIV/AIDS (UNAIDS; 2007), and the Centers for Disease Control and Prevention (CDC; 2008) state that evidence indicates male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, but also state that circumcision only provides partial protection and should not replace other interventions to prevent transmission of HIV.

 

 

 

 

:mtc:

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How would you know if a doctor specializes in circumcision? Is circumcision something that any doctor in the field of 'General Surgery' can do?

 

Most doctors, including medical interns, would be competent to perform circumcision.

However, not all of them are adept in the different techniques of circumcision. Usually, the dorsal slit technique is performed. It is easier and faster to do. It is the preferred method in medical missions. However, this technique leaves excess skin underneath the penis (we call this "lambi" in Pilipino).

 

Surgeons are trained to perform most techniques other than the dorsal slit. Some prefer other cuts.

Also, surgeons are in a better position to handle of complications from the procedure as they receive complications of the procedure performed by other physicians.

 

In the practice of mainstream surgery, your best bet for circumcision would be doctors who had general surgery training or urologic training.

  • Like (+1) 1
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  • 3 weeks later...
adult, about 40 year old.

 

 

here are some info regarding the risks and complications of a vasectomy and circumcision for an adult male :

 

Vasectomy Risks and Complications

 

Vasectomy is a safe, simple and effective birth control method.

 

 

What are possible vasectomy complications and risks?

...What are the causes for any post vasectomy pain?

 

Any surgical procedure carries some risk, but vasectomy is considered to be low-risk, typically not painful, and vasectomy complications are uncommon. It is important to note that vasectomy should be considered a permanent form of birth control, and it does not protect against sexually transmitted diseases or AIDS.

 

Discuss any concerns and risks associated with vasectomy with your physician. The following is a list of most, but not all, of the risk issues to consider.

 

Allergic Reaction - Rarely, some men may experience itching and hives, as an allergic reaction to local anesthetic.

 

Antibodies - Sperm which are no longer released through ejaculation and absorbed by the body may attract antibodies produced following vasectomy.

 

Bleeding - Generally painless bleeding may occur following vasectomy and collect under the skin, so that the penis and scrotum appear bruised and/or swollen. The scrotum skin is very thin, which may make bruising appear worse than it actually is and is a normal reaction after vasectomy.

 

Chronic Orchialagia- A rare vasectomy complication - the patient may experience a dull post vasectomy pain or ache in the testicles that is thought to be caused by a congestion of the epididymis with dead sperm and fluid. If this condition occurs, it usually disappears within six months.

 

Congestion - A common name for chronic orchialgia (see above).

 

Epididymitis - One of the more common of the vasectomy complications, epididymitis is a condition which occurs when the larger tube behind the testicle, connected to the vas, becomes inflamed and swollen. The application of heat and the use of anti-inflammatory medication with or without antibiotics usually clear this up within a week.

 

Failure - Pregnancy may result if a man fails to abstain from sex or use alternative forms of birth control during the waiting period, until the testing for live sperm is completed. There is also one chance in 10 thousand that the cut vas will spontaneously rejoin.

 

Hematoma - Bleeding may occur inside the scrotum causing post vasectomy pain or swelling. When it occurs, it is usually within the first week of the vasectomy. While seldom serious, it should be reported to a physician.

 

Immune Reactions - Following vasectomy, the immune system may recognize the absorbed sperm cells as foreign proteins and produce antibodies in response. While many men may experience this immune reaction, current evidence indicates that this reaction generally is not harmful. Immune reactions can also contribute to the development of clogging of arteries, which in turn could lead to heart attacks. However, there is no evidence of an increased risk of atherosclerosis because of a vasectomy.

 

According to the National Institutes of Health, research that examined this issue found no evidence that vasectomized men were more likely than others to develop heart disease or any other immune illness. (NIH Publication Number 96-4094, April 1996)

 

Infection - If blood collects under the skin following vasectomy, it can become infected. Post vasectomy infection at the incision site or in deeper tissue occurs in less than 5 percent of all cases. Such vasectomy infections usually respond favorably to antibiotic treatment, antimicrobial creams and hot baths, usually within a week.

 

Postoperative Pain - Some degree of post vasectomy pain or ache is normal following a vasectomy. The use of acetaminophen (Tylenol), with or without codeine frequently is recommended over aspirin, which can cause bleeding. Any painful discomfort normally resolves within a day or two, while a slight ache may remain longer.

 

Prostate Cancer - Studies looking at the association of prostate cancer with vasectomy have demonstrated conflicting results in the past. To answer this question, a major study involving over 2000 men was performed and reported in the Journal American Medical Association (JAMA 2002; 287:3110-3115). The conclusion was clearly that there is no increased risk of prostate cancer with vasectomy (NIH News Release).

 

Sexual Difficulties - It is usually reported that men who undergo vasectomy and their partners express greater enjoyment and spontaneity of sex. However, occasionally a man may experience sexual problems after vasectomy, but these almost always have an emotional basis. Counseling usually alleviates the problem.

 

Sperm Granulomas - One of the more typical vasectomy sequelae, sperm granulomas occurs when sperm leakage from the testicular cut end of the vas causes a small and usually painless lump. This lump does not pose a danger and frequently resolves over time.

 

In Summary:

 

Although a simple, safe and common surgical procedure, any surgical procedure includes some risk.

Vasectomy complications are usually uncommon.

Some post vasectomy pain and discomfort may be expected, but this normally decreases and disappears within days, given routine post operative care.

It’s important to review possible vasectomy complications and risks with your physician.

 

 

 

:mtc:

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adult, about 40 year old.

 

 

Risks/Complications

 

As with all surgical procedures, there is a risk for bleeding and infection when performing a circumcision. Other risks include severe bruising (hematoma), poor cosmetic result, and a change in sensation during sex.

 

 

Complications that can occur following adult circumcision may include the following:

 

Buried penis (penile shaft buried below the surface of the pubic skin)

Chordee (abnormal downward bend of the penis)

Complications from the anesthetic

Meatal stenosis (narrowing of the urine channel [urethra] at the top of the penis)

Poor cosmetic appearance

Skin bridges (foreskin reattaching to the glans)

Tearing of the sutures, usually due to erection

 

 

 

 

:mtc:

Edited by peterparker
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  • 3 months later...

ok pa din ba ang "pukpok" tuli procedure? It was my big brother used to say when i asked him,ano procedure sa kanya. ouch... la pang anesthesia sa kanya that time...

 

docs, my nephew will be turning 9 next year,how will i know if he is ready for circumcision?.... Will it be proper for a nurse to do the procedure since here in our place (tertiary hospital) i sometimes see nurses do the suturing...

Edited by powerpuffgirls
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ok pa din ba ang "pukpok" tuli procedure? It was my big brother used to say when i asked him,ano procedure sa kanya. ouch... la pang anesthesia sa kanya that time...

 

docs, my nephew will be turning 9 next year,how will i know if he is ready for circumcision?.... Will it be proper for a nurse to do the procedure since here in our place (tertiary hospital) i sometimes see nurses do the suturing...

 

 

hmm.. strictly speaking nurses should not be doing the job of a physician, in your case performing circumcision which is supposed to be done by a surgeon.. nurses are not properly trained and qualified for this and should not be condoned even if there is a shortage of qualified physicians in your place.. mahirap na lalo na kung magkaroon ng problema at komplikasyon..

 

 

:mtc:

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  • 9 months later...

Traditionally, circumscision is done on the summer before entering first-year high school. That way, the boy's penis is large enough to be manipulated and mahihiya syang pumasok ng hindi pa tuli. But nowadays, it's only done for traditional purposes.

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