May 27, 2016
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Circumcision The Medical Pros and Cons (cont.)

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What is newborn circumcision?

Newborn circumcision consists of removal of the foreskin -- the foreskin is resected to near the coronal sulcus -- in the newborn period (before the age of 2 months).

Incidentally, the Latin circum means around (or about). Circumcision is a cutting around.

What is the status of the foreskin at birth?

Few boys are born with a retractable foreskin. This reflects the fact that the tissue development of the foreskin is usually not complete at birth.

The foreskin is thus not fully separable from the glans in most newborn boys. By 1 year of age, the foreskin can be retracted in about half of boys, and by 3 years, the foreskin can be retracted in a majority of uncircumcised boys.

What does this have to do with circumcision?

It means that the inability to retract the foreskin at birth and in infancy is normal and does not constitute a medical reason for a circumcision.

What is phimosis?

Phimosis is a medical indication for circumcision. It is defined as "stenosis of the preputial ring with resultant inability to retract a fully differentiated foreskin." In other words, phimosis is present if the foreskin cannot be retracted at an age when it should normally be retractable.

What is the treatment for phimosis?

Phimosis can be treated by circumcision or by surgical enlargement of the phimotic ring, the ring of tissue causing the phimosis.

What is paraphimosis?

Paraphimosis occurs when the foreskin, once retracted, cannot return to its original location. The foreskin is trapped behind the groove of the coronal sulcus. Paraphimosis causes blood to pool in the veins behind the entrapment, which induces swelling. The swelling leads to severe pain in the penis and makes it impossible to return the foreskin manually to its original location.

What is the treatment for paraphimosis?

The foreskin, after lubrication, can sometimes be reduced. However, this works only if the paraphimosis is discovered very early. Because of the pain, the child has to have a short-acting general anesthetic or heavy sedation for the treatment. Paraphimosis may be treated by circumcision.

Medically Reviewed by a Doctor on 11/6/2015


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