Advantages and disadvantages to being circumcised?

Monday, November 13, 2006
It's not something blokes like to talk about much, but there was a time not so long ago that pretty well most men had the unkindest cut — were circumcised.

But not any more. Fewer than one in 10 boys will have the op — and the trend continues down.

So why the change in attitude? What are the advantages and disadvantages to being circumcised?

Circumcision's been performed for thousands of years. Even some Stone Age cave drawings depict circumcised males. So how did it first start?

Well, according to John Hutson, Professor of Paediatric Surgery at the Royal Children's Hospital in Melbourne, it all came about because of the outdoor lifestyle of our ancestors.

"Probably because every time there was a sandstorm, children or young adult males got sand under their foreskin and they got chronic inflammation, which was known as balanitis, and so ritual circumcision both of males and babies became normal in all societies where there's sand," says Professor Hutson.

Circumcision is also part of aboriginal culture, for the same reason. But these days, things have changed.

For the thousands of years that circumcision has been practised, it's taken on more than a medical role. For many people it holds religious and cultural significance.

Lisa and Faz Rahman are Muslims. Their son Zain is two-and-a-half years old and he's about to be circumcised. "All the Muslims, anywhere in the world … without circumcision you can't be a Muslim," says Faz.

Well, Zain's about to become a full Muslim and Dr Tamer Kahil's going to do the honours.

"The procedure, in short, is peeling back the foreskin, off the head of the penis, we clean the smegma, and then we do the cutting," says Dr Kahil.

First, a local anaesthetic so Zain doesn't feel anything. Then, it's down to business.

"We clean the smegma, then we do the cutting … something to stem the bleeding, then we close the wound with dissolvable stitches," says Dr Kahil.

While Doctor Kahil's happy to circumcise for religious reasons, he doesn't encourage it. In inexperienced hands, too many things can go wrong. "If circumcision is done badly, then certainly there will be lots of drawbacks including infection, bleeding, pain," he says.

But for Zain, everything's gone smoothly.

Three weeks later, young Zain's on the mend. The circumcision went off without a hitch.

"Things went really well — a lot more calm than I thought, he only cried a little bit when he got his local but everything went perfectly, actually, that was fine," says Lisa Rahman.

But if you don't have religious reasons for circumcision, why would you? Well, many circumcised dads want their sons to look like them. But since only a minority of boys are being circumcised, that may not be the best decision.

Professor Hutson: "The boy needs to look like his friends, not like his father, so for parents trying to make a decision about this, they probably want to go with the majority and the majority are uncircumcised."

It's a topic that certainly causes discussion among new parents. For their boys Felix and Luca, Johanna and Gavin decided to go with the majority.

"Honestly, out of all of our friends that have kids around the same age as us, there is one couple that chose to circumcise out of 20 or 30 that we know," says Johanna.

"There's no need to do it, there's no medical support for it and it's the choice that they can make if they really want to later in life," says Gavin.

And the reality is, in countries like Australia, the need for circumcision on grounds of hygiene simply doesn't exist. With plenty of running water, the foreskin stays clean. The choice to go with circumcision remains mostly a religious one.

Just as with Islam, circumcision is a fundamental part of Judaism.

Rabbi Nachum Schapiro says: "Right at the beginning of the child's life. We're actually told that the entry of a divine soul into the child begins at the time of circumcision."

According to the Jewish bible, the Torah, it should be performed when the boy is eight days old.

There's medical evidence to suggest that it's the best time to remove the foreskin, as the pain is least at that age.

Whilst circumcision is no longer routine in Australia, there are certain benefits this procedure may bring. If you are thinking of having your child circumcised, consult your doctor for more information and the best age to perform the surgery.

Some studies suggest that having your child circumcised may:

  • Reduce the risk of penile cancer.
  • Reduce the risk of urinary tract infections and consequent renal complications.
  • Provide greater protection against sexually transmitted diseases.
  • Eliminate the risk of phimosis.
  • Reduce the risk of prostate cancer.

But the weight of medical opinion seems to be that circumcision isn't really necessary.

"In a modern society where everyone's got access to running water and particularly hot water where you can have a wash, the risk of a unclean foreskin in an adult male is effectively a non-issue," says Professor Hutson.

Well, there you have it. We've moved on from the time when all blokes were circumcised. Now amongst the younger generation, if you've had it done, you're very much the odd man out. That's not to say there aren't valid cultural, religious and medical reasons for circumcision. But these days the odds are pretty high that men will be exiting the world with all the bits they entered with.

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