A Journey with Love and Laughter

Read about our family as we journey through life as a family, with siblings, school and spina bifida, and lots of fun and laughter along the way!

Tuesday, July 27, 2010

Clinic Part 2 - The circumcision Question

Another interesting thing that came out of the visit – the question about circumcision. Nickolas is not circumcised – before we found out about the spina bifida, when we knew we were having a boy, we decided that yes we would get him circumcised. Then when we found out about the SB that went out the window, with the idea to keep as much sensation as possible. That and when he was born that was the last thing on our mind, and no one asked/offered/explained the pros and cons.


Well the urologist that we saw asked why Nickolas wasn’t circumcised. I just explained pretty much the same as above. He said that a major pro would be the decrease of infection, and it would actually be a medical indication – and covered by OHIP (saving us $300). Hmmm. So I’m thinking yes. And then we talk about what that means.

Well, as an infant a circumcision means a bit of local freezing, being strapped down and having a kind of clamp attached and cut around. Gross-sounding, wait ‘till you assist with them! As an older baby it does not mean the same thing. Circumcision as an 8 month old means general anaesthetic, and stitching, but also a specialist (urologist) who can make a ‘neat’ job. (Whatever that means). Well now I don’t know what to do! I don’t want Nickolas to go under general (put to sleep), but if it is a medical indication… AND if he does need it, I don’t want to wait until he’s a toddler.

Kyle is no help. I can’t even use the he-has-the-penis excuse for him making the decision. Now he comes back with the you-have-the-medical-knowledge excuse. He wants me to make the decision, I want him to make the decision. And here we are. Time to look up some research papers and do some investigating!

OK enough with the penis talk - time for some cuteness!



Nickolas enjoying a floaty toy


I LOVE this bathing suit - I call it her tarzan swimsuit!

12 comments:

  1. Please check out the many excellent articles and videos at: http://www.icgi.org/birth_care_providers.htm

    "The Prepuce" describes the anatomy and functions of the foreskin. I suspect it has information that the urologist may be unaware of.

    The urologist has a financial interest in recommending circumcision, so that could be influencing him.

    ReplyDelete
  2. In some countries they won't circumcise till a baby is six months old btw, specifically so that general anesthetic can be used. The only reason they don't use general on newborns is because the risks are too high.

    SB seems to be a reason not to circumcise, rather than a reason to have it done:
    http://www.cigna.com/healthinfo/hw142449.html

    I wouldn't let the money be a factor btw. Personally, I'd pay a years's salary just to keep my son intact.

    I'm skeptical of circumcised doctors recommending circumcision. It's easy to find circumcised doctors who are against circumcision, but almost impossible to find doctors who grew up intact, but are in favor of circumcising infants.

    You might also want to check out the following:

    Canadian Paediatric Society
    "Recommendation: Circumcision of newborns should not be routinely performed."

    http://www.caringforkids.cps.ca/pregnancy&babies/circumcision.htm
    "Circumcision is a 'non-therapeutic' procedure, which means it is not medically necessary."
    "After reviewing the scientific evidence for and against circumcision, the CPS does not recommend routine circumcision for newborn boys. Many paediatricians no longer perform circumcisions.


    RACP Policy Statement on Circumcision
    "After extensive review of the literature, the Paediatrics & Child Health Division of the Royal Australasian College of Physicians has concluded that there is no medical reason for routine newborn male circumcision."
    (almost all the men responsible for this statement will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%. "Routine" circumcision is now *banned* in public hospitals in Australia in all states except one.)

    British Medical Association: The law and ethics of male circumcision - guidance for doctors
    "to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate."

    The Royal Dutch Medical Association
    http://knmg.artsennet.nl/Diensten/knmgpublicaties/KNMGpublicatie/Nontherapeutic-circumcision-of-male-minors-2010.htm
    "The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications."

    Drops in male circumcision:
    USA: from 90% to 57%
    Canada: from 48% to 32%
    UK: from 35% to about 5% (about 1% among non-Muslims)
    Australia: 90% to 12.6% ("routine" circumcision has recently been *banned* in public hospitals in all states except one, so the rate will now be a lot lower)
    New Zealand: 95% to below 3% (mostly Samoans and Tongans)
    South America and Europe: never above 5%


    Obviously I'm against it, but good luck to you and your son whatever you decide.

    ReplyDelete
  3. We were told being circumcised was better when they are older if they need to continue being cathed. Although we have another urology surgery that allows them to circumcise him at the same time. Your decision to put him under just for that is a tough one.

    ReplyDelete
  4. I don't know what to tell you about the circumcision - but I will say Nickolas is so cute! And I totally relate to the "you decide", "no you decide" conversatoins with your husband!

    ReplyDelete
  5. What benefits there are to male circumcision are also applicable to female circumcision. Consider the glaring double standard when we stand arm-in-arm against female genital mutilation, yet willfully mutilate male genitals out of no medical necessity (there are exceptions, but I'm addressing the widespread 'cosmetic' procedure).

    Certainly read up on both sides. But you might be better served just watching the procedure performed. It's no wonder that pro-circumcision advocates steer away from the obvious barbarism by conveniently avoiding a simple youtube link with the damning evidence:

    http://www.youtube.com/watch?v=47gJzRSsRLU

    This is a very informative and well made video by the YouTube user Happy Cabbie. It's a debunking of every pro-circumcision arguement, plus some seriously disturbing footage of the procedure. It's brutal, but he warns you before it starts.

    If you're really considering it, you owe it to your son to see what other human beings have endured at the whim of cultural and religious directives with respect to the condition of our genitals.

    Unless a child has a legitimate medical reason for the removal of the foreskin, there is no justifiable reason to make a choice to amputate their body. Let them decide as an adult, should they so choose.

    Thanks for keeping an open mind on this issue. My best to you and yours. It looks like you have a really wonderful family.

    http://historyofcircumcision.net/

    ReplyDelete
  6. Please ignore the comment at 12:35pm.

    ReplyDelete
  7. HAHA! Wow, you opened a can of worms with that one ;) We didn't do King either and wouldn't have done it either way. All of King's doctors are immigrants to Canada and thought it was weird when we asked about it. No one's ever said we should get it done, so we didn't. Have you guys had problems with infections? K hasn't had any and I've never had any trouble cathing as a result of not being snipped.

    ReplyDelete
  8. Wow, that is quite the debate you have going there. Both my boys are not circumsised. It was never really a question for me...and when I asked Jeff for a good reason to have it done, he couldn't come up with one. Most of the little boys we know are not either. No infections or concerns at all and they are 4.5 and 2.5. Now, neither has spina bifida or needs to cath, so I can't speak to that. I can say that my experience is no concerns and it is more of the majority around here now.

    Good luck researching!

    Sara

    ReplyDelete
  9. Hi Amanda! I've got a girl, as you know...so I offer no opinion!

    I just wanted to say I know you guys will, no matter which choice you make, have made one that is the best for your son, given his medical history and outlook. You certainly have more than the usual "to C or not C decision" here, with SB factored in.

    Best of luck in your research and your pondering this over.

    ReplyDelete
  10. Wow - who knew I would get so many responses. After reading some of the websites posted it is obvious that these people are only weighing in on the routine circumcision debate.
    This is a seperate issue. We do have a valid medical reason for circumcision - to decrease chance of UTI. While Nick has not had a UTI he is at risk because of his neurogenic bladder and was actually on antibiotics to prevent this. So valid medical reason.
    But does it outweigh the negatives - specifically losing sensitivity and the needs for general anestetic. I don't know. There is no research on circumcision consequences ect with the spina bifida population. THAT is what I'd like to see!

    As for what Mark Lyndon wrote - the article that says that spina bifida is a contraindication. I beleive that was talking about the immediate neonatal period - with the immediate need for surgery and so much more on our plate. I think spina bifida WOULD be contraindicated - which brings us to the dilema at 8 1/2 months old.

    Thanks to everyone. I'll make another post with more info that I find out. There is also a thread with this question on both the SB forums I've joined - I'm not posting what forums - you should know if you are looking at my blog.

    OK bring on more debate!

    ReplyDelete
    Replies
    1. My son is 24 with SB at L5/S1. Been cathed since he was 2 years old. Not circumcised. Never been a problem, not once. Never been mentioned as a potential problem even. I wouldn't have done it anyway but my aim has always been as few surgeries as possible. Good luck.

      Delete