Cut or uncut?

Miss Fluff

Prefer an uncut man's cock way more tbh, both aesthetically speaking and physcialy have always thought circumsised cock's seem to have an almost "spongy" centre imo

Wibbs

tallaght01 wrote: »

There's a lot of untruths in it.

Can you point them out?

I'm as big an advocate of the rights of children as anyone. It's an issue very close to me.

Which is a good thing.

If you're going to talk about human rights, there are far greater issues to concentrate on than male circumcision.

While there exists an obvious sliding scale of human rights and their abuse, any issue concerning human rights and lack of consent for a procedure is important.

That's why it's an attractive option in helping in the fight against HIV, and also penile carcinoma, which is much more common in developing countries.

Both of which are more prevalent in countries that already practice circumcision. Surely money would be better spent in education and condom supply which are far more effective?

JC 2K3

tallaght01 wrote: »

I don't know what bit you're describing as bollocks. If you let me know, I'll clarify. Presumably, though, when you say "if you include developing contries in this" you're implying I'm including "backstreet" circumcision. I'm not. But most devloping world hospitals do well with their operative risk when it comes to circumcision. That's why it's an attractive option in helping in the fight against HIV, and also penile carcinoma, which is much more common in developing countries.

No, I didn't mean backstreet circumcisions. I meant the fact that there's little access to running water in these countries and therefore much less likely that a man will wash under his foreskin every day.

In a developed country, with free access to running water, there's no way circumcision is a better option to teaching a child to wash under his foreskin every time he takes a shower.

b3t4

Wibbs wrote: »

Lube or lack of it may be an issue as both of you age though.

This will be an issue for all couples not just couples where the man is circumsised.

I would though that as he has no idea what it is like to have a fully functioning foreskin, his understanding is not as great as first appears.

I would think that a person who hasn't been circumsised would not have very much understanding of what it's like to be circumsised. His understanding will be based on the fact that being circumsised never hindered him or his father with regard to sex.

I'm not keen on the image being portrayed of circumsised men in this thread. The way things have been worded it's as if people are trying to convey the idea that men who are circumsised are in some way sexually inadept. From my experience this is very far from the truth.

A

Wibbs

b3t4 wrote: »

This will be an issue for all couples not just couples where the man is circumsised.

More of a problem with cut guys though as the glans is dryer and rougher due to keratinisation. In any event KY is cheap.:D

I would think that a person who hasn't been circumsised would not have very much understanding of what it's like to be circumsised. His understanding will be based on the fact that being circumsised never hindered him or his father with regard to sex.

That's my point, he doesn't know the difference. Like a blind man from birth he can't truly know what red is. From simple logic the only man who would is a guy with a normal functioning foreskin who got the operation later in life. Indeed a man who hasn't been circumcised has an idea how uncomfortable retracting his foreskin all the time would be. If he had a mind too, he could retract it for a month and see how it felt. A cut man simply can't do the opposite, cover his glans and know what that feels like, so again logically an uncut man actually has more of an idea about what may be lost in sensitivity. Again the clumsy analogy of a blind man. A man who can see can close his eyes and know what it is to be blind, a blind man can't open his and know what it is to be sighted.

I'm not keen on the image being portrayed of circumsised men in this thread. The way things have been worded it's as if people are trying to convey the idea that men who are circumsised are in some way sexually inadept.

I honestly don't see where you're reading that into the debate. I really dont. At no point did anyone pro or anti suggest that cut guys are any better or worse in bed from a woman's point of view. All that was said was that the guy has lost erogenous tissue which could impact how he feels the experience.

Ickle Magoo

I'm not bothered either way tbh - don't think one is better than the other, just different.

Unless there was a medical reason there is no way on earth I would have my son circumcised any more than I would have him tattooed. I don't think lopping off a piece of his penis because of my own or anyone else's penile preference is really appropriate. :eek:

Sangre

MIN2511 wrote: »

Not so keen on the extra skin, can be a nightmare when giving a bj. The men in my family were circumcised.

You're sick in the head.

dr.bollocko

This thread should be locked and retitled Wibbs pwns circumcision, owns foreskin.
Fair play good sir. I wholeheartedly agree.

You people are NOT taking the tip of my wee-fella just cos you like the look of it without its polo neck on.
But back to the original question. Would it look better without the poloneck on, not taht Im taking it off, so it doesnt matter really, but would you refuse Dr. Love because of his helmet?

tallaght01

I'm not particularly for or against circumcision. I have never suggested it to the parents of one of my patients, but I don't advise against it. I give them the figures, and let them make their minds up themselves. The parents have the choice between reducing the risks of certain diseases in their child, or removing the foreskin. The rights of the child Vs protection against disease. The parent has to act in what they regard as the best interest of their child, within limits, and that is their right. Similiar to parents vaccinating their kids when the worry surfaced about the MMR vaccine and autism.

Circumcision reduces the spread of HIV. You can talk about that til the cows come home, but it's true. Removing the immune cells on the inner surface of the foreskin reduce the ability of the virus to enter your system. You can say that people should use condoms instead. But they don't. The 60million people currently infected with HIV mostly didn't use condoms. Most of those infected are women, who very often don't have a say i whether condoms are used, or don't have access to them. You can't just say we should "spend money on condoms". if you're going down that route, then we shouldn't encourage condoms, we should only talk about abstinence. You have to use every weapon in your arsenal, not just those that are foolproof.

In terms of penile carcinoma, it's uncommon in Ireland. That's because it's uncommon in caucasian males. This isn't the same for different races. We can't just proclaim something as unneccesary because it doesn't affect white Irish males. The AMA don't suggest circumcision solely for the prevention of penile carcinoma, and they're right. In isolation, it probably doesn't warrant a national programme across america. But it accounts for up to 30% of male cancers in African, Asian and South american males. It's about 5-8% in India.

The wikipedia links posted by Wibbs are statistically bogus for all sorts of reasons, and don't reflect the reality of the published data. Most of which, sadly, isn't available without paid access to journals. Wibbs is saying things about how we invent new reasons to justify continuation of the practise, and talks about "dodgy" statistics. I, nor any of my coleagues (who give the same data as I do), have never given dodgy stats to parents to justify circumcision. I'd love to know what benefit there would be to us? The data posted in the wikipedia page talks about studies which relate to pain in babies in circumcisions where no pain relief is given. It's very rare for a paediatrician nowadays to refer a kiddy to anyone who performs the procedure withouth anaesthetic. It boils my blood to hear about circumcision withouth anaesthetic. I am 100% against it.

That aside, you also can't keep ignoring the fact about UTI's. You can't just say "we don't operate on baby girls' urethras". Saying this shows a deep misunderstanding of what urethral surgery involves, versus what male circumcision involves. Urethral surgery would carry far more risks than the risk of a UTI in your average baby.Try looking at a baby who has a UTI, which has shut down their kidneys, and is infecting their blood. It's one of the most common, and the one of the most serious infecions that paediatricians deal with routinely. People think all UTI's are like those we get as adults. A few pills formt he GP will sort them out. The last patient I had with a UTI was a baby, where it spread to his blod, and gave him meningitis. This isn't the norm, but it's a very serious illness in anyone under 6 months. Young babies can die from a UTI.

The cervical cancer issue has produced some different results. BUT, when you look at all the data together, like they did in the New England Journal of Medicine, you see that circumcision carriage is reduced in circumcised males, and cervical cancer is reduced in the partners of these males if they have had 6 partners or more.

JCK talks about running water. This is an issue. But the presence of a foreskin, even in the presence of excellent hygiene, is a risk factor for penile carcinoma.

You can debate the facts all night. Circumcision prevents disease. There are other ways of preventing those same diseases, but none work in isolation. So, as a parent, you have a choice to make. Protect against diseases, or not. If you choose to circumcise, then your baby is the one who faces the consequences when things go wrong. This is a heavy burden for most parents who go down this route, and one which causes most of them considerable angst.

Having said that, I don't believe for a minute that there's a world of circumcised guys around the world who can't enjoy sex. But fair enough, for a white Irish male born in 2008, circumcision isn't going to be a big issue. However, for many individuals it's a choice that's reasonable.

Just because something seems on the surface to be wrong, or just because it doesn't suit us, doesn't mean that sometimes it's not the right option.

EDIT: apologies to the mods. I just realised how long this post is. I just wanted to put the facts out there, so people can make their own mind up. I realise this wasn't the type of discussion the OP was seeking, so I'll keep me gob shut from hereon in, with regard to medicalese :P

Grawns

Here's my logical solution to this fun

If a parent wishes to reduce the risk of such diseases ( HIV, penine cancer, transmission of stuff to us ladies etc..) by penis surgery, the parents should have to wait until the child is of an age to make such a choice, e.g. when they hit puberty, 18, 25 are getting married whatevr... and then tell them all the pros and cons of circumcision. ( Yes young men of Ireland will queue up on such advise -Not bloody likely eh!) At the very least it encourage stricter hygiene.

tallaght01

Problem is that some of the benefits are only seen if you circumcise when the baby is newborn. Again, not such an issue for Irish guys. But we don't circumcise much, anyway.

The risks of the procedure are also much higher the older you get.

JC 2K3

tallaght01 wrote: »

So, as a parent, you have a choice to make. Protect against diseases, or not.

I'm sorry, but I just don't accept the mutilation of a guys genitals to be an ethical or intelligent method of disease prevention. It's not as simple as this.

tallaght01

JC 2K3 wrote: »

I'm sorry, but I just don't accept the mutilation of a guys genitals to be an ethical or intelligent method of disease prevention. It's not as simple as this.

Well, that's fine. You would be one of the many many parents who we discuss circumcision with, and decide against it.

But my point is simply that it's right for some people, and the fact that you don't agree with it doesn't make it globally wrong.

Ginny

from the AMA
"Urinary Tract Infection: There is little doubt that the uncircumcised infant is at higher risk for urinary tract infection (UTI), although the magnitude of this risk is debatable. A meta-analysis of 9 studies published between 1984 and 1992 revealed a 12-fold increased risk of UTI in uncircumcised males.4 Most of the studies analyzed were case-control designs that analyzed the rate of UTI in the first year of life. A more recent population-based cohort found a relative risk of 3.7 for hospitalization for UTI in the first year of life in uncircumcised boys.16 A similar relative risk (4.8) was detected in another case-control study.17The reliability of many studies examining circumcision status and UTI in infant males is weakened by lack of controls for potential confounders such as prematurity, extent of breastfeeding, and the method of urine collection used to identify bacteriuria.

Despite the increased relative risk in uncircumcised infants, the absolute incidence of UTI is small in this population (0.4%-1%).18 Depending on the model employed, approximately 100 to 200 circumcisions would need to be performed to prevent 1 UTI.16,19 In this case, a large relative risk reduction translates into a small absolute risk reduction because the baseline prevalence is low. One model of decision analysis concluded that the incidence of UTI would have to be substantially higher in uncircumcised males to justify circumcision as a preventive measure against this condition.20"

tallaght01

GinnyJo wrote: »

from the AMA
"Urinary Tract Infection: There is little doubt that the uncircumcised infant is at higher risk for urinary tract infection (UTI), although the magnitude of this risk is debatable. A meta-analysis of 9 studies published between 1984 and 1992 revealed a 12-fold increased risk of UTI in uncircumcised males.4 Most of the studies analyzed were case-control designs that analyzed the rate of UTI in the first year of life. A more recent population-based cohort found a relative risk of 3.7 for hospitalization for UTI in the first year of life in uncircumcised boys.16 A similar relative risk (4.8) was detected in another case-control study.17The reliability of many studies examining circumcision status and UTI in infant males is weakened by lack of controls for potential confounders such as prematurity, extent of breastfeeding, and the method of urine collection used to identify bacteriuria.

Despite the increased relative risk in uncircumcised infants, the absolute incidence of UTI is small in this population (0.4%-1%).18 Depending on the model employed, approximately 100 to 200 circumcisions would need to be performed to prevent 1 UTI.16,19 In this case, a large relative risk reduction translates into a small absolute risk reduction because the baseline prevalence is low. One model of decision analysis concluded that the incidence of UTI would have to be substantially higher in uncircumcised males to justify circumcision as a preventive measure against this condition.20"

A good, but outdated point. Meta-analyses in the archives of diseses of childhood in 2005 back that up...but only to an extent. Note that the recommendation isn't coming from the paediatric bodies.

a) The figure is 111 circumcisions to prevent one infant UTI. That means in America, circumcision prevents millions of UTIs every year. That's a lot of very sick babies.

b) The main problem with this AMA data is that it only looked at UTI occurence, as opposed to sepsis_renal damage. I dont want to get too technical, but the reality of this data is that 11 circumcisions in boys with recurrent UTI will prevent a UTI. It also shows that you only require 3 or more circumcisions in boys with bad bladder reflux to prevent a UTI.

c) The data by the AMA is old and not really adhered to by the paeds community worldwide. BUT what any paediatric urologist will tell you is that we need research into how many circumcisions we need in order to prevent renal damage. That would be much better info for us to be able to give to parents.

D) the most important point here (and the point the AMA are really making) is that there are very few individual conditions that would, in isolation, justify a circ. So, 100 circs will prevent 1 UTI, plus one case of xerotica obliterans, and 1 case of balanitis etc etc. When you look at all the figures cumulatively, you may decide that a circ is right for your kid. But if you just look at one illness, you probably won't (except with family history/high racial risk of penile carcinoma, or family history of bad renal diseasae etc)

Drift

tallaght01 - Do you have sons, if so did you get them circumcised at birth?

If not would you get a future son circumcised at birth? (Or say you haven't decided yet if this is the case)

Star Lord

I would love to know why people keep referring to it as "mutilation".

Am I mutilated because I am circumcised? No.
Does it not function as well or mean that I don't have anywhere near as much feeling there? No.
I do believe that circumcision later in life may mean that the people getting it done are affected more by the procedure, possibly de-sensitised more than someone that had it done young, and went through their sexual development while already circumcised.

Guys that are circumcised do not automatically need to use lube.

Guys that are not circumcised cannot really argue against circumcision the way that they are, because they do not know what it is like. Yes it is a lot cleaner circumcised, and yes regular washing can help keep things working perfectly in uncircumcised guys, but do you clean the whole thing every time you go for a pee? Some of that is held under the foreskin, which is what is prevented by circumcision in the UTI studies that Tallaght01 references above.

I would definately NOT condone circumcising children at birth, or out of any cultural history, as I believe it is unnessecary. It should really only be done out of medical nessecity in young children. Older guys can decide for themselves if they want it done.

tallaght01

Drift wrote: »

tallaght01 - Do you have sons, if so did you get them circumcised at birth?

If not would you get a future son circumcised at birth? (Or say you haven't decided yet if this is the case)

I dont have kids.

I would discuss the issue with his mum, if I had a son. But I personally wouldn't be in favour of a circumcision for him.

Grawns

From last Sunday's sunday times magazine (Teenagers and sex - what's love got to do with it?)
His mother was careful not to endorse Jonni’s sexual antics until he turned 16. From then on she was very keen to instil the importance of safe sex – ensuring there is always a ready supply of condoms in the house. Perhaps as a result, Jonni always uses contraception – and at 17 he even had himself circumcised for hygiene reasons.
Wouldn't you love to know more about Jonni's weener!

Gyalist

As usual in these matters, it is always useful to follow the money. Who stands to benefit most from circumcision? What happens to infant foreskins? In the US, doctors can have undeclared financial interests in biomedical companies.

gcgirl

Having 2 daughters and 1 son none of them have suffered from UTI's and hopefully they won't in the future with the girls if you teach them how to wipe properly there's a slim chance, as for the son well he loves his forskin and he is not even 4 yet! typical boy ! and i still think that the only way we can stop Aids & Hiv is by promoting the use of condoms think of the guys coming on to this thread and seeing that if you get circumcised that you'll never get Hiv/Aids its not very forward thinking and think of all those std's that is gonna spread across Ireland !

Wibbs

tallaght01 wrote: »

The parents have the choice between reducing the risks of certain diseases in their child, or removing the foreskin. The rights of the child Vs protection against disease.

That can be a very loaded option in the case of circumcision.

Circumcision reduces the spread of HIV. You can talk about that til the cows come home, but it's true. Removing the immune cells on the inner surface of the foreskin reduce the ability of the virus to enter your system. You can say that people should use condoms instead. But they don't. The 60million people currently infected with HIV mostly didn't use condoms. Most of those infected are women, who very often don't have a say i whether condoms are used, or don't have access to them. You can't just say we should "spend money on condoms". if you're going down that route, then we shouldn't encourage condoms, we should only talk about abstinence. You have to use every weapon in your arsenal, not just those that are foolproof.

My point is that suggesting a protective effect may well have the opposite outcome. It's not as protective as condoms/safe sex/abstinence. Fact. Not even close. So those self same women will feel safer with a cut guy. That increases the risk for the general population.

In terms of penile carcinoma, it's uncommon in Ireland. That's because it's uncommon in caucasian males. This isn't the same for different races. We can't just proclaim something as unneccesary because it doesn't affect white Irish males. The AMA don't suggest circumcision solely for the prevention of penile carcinoma, and they're right. In isolation, it probably doesn't warrant a national programme across america. But it accounts for up to 30% of male cancers in African, Asian and South american males. It's about 5-8% in India.

It's statistically uncommon anyway. In this study http://cebp.aacrjournals.org/cgi/content/abstract/16/9/1833 The highest rates of penile cancer were found among hispanic men at 46.9 per million. That's a very low rate and judging by other studies even the protective effect of circumcision would still have quite a proportion of those circumcised. Both the AMA and the ACS among other groups have suggested that circumcision is hardly warranted because of the reduction of risk. Can you provide any link that shows the rate of 30% of cancers in any population? Again condoms and hygiene would have a far greater effect. Again no one is suggesting that we don't use all the armoury at our disposal, but only when it shows a useful result. IMHO the disadvantages outweigh the advantages. If there exists a population where for genetic or cultural reasons that risk goes the other way then I can see the reasoning.

The wikipedia links posted by Wibbs are statistically bogus for all sorts of reasons, and don't reflect the reality of the published data.

So the American medical assoc and the American cancer assoc are not good judges based on peer reviewed research? And this is america where circumcision is at it's highest in the west.

Wibbs is saying things about how we invent new reasons to justify continuation of the practise, and talks about "dodgy" statistics. I, nor any of my coleagues (who give the same data as I do), have never given dodgy stats to parents to justify circumcision. I'd love to know what benefit there would be to us?

I'm simply saying that too many medical practices and procedures that were considered justified have since proven wrong. Naturally medicine like any science continues to grow as evidence comes in. We are not in some end point where we're sure. Every generation may think that to a lesser or greater degree but it's never the case.

The data posted in the wikipedia page talks about studies which relate to pain in babies in circumcisions where no pain relief is given. It's very rare for a paediatrician nowadays to refer a kiddy to anyone who performs the procedure withouth anaesthetic.

Actually the article goes on to say that evidence exists that even with anaesthetic it's not always pain free. Injecting the anaesthetic alone would hadly be comfortable.

It boils my blood to hear about circumcision withouth anaesthetic. I am 100% against it.

I agree with you there. Barbaric isn't in it.

That aside, you also can't keep ignoring the fact about UTI's. You can't just say "we don't operate on baby girls' urethras". Saying this shows a deep misunderstanding of what urethral surgery involves, versus what male circumcision involves. Urethral surgery would carry far more risks than the risk of a UTI in your average baby.

Well duh. Of course hypothetical urethral surgery on a girl would be a big deal I was using it as an example. What I'm simply saying is that women get more uti's anyway.

JCK talks about running water. This is an issue. But the presence of a foreskin, even in the presence of excellent hygiene, is a risk factor for penile carcinoma.

A tiny risk in the tiny amount that suffer from it(in the west at least. I'd like to see your data for a figure of 30% of males)

DamoElDiablo wrote: »

Am I mutilated because I am circumcised? No.

You don't have a fully functioning penis as it evolved though.

Does it not function as well or mean that I don't have anywhere near as much feeling there? No.

It may function as well, but sensitivity/feeling is less. Forget about the head, you've lost the foreskin itself which has loads of nerve endings. Depending on how complete the procedure the frenulum can also be lost which would be the most sensitive part.

I do believe that circumcision later in life may mean that the people getting it done are affected more by the procedure, possibly de-sensitised more than someone that had it done young, and went through their sexual development while already circumcised.

Well later in life if they do it for non medical reasons they will notice a difference. Never having one? I suppose what you don't know won't trouble you.

Guys that are circumcised do not automatically need to use lube.

Guys that are not, pretty much never do. As an idea of sensitivity I could not do what you do without lube, it would be sensitive to the point of actual pain.

Guys that are not circumcised cannot really argue against circumcision the way that they are, because they do not know what it is like.

As I pointed out a non cut man can retract and know how sensitive the head is. There is no way I could walk very far with it out. It would be simply too painful rubbing against cloth. Hey I could keep it back for a month and see. Cut guys have no equivalent. Apparently guys who have reconstructed their foreskin notice a big jump in sensitivity.

Yes it is a lot cleaner circumcised, and yes regular washing can help keep things working perfectly in uncircumcised guys, but do you clean the whole thing every time you go for a pee?

Pretty much actually.

Some of that is held under the foreskin, which is what is prevented by circumcision in the UTI studies that Tallaght01 references above.

yes and no. The theory would seem to be that it would be easier for a virus or to get through the non toughened skin of a uncircumcised willy and/or through the immune cells that line the foreskin itself. I suppose in much the same way that the flu virus won't go through the skin of the hands but will through the wetter mucus membranes of the nose where the environment is more conducive.

I would definately NOT condone circumcising children at birth, or out of any cultural history, as I believe it is unnessecary. It should really only be done out of medical nessecity in young children. Older guys can decide for themselves if they want it done.

That much I wholeheartedly agree with. Medical necessity not out of fashion or tradition.

tallaght01

The full epidemiological data on penile carcinoma isn't available online. Hence the problems with people thinking they're experts on a subject after reading wikipedia. However, here's a link to an article written by the prof of urology at the uni of southern california medical school. Have a look under the "frequency" section to see the stats about up to 30% of male cancers being penile in some populations. He pretty much just quotes straight from the published research. He also cites the interesting data from Uganda, where it now seems to be the most common male cancer. http://www.emedicine.com/MED/topic3046.htm

You also say condoms and hygiene have a greater effect on penile carcinoma that circumcision. This is untrue.

As for the inverse effect on HIV/AIDS, that's an argument that's been mooted before, unsurprisingly. But it doesn't hold water because circumcised males in high risk environments catch less HIV. In an environment where condoms are used uncommonly, despite years of public health initiatives, I'm not willing to sit back and wait for people to start using them (especially as those who get infected often have no say over whether a condom is used). There is no evidence that it promotes less safe sex. There is evidence that is reduces the spread of HIV. HIV kills.

The wikipedia article uses old data. It doesn't include a lot of important recent studies. Like I said, the AMA aren't the be all and end all, neither is wikipedia. Paediatricians rely on neither for guidance.

I have no strong views one way or the other. Like I said above, I wouldn't be keen to have a son of mine cicumcised. But we have to be a bit more open minded and, most importantly, we need to deal in facts, not knee-jerk reactions.

Wibbs

tallaght01 wrote: »

The full epidemiological data on penile carcinoma isn't available online. Hence the problems with people thinking they're experts on a subject after reading wikipedia. However, here's a link to an article written by the prof of urology at the uni of southern california medical school. Have a look under the "frequency" section to see the stats about up to 30% of male cancers being penile in some populations. He pretty much just quotes straight from the published research. He also cites the interesting data from Uganda, where it now seems to be the most common male cancer. http://www.emedicine.com/MED/topic3046.htm

Really? You maybe should read this again and maybe he better get the old abacus out, or maybe I should as I would surely love an explanation. Maybe I'm missing something or the good professor needs new batteries for his calculator.

Penile carcinoma represents 20-30% of all cancers diagnosed in men living in Asia, Africa, or South America.

Ok then he writes;

In urban India, the age-adjusted incidence varies from 0.7-2.3 cases per 100,000 men. In rural India, the rate is 3 cases per 100,000 men. This accounts for more than 6% of all malignancies in men.

6%. Not quite 20-30% in a given population, is it? And that's the highest rate.

Then he goes on to write;

In Brazil the age-adjusted incidence is 8.3 cases per 100,000 people. In Uganda, this is the most commonly diagnosed cancer, with 1% of men being diagnosed by age 75 years.

1%. 1% of males mostly older males by the look of it. Where's the 30%? If it's the most commonly diagnosed cancer, either Ugandan males have sod all cancer anyway, they die too young to get cancer prevalent in the west, or their diagnosis methods are pretty poor. What about prostate, lung, bowel etc? Prostate alone in older men is very common, not quite but almost a given in men above 75, who will likely die with it than from it.

You also say condoms and hygiene have a greater effect on penile carcinoma that circumcision. This is untrue.

No, it is a factor. The self same article notes the presence of HPV in a third of cases, though notes that causation is yet to be confirmed(though lets be honest pretty likely). Condom use reduces the risk of acquiring HPV. Though he dismisses smegma as a causative agent it's presence in uncut males(among other things) is likely part of it. I also note that phimosis and balanitis are also noted as possible risk factors on top of that which would likely plug into the hygiene area. Wood for the trees time.

As for the inverse effect on HIV/AIDS, that's an argument that's been mooted before, unsurprisingly. But it doesn't hold water because circumcised males in high risk environments catch less HIV. In an environment where condoms are used uncommonly, despite years of public health initiatives, I'm not willing to sit back and wait for people to start using them (especially as those who get infected often have no say over whether a condom is used). There is no evidence that it promotes less safe sex. There is evidence that is reduces the spread of HIV. HIV kills.

Very emotive, but dodging the issue and while some studies have shown a protective effect, there was one quite recently (in the Lancet IIRC) that didn't(a few of the family are docs, so I do read this stuff for fun and frolics.:D). The simple fact that with the exception of the middle east where data is hard to come by, areas that routinely circumcise males are in general more HIV risky areas. This includes the US where the infection rate is higher than Europe.

The wikipedia article uses old data. It doesn't include a lot of important recent studies. Like I said, the AMA aren't the be all and end all, neither is wikipedia. Paediatricians rely on neither for guidance.

So while no single body is or should be the be all and end, American paediatricians don't take the AMA's or the surgeon general's guidance on board on matters concerning paediatrics?

I have no strong views one way or the other. Like I said above, I wouldn't be keen to have a son of mine cicumcised. But we have to be a bit more open minded and, most importantly, we need to deal in facts, not knee-jerk reactions.

Looking at the facts and even if I agreed with all of them, the fact remains that routine male circumcision in the west is an outdated practice that reduces the function of the evolved healthy penis. We can argue all day back and forth and while cut men may not know the diff, it does remove erogenous tissue and reduces function because of that loss. That loss is suffered not for medical reasons for the most part it's done for cultural reasons.

tallaght01

Wibbs you're confusing your "30% of a given population get penile cancer", which is obviously untrue (and was never claimed) with "30% of cancers of males in certain countries are penile". I think the Prof's abacus is fine.

The indian figure was always 6-7%. He stated this at the start. The 30% figure is for parts of Africa, south america and parts of Asia. I have even mentioned the 6% rate in india a few posts previously!

And Ugandans don't generally live long enough to get prostate cancer! They are the only country to have reversed an increase in HIV in Africa. part of the reason for this is their circumcision programme. most of it is education related, though.

Circumcision has a greater reductive effect on penile carcinoma than hygiene or condom use. You may not like that, but it's true. There have only been a small few cases of penile carcinoma in cicumcised males. You won't find any decent data to refute that!

I'm fascinated that you don't think there is a protective effect against HIV from circumcision. The recent WHO expert meeting on the issue concluded that were was definitely an effect, which is possibly as high as 60% from preliminary data in a big trial in Uganda(although we're waiting for final data to come through). There is a small report on it here:

http://www.afro.who.int/aids/publications/male_circumcision_en.pdf

It's summarised in the 2nd paraghraph.

If you are actually claiming there is no protective effect against HIV!! You really will need to supply good references for that. The WHO would strongly disagree with you. So would the Lancet!

I'm not surewhat Lancet paper you're talking about. Are you sure you interpreted the stats properly. The Lancet has published data that is supportive of male circumcision as a weapon against HIV. You need to have access to read their stuff online, so I'll cut and paste their editorial from 2007 on the issue:

the lancet wrote:

Observational studies over many years, followed by three randomised trials in Africa, preceded the decision by WHO and UNAIDS in late March to recommend circumcision as an intervention to reduce the risk of men heterosexually acquiring HIV infection. Male circumcision has been hailed as the most exciting news in HIV prevention since perinatal zidovudine was shown to protect against vertical transmission more than a decade ago. In the trials setting, risk of acquiring HIV was more than halved by male circumcision. If implemented on a large scale in appropriate settings, circumcision has been predicted to have the potential to avert about 5·7 million new HIV infections and 3 million deaths over 20 years among both men and women. But there are barriers to realising this potential in routine practice.

It cannot be overstated that male circumcision does not provide complete protection against HIV infection. Furthermore, circumcision as a public-health intervention is only appropriate in settings of high HIV prevalence. The WHO/UNAIDS recommendation is for circumcision to be added to the current HIV prevention package, which includes use of male or female condoms, reducing the number of sexual partners, delaying the onset of sexual relations, and abstaining from penetrative sexual intercourse. Since every element of the existing prevention package has attracted criticism, adding male circumcision to the mix is unlikely to escape controversy. Similarly, experience with antiretroviral drugs shows that strong evidence of effectiveness does not necessarily lead to rapid, widespread deployment.

An obvious barrier to routine implementation of male circumcision is limited health-care resources. Circumcision costs US$50–100 per procedure. In South Africa—a country most likely to benefit because of its high HIV prevalence and low current rate of male circumcision—the cost of setting up new surgical facilities has been estimated at $32 million, plus the same amount in annual operating costs. However, this investment might eventually save nearly $1 billion from the annual bill for treating HIV.

To be acceptable in terms of safety and minimising complications, circumcision must be done under hygienic conditions by trained personnel with access to sterile surgical instruments and anaesthesia. Men who wish to be circumcised will have to be counselled about the advantages and risks of the procedure, and the need to continue with other HIV prevention measures. Failure to counsel adequately could lead to increased risk taking and therefore ameliorate the benefits of circumcision. Provision of routine male circumcision cannot be at the expense of provision of other important services—for example, tuberculosis and malaria treatment. And the cost to the individual of circumcision must not become a barrier to its uptake. Operational research into how health systems can scale up male circumcision, and to establish its cost-effectiveness, will be essential.

In the three randomised trials in Africa, men aged 18–24 years or 15–49 years were circumcised. However, the procedure is considerably safer and cheaper for baby boys than it is for adolescents and adult men. If this approach were taken the benefit in terms of population-level HIV reduction would take a generation to be realised; nevertheless, it may be time to reconsider routine circumcision of neonates as a public-health intervention. In cultures where neonatal circumcision is not the social norm, the ethics of operating on an infant who cannot consent to the procedure and might not benefit from it for many years must be considered. Indeed, circumcision under the age of 16 years has been banned in South Africa in an effort to protect boys from unsafe procedures done as tribal rites.

The indications are that most men in communities with low rates of circumcision in sub-Saharan Africa consider circumcision to prevent HIV infection to be acceptable. In Swaziland, which has the highest adult HIV prevalence and among the lowest rates of circumcision in the world, there have been reports of circumcision “riots” at clinics unable to keep up with growing demand.

Despite the caveats and potential pitfalls, male circumcision has a promising future as an addition to the armamentarium of measures to prevent HIV infection. Major donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the US President's Emergency Plan for AIDS Relief have already indicated their willingness to pay for circumcision programmes in high-prevalence countries. Long-term funding support from international organisations will be essential to ensure that male circumcision is an intervention that has a chance to succeed.

The Lancet Infectious Diseases
.

That's very long, so I've underlined some of the more relevant parts.

Re-reading your post I see where the mistake your making with the circumcision/HIV issue is.....you're claiming it doesn't work because the areas where circumcisions are higher have higher rates of HIV. This is true, but...

A) circumcision is often higher in these contries because of the risk of HIV

most importantly, that's not a statistically sensible way to look at it. The way to do it (and what is done in all the studies) is to compare 2 groups of guys of the same age (usually 16-45). One group is circumcised, and the other isn't. Then follow them over a number of years, and look at the rates of HIV in both groups. When this is done, it's seen that circumcised males get less HIV.

As for the AMA issue...if the paediatricians took their views as rigid protocol, there wouln't be so many cicumcisions in America :P We look at all the data, and use it to inform parents.

AckwelFoley

im not cut..just for the record (a bit of info you didnt want to know), bt a mate of mine is .. he had it done at 13, due to infection.


Personally, if im lucky to father a son, i certainly wouldnt get it done...


.. i cant bloody get my dog neutered let alone cut the skin iff the top of my sons penis because i dont want to inflict pain onto somthing i love.



What a puss..

gcgirl

snyper wrote: »

im not cut..just for the record (a bit of info you didnt want to know), bt a mate of mine is .. he had it done at 13, due to infection.


Personally, if im lucky to father a son, i certainly wouldnt get it done...


.. i cant bloody get my dog neutered let alone cut the skin iff the top of my sons penis because i dont want to inflict pain onto somthing i love.



What a puss..

do you and your mate ever compare and contrast?? :rolleyes:

2 stroke

Any woman considering Circumcision on a baby should get an uncircumcised man, peel back his foreskin and run her tounge over the piece that would have been cut off and see how much pleasure he feels.
As a teenager I was presented with the choice of circumcision, even then I didn't understand all the issues, but I'm glad I made the decision to wait a few more years and see if it caused difficulties later on.

Star Lord

Wibbs wrote: »

You don't have a fully functioning penis as it evolved though.

I've my tonsils out, I don't have a fully functional throat as it evolved either.
The most likely reason for the foreskin would be to protect it when we were naked Neanderthals running through bushes hunting prey. It's really as useful as your appendix at this stage.

Wibbs wrote: »

Guys that are not, pretty much never do.

I've never had to use it either.

Wibbs wrote: »

As I pointed out a non cut man can retract and know how sensitive the head is. There is no way I could walk very far with it out. It would be simply too painful rubbing against cloth. Hey I could keep it back for a month and see. Cut guys have no equivalent. Apparently guys who have reconstructed their foreskin notice a big jump in sensitivity.

I yeah you can try that if you wish, but when it comes to intimacy, it still works just the same. I firmly believe that a lot of those that have it done later in life find it so different due to their mindset that it must be different, as they have lost part of their manhood.

Wibbs wrote: »

That much I wholeheartedly agree with. Medical necessity not out of fashion or tradition.

Completely, for the same reason that we do not remove peoples appendix routinely, even though it can also lead to complications and in some cases death. There is no need to put a person through the trauma of surgery unless there is a problem.

Red Hand

DamoElDiablo wrote: »

The most likely reason for the foreskin would be to protect it when we were naked Neanderthals running through bushes hunting prey. It's really as useful as your appendix at this stage.

1. Not to be graphic, but an uncircumcised appendage needs protection even from one's own clothing.

2. Neanderthals would have worn clothing from the animals they hunted-they had to, for they lived in ice-age Europe.

3. Homo Neanderthalus and Homo Sapiens evolved from a common ancestor-homo sapiens did not evolve from Neanderthals.