Male Circumcision by

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Male Circumcisionby

• Lucy Etukakpan

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• Male circumcision is defined as removal of all or
  some of the foreskin (prepuce) from the penis.
• It is the most common surgical procedure in the
  world and has sparked a lot of debate.
• It may be done for religious or medical reasons.

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Religious Reasons.

• Neonatal circumcision on the eight day of life is
  practised by the Jewish faith.
• In Islam, circumcision is widely practised
  although timing is not as strict.
• It is also customary in some churches in Africa.

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And God said unto Abraham, Thou shalt keep my
covenant therefore, thou, and thy seed after thee
in their generations. 10 This is my covenant,
which ye shall keep, between me and you and thy
seed after thee Every man child among you shall
be circumcised. 11 And ye shall circumcise the
flesh of your foreskin and it shall be a token
of the covenant between me and you. 12 And he
that is eight days old shall be circumcised among
you, every man child in your generations, he that
is born in the house, or bought with money of any
stranger, which is not of thy seed. 13 He that is
born in thy house, and he that is bought with thy
money, must needs be circumcised and my covenant
shall be in your flesh for an everlasting
covenant. 14 And the uncircumcised man child
whose flesh of his foreskin is not circumcised,
that soul shall be cut off from his people he
hath broken my covenant.
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Medical Indications.

• Pathological Phimosis- secondary to other
  conditions that cause scarring, including
  recurrent balanitis, traumatic foreskin
  retraction or balanitis xerotica obliterans.
• Paraphimosis- inability to reduce a retracted
  foreskin (especially following catheterization)
• Recurrent UTIs especially with proteus spp.(very
  occasionally)

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Arguments in support of circumcision.

• Prevention of penile and cervical cancer
• Prevention of sexually transmitted infections
  including HIV. This is supported by the WHO, CDC
  and UNAIDS.
• Prevention of UTIs.

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Arguments against Circumcision.

• Violation of human rights.
• ?Reduced penile sensation and sexual
  satisfaction( in the male as well as the female).
• Complications following circumcision such as
  bleeding, infection, meatal stenosis and scarring
  from the circumcision.

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Circumcision Procedures.

• Pain relief is achieved by EMLA cream, dorsal
  penile nerve block, subcutaneous nerve block or
  general anaesthetic.
• Devices such as the Gomco clamp, the plastibell
  and the Mogen clamp are used to perform the
  circumcision.
• After hospital circumcision the foreskin may be
  used in biomedical research, consumer skin care
  products and skin grafts.

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• In the UK, circumcision for Religious or cultural
  reasons cannot be performed on the NHS.
• In Derby, patients can be referred to Peartree
  clinic and it is usually done by Dr Singh.