Essay On Circumcision

Introduction

Circumcision is a minor surgical procedure that involves the removal of the foreskin of the penis. Circumcision is not only one of the most common procedures but is also recorded as one of the most oldest procedures, traditionally believed to be part of cultural and religious activities but has now become established in the healthcare world as being vastly advantageous for one’s health and is some regards, one’s social status.

Circumcision is still widely prevalent in today’s society. Statistics in the Jewish culture show that almost all new born Jewish males in Israel as well as 99% of Jewish men in the UK are circumcised (1). A study by the National Hospital Discharge Survey (NHDS) of America showed that 59.1% of all newborn males in the US were circumcised (2). Lastly, worldwide statistics further show that 25% of men in the world are circumcised; the largest totals coming from the Asian, Muslim, African and Middle Eastern populations (3)

Origin & History

The exact origin of circumcision remains largely unclear. The earliest record of circumcision, however it is unclear of whether is originated here, comes from Egypt in the form of a carved image on a tomb depicting the circumcision of an adult (1). Historically it is also known that circumcision has been practiced ritualistically in West Africa and in the Middle East for 5000 and 300 years respectively but it is unclear weather is was adopted from the Egyptians or adapted on their own. (2) Circumcision also became a very important ritual to the Jewish and Muslim shortly after it was first practiced however this exact time is unclear (4). It was only until the late nineteenth century where circumcision was first practiced as a medically sanctioned procedure in Bri...

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Technique

Methods of circumcision vary worldwide but follow the same general procedure: (22)

1. Freeing the foreskin

2. Excising the foreskin

3. Haemostasis

4. Wound healing

Procedures are divided into two general categories which revolve around the age of the patient: First weeks of life and older

A. Procedures in first weeks of life

a. Freehand with guided cutting e.g. Mogen Clamp

b. Free hand with haemostatic device e.g. Gomco (23)

B. Procedure in older patients (infant, child or adult)

a. Sleeve technique (sometimes with a haemostatic device) (23)

Complications and Risks

Complications of circumcision is generally reported as low, between 1 and 4% (24). The most common acute complications include: (22)

 Infection

 Haemorrhage; most commonly due to a Vitamin K deficiency

 Post-operative bleeding

 Fistula formation

 Uncommonly septicaemia and meningitis