Circumcision refers to the cutting off of the foreskin
of the penis. The foreskin or prepuce covers the glans or the
soft front portion of the penis.
Circumcision may be done:
For religious reasons
For any complication
For no definite reason
The foreskin is normally adhered to the glans penis in
most newborns. If nothing is done, it separates on its own by the age of 3 or so, in almost all cases. Therefore, instruct
people at home not to make any attempt to retract the foreskin.
If it is still adhered, you may yourself try to gently push
the foreskin behind and clean any stuff between the skin and glans penis.
If no separation of the foreskin is noticed by the age
of 4 years, consult a paediatric surgeon.
Do not circumcise because the child has a long foreskin or is wetting the bed or has ballooning of the
foreskin while passing urine, but has no other problem. Some reports indicate that circumcision reduces
the overall incidence of urinary tract infections. Circumcision should be considered if a child with an
adhered prepuce gets repeated attacks of urinary infection in the absence of any proven obstruction in
the urinary tract.
If proper attention is not given to treat a severe
diaper rash, secondary bacterial infection may result in
scarring of the foreskin. This may result in the foreskin getting permanently adhered to the glans penis. In such cases,
circumcision has to be undertaken because spontaneous retraction is not going to take place. It is also mooted
that cancer of the penis in males and cancer of the cervix in
wives of circumcised males is less common. An editorial in the reputed British
Medical Journal has
refuted this view.
Some advocate circumcision from a hygienic point of
view. This is not tenable because smegma (the cheesy material
which collects between the foreskin and glans) can be removed daily while having a bath.
If the skin is forcibly retracted, you may find it
difficult to bring it back to its original place and the penis gets swollen.
Your doctor can set it right but if it recurs, he may
advise circumcision. The operation may also be advised for pus collection behind the prepuce.
People who believe circumcision should be done as a routine minor operation do not realise that even this
operation can cause infections, excessive bleeding and
other problems. I am against routine circumcision. If
religious reasons dictate circumcision, get it done by a reputed
doctor. Defer the operation to a later date if the baby was
premature or had some complication at birth.
Do Not Circumcise In Case Of Hypospadias
Paediatric surgeons warn against circumcision in hypospadias,
a condition in which the opening of the urinary passage is on the undersurface of the penis. In these male infants,
the urethra (urinary tube) is deficient and circumcision
must be categorically avoided as the excess foreskin on the
penis is used to construct the deficient urethra. The penis bears
a neatly circumcised look after this operation.
