Circumcision

From Encyclopedia of Sex and Sexuality

Circumcision is probably the oldest and most widely practiced surgical procedure. First described in the Bible about 3,000 years ago, ritual circumcision was probably practiced many years prior to that. Controversy still exists over the need for, or advisability of, routine circumcision. Apart from religious reasons, there are several commonly recognized medical grounds to perform circumcision. These include preventing recurring infections of the glans (head of the penis) and prepuce (foreskin); averting the narrowing of the prepuce’s opening, obstructing the flow of urine; and preventing a tight prepuce from retracting over the glans. There is also evidence that circumcision reduces the incidence of penile cancer.

The operation is essentially the removal of the prepuce under anesthetic. The area is cleaned and the prepuce is retracted to release adhesions and to clean under it. It is then pulled forward symmetrically, usually with fine clamps. A clamp is placed crosswise on the prepuce to hold the glans back, the prepuce is removed with a scalpel or scissors, and the clamp is removed. The skin of the penile shaft usually retracts and a rim of skin remaining around the glans is sutured to the skin of the penile shaft, completing the procedure. The patient can return home after he has urinated without trouble. In a simplified technique, a bell-shaped cap is placed over the glans, under the prepuce. A suture is tied around its base and the excess prepuce is removed.

Complications involving circumcision are rare, although there is frequently a period of discomfort lasting several days. Bleeding, the most common complication, can usually be controlled. Other complications include damage to the glans and infection.

[edit] Cultural Aspects

In the United States today, most males are circumcised. Although parents usually cite hygienic reasons for this, medical professionals are in disagreement over the hygienic value of the operation. It can, therefore, be said that circumcision is the most common form of cosmetic surgery in the United States.

Many peoples around the world perform circumcision for divergent ethnic and cultural reasons. It is universal among Jews and Muslims, and among some smaller Christian sects such as the Copts of Egypt. It can also be found among various ethnic groups in Africa, India, and Oceania. In Europe, however, circumcision was rarely practiced—even today it is less common than in the United States.

Sociologists and anthropologists have suggested several reasons for circumcision. It may have been believed to be hygienic, a sign of ethnic belonging, or as attractive to the opposite sex, or it may have been believed to increase sexual pleasure. No single explanation, however, accounts for the prevalence of circumcision among certain groups. For instance, while it may be believed to increase sexual pleasure, this does not explain why so many groups perform circumcision on infants.

In the West circumcision is often associated with Judaism. Traditionally, all Jewish males are circumcised. This is in keeping with the biblical injunction: “This is My covenant between Me and you and your progeny after you; every male child among you shall be circumcised” (Genesis 17:10). Circumcision is performed on the eighth day after the child’s birth, unless medical circumstances show that this would be harmful to the child. Circumcision is integral to the Jewish religion: it is the first biblical commandment that Jews are ordered to observe. Circumcisions are generally performed by a mohel, an individual who specializes in circumcisions, although in the United States it is not uncommon for the mohel to have medical training.