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Sunday, July 10, 2011

Is Circumcision Good or Bad in Early Childhood?

Posted by Dr Prahallad Panda on 8:36 PM Comments

There has been a lot of buzz whether to circumcise a baby or not. Some follow it for custom/ritual and many do not follow it, if seen in global perspective.

Circumcised men are now in the minority worldwide, but they are the vast majority in the U.S. It has been seen that early circumcision prevents cancer of penis. The exact cause is not known. Possibly, that is due to creation of a hostile environment following absence of fore skin; that becomes hard for colonization of viruses those may cause genital warts, a precursor of cancer; and sepsis as bacterial infection is not sustainable.

The foreskin provides a ready access to cells that are the entry point for HIV because the skin there is very soft and permeable; and provides a hospitable environment making it more vulnerable to infection. They can't proliferate as well on the dry skin of the circumcised penis.

In Africa, there have been three randomized trials — two published in the journal Lancet in 2007 and one in the journal PLoS Medicine in 2005 — demonstrating that circumcision reduces heterosexual HIV infection in men by at least 60%.

There is small but definite medical risks like bleeding, infection and sometimes death associated with circumcision. The baby loses the protective function of the foreskin. A study published in the British medical journal Lancet in 1997 demonstrated that babies who have been circumcised have a lower pain threshold for subsequent immunizations; they are extremely distressed, their cries are different.

The argument continues in favor and against of circumcision. But, there are definite indications of circumcision in the childhood:

· Narrow prepucial opening, phimosis.

· Recurrent urinary tract infections.

There are also definite contraindications for circumcision:

· Urethral defects like hypospadious or epispadious; which may require nearby skin available for future reconstruction.

Circumcision can be made available to such cases after the age of 4 years;

· Where those contraindications are not present,

· Indications present.

· Where demanded.

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