circumcision singapore

Last summer, I attended the American Congress of Obstetricians and Gynecologist's (ACOG) annual meeting in Washington DC, within my state-required continuing medical education. It absolutely was nice to listen to new perspectives on common OB and GYN topics, ie. VBAC, preterm delivery, PCOS, robotic surgery, etc.

While there, as expected, there were lots of abortion protesters circling the convention center within their message-laiden vehicles. I was surprised, however, to see dozens of protesters of male circumcision along the sidewalks flanking the building. In the beginning I was puzzled, thinking to myself, "Why would one spend all day for all days in a line protesting circumcision?" I never considered it as a warm topic for debate, unlike abortion, for which I can simply understand the polarizing nature.

I also never considered writing a post on circumcision singapore until I saw a very popular OBGYN blogger (academicobgyn.com) recently touch upon it. After reading mine, please read his, because it is even more insightful than what follows below.

I honestly never gave very much thought to the debate of "to circumcise or never to circumcise." I just figured it absolutely was a family's decision. Some make this predicated on religious or cultural beliefs, and others have a more secular approach, ie: what does the baby's daddy's penis look like. I feel that many men, with exceptions I am sure, are pleased with whatever "theirs" looks like. And, I have not met whoever has any memories of these circumcision.

If you ask me, it appears that circumcision is just something a person learns to accept as "it is what it is." And that's where many opponents to circumcision feel it is wrong; these young boys are not giving informed consent themselves for the procedure. I cannot argue with that point; however, the paradigm of foreskins would change greatly if a man had to hold back until age 18 to acquire a circumcision. I don't think there could be a lot of takers on the task then. And if that were the case, would there be protesters outside ACOG meetings with signs opposite of these I witnessed?

The evidence-based approach doesn't add very much insight. There's literature to suggest a decline in transmission of STDs and of penile cancers, but these effects are too small to warrant routine recommendation of circumcision. Then you will find the surgical risks of the task, which are rare in the hands of an experienced provider. These generally include bleeding, infection, and damage to the penis, combined with possible need for a revision in the future.

I believe I speak for the majority of the providers in Kamm McKenzie when I say that individuals support the ACOG and American Academy of Pediatrics stance on circumcision, which states there is insufficient evidence to routinely recommend neonatal circumcision and that parents should be provided with accurate and impartial information to help them make the best decision. Well, the above paragraph provides the unbiased information. I probably didn't change anyone's opinion did I?

In regards to circumcision, there is good evidence that analgesia contributes to less pain and stress to newborns. At WakeMed, newborns are swaddled, soothed with Tylenol, and some get a sweet sugary snack. In addition, all of us provide local anesthesia with a lidocaine penile block.

Lastly, I wish to clear up the confusion on the various kinds of circumcision. I am alert to three techniques; plasti-bell, gomco, and mogen. In Kamm McKenzie, our providers only perform among the first two methods. A lot more than I imagined, I've patients ask me which way I really do the circumcision, or which way does another provider do them. I usually answer, "the direction they have inked hundreds to thousands before."

In regards to plasti-bell versus gomco, the biggest thing to learn is that in a fourteen days, no-one will ever know the technique employed for the circumcision. In the temporary, you will find pros and cons to each. With the gomco, the foreskin is removed at the time of the circumcision, and the post-operative care could be the keeping of Vaseline on the penis with each diaper change. For the plasti-bell, the foreskin is tied tight around a plastic bell and it will ultimately just fall off in a few days. They are lower maintenance at first but could be a nuisance if the foreskin "hangs" on with a strand. In reality, either technique is equally good and neither is high maintenance.