MALE CIRCUMCISION: the case against

Dr Peter Ball discusses the case against circumcision

A fundamental principal in Medicine is that 'thou shalt do no harm'. NORM-UK is an educational charity that believes that the act of circumcision does irreparable harm. It was founded by Dr John Warren who realised that there are many men whose lives had been marred because they had been circumcised without their consent. Many complained of an increasing intolerance of clothing on the unprotected glans which seemed to worsen with age, some found sex unsatisfactory either from decreased sensation from the glans, or discomfort on erection from removal of too much skin. Some experienced symptoms characteristic of a post traumatic stress disorder(1). Their circumcision left them feeling mutilated, incomplete, and very angry with either their parents for allowing the operation or with their doctors for doing it.

Foreskin restoration

In order to help these men, Dr Warren reviewed the technique of subjecting the shaft skin to prolonged gentle tension. This results in the growth of sufficient new skin to cover the glans. We advise the avoidance of surgical methods. Most plastic surgeons admit that the stretching methods give a better cosmetic result than can ever be achieved by surgery. Indeed NORM-UK has several well-documented cases of penile surgical restoration that have gone disastrously wrong. NORM-UK runs support groups to counsel and advise such men who are keen to rebuild both their lives and their foreskins.

Taylor and Lockwood(2) have shown that the inner lining of the foreskin has thousands of unique erogenous receptors that greatly enhance the enjoyment of sex. These are lost for ever as a result of circumcision. Much of the enjoyment of intercourse and masturbation results from the foreskin gliding along the shaft and over the glans. This action also enhances the enjoyment of sex by the woman(3). NORM-UK knows that there is still widespread ignorance about the function of the foreskin and its natural development both among doctors and the laity, which it seeks to remedy.

Dr Punia and Mr Lander write in their article on the paediatric surgical perspective of circumcision (on this website) 'the commonest medical indications for circumcision are BXO and recurrent troublesome balanoposthitis'. We believe that the latter can usually be cleared with oral or locally applied antibiotics. If a foreskin remains tight and circumcision is suggested, the application of half-strength(4) Betnovate cream twice daily for one month together with regular stretching may cure it. Failing that, the less mutilating operation of preputioplasty or dorsal slit is a better alternative(5).

It is significant that there are now members of the Jewish faith, who on learning of the function of the foreskin and that there is no medical value in the operation, are refusing circumcision and opting for a naming ceremony in its place.

Conclusion

NORM-UK believes in the right of the child to keep its bodily integrity, and aims to educate the profession and laity alike on the functions and care of the foreskin, to promote alternatives to circumcision and to support men whose lives have been adversely affected by their circumcision.

Peter Ball is a retired general practitioner and member of NORM-UK

References

1 R.Goldman. The psychological impact of circumcision; BUJ International. 1999: 83; Suppl.1: 93-102
2 Taylor JR,Lockwood AP, Taylor AJ. The prepuce:specialised mucosa of the penis and its loss to circumcision. BUJ International 1996; 77: 291-295
3 K.OHara and J.Ohara; The effect of male circumcision on the sexual enjoyment of the female partner. BUJ International.1999; 83,Suppl 1:79-84
4 Wright J.E The treatment of phimosis with Topical steroid. Aust ZJ 1994; 64: 327-8
5 Cuckow PM, Rix G,Mouriquand D.E. Preputioplasty: A Good Alternative to Circumcision. J Paediatric Surgery 1994; 29: 561-563 Peter J Ball is a retired general practitioner and member of NORM-UK

Other articles on male circumcision on Family Medicine's website

Male circumcision: a paediatric surgeon's perspective

Male circumcision: a Jewish perspective

Male circumcision: a Muslim's perspective