Circumcision - what is it and when should you have it done

Circumcision is the removal of the foreskin around the entire “circum”ference of the penis shaft. It is a form of amputation of a specialised set of cells designed to protect the glans and generate excitement during sexual activity. 

Circumcision, it is believed, was originally conducted by ancient humans to treat phimosis and related infections. It is proposed that living in deserts and jungles lead to a higher incidence of phimosis and related disorders. It is proposed that the practice whilst killing many children with infection and uncontrolled bleeding probably reduced the incidence of phimosis in adult hood and therefore was an acceptable trade-off. The death of an infant was preferable to the death of an otherwise productive teenager that has to contribute to food production and protection duties of the ancient family of tribes.

Circumcision probably made its way into religious law as a means to keep the practice as mainstay of the prevention of phimosis and to ensure parents undertook the procedure obligingly to meet their duty to their god(s). The Jewish bible in fact makes it clear that is a covenant with god that circumcision be performed on all male infants. When understood in the historical context, it is understandable that such practices existed. However, modern science and medicine has evolved and is practiced based on ethics not religious law. That means that surgery is always a last resort if a good outcome can be achieved using conservative measures, such as gentle foreskin stretching for uncomplicated phimosis.

We have spoken to many urologists regarding the role of gentle foreskin stretching and circumcision in management of phimosis. The general view of urologists is that offering a conservative measure prior to surgery does not fit neatly into their practice. They believe that because surgery is 100 percent effective for phimosis (amputate the offending part) the best thing they can offer is surgery as it is sure bet and they get paid a lot more and use their hard earned skills. They agree that the risk of side effects and cost to patients means that ethically they should at least offer a more conservative measure. They claim that they offer a trail of a specially formulated skin conditioning cream to meet their ethical obligations. Almost all urologists agreed that the use of a specially formulated skin conditioning cream without gentle foreskin stretching was a waste of time, but offered the treatment to meet insurance requirements.

We think it is important to note that if a urologists advices that circumcisions required to remove cancerous tissue, prevent cancer (in people at high risk) or due to paraphimosis or repeated serous infection, then circumcision is clearly indicated. If on the other hand, it is offered because it fits neatly into their practice, then we believe that an ethical red line has been crossed. In the absence of serious threat to a patient, more conservative measures like gentle foreskin stretching should be prescribed.

It is pleasing to see that the Royal Society of Urologists in the UK now advocate the use of gentle foreskin stretching as a conservative measure to treat simple phimosis. The more educated our men fold become about their foreskin and phimosis the sooner other urology groups will make the same findings. Remember, surgery should only be undertaken when conservative measures have failed.

The bottom line is this – Your foreskin is an important part of your body. Don’t let a surgeon remove it unless you have a serious threat to your wellbeing or if your have given gentle foreskin stretching a good go and it has not worked for you. Check out our Novoglan product range before considering surgery.