Click here to e-mail a story to the editor.
Click here to e-mail a story to the editor.Evidence mounts: Circumcision does not reduce men's sexual function or pleasure.
A popular article by Michael Castleman in the magazine Psychology Today looks at this question. The answer, as I guess we all know, is that it doesn't.
Thanks to Brian Morris for the link - which it has to be said draws heavily on work by him and his team of collaborators.
Campaigning for greater access to infant circumcision, and world incidence of penile cancer.
It seems that access to infant circumcision in the USA is becoming increasingly difficult for ethnic minorities and poor people. A recent paper "Physician Perspectives on Performing Newborn Circumcisions: Barriers and Opportunities" in Maternal and Child Health interviewed physicians (mostly female) working in the field in the Chicago area. They identified multiple barriers both financial and cultural to parents seeking infant circumcision, and called for access to be improved. The paper is behind a paywall but you can read an extensive abstract at PubMed.
A major review looked at world incidence and trends in penile cancer, a disease which is virtually totally prevented by infant circumcision. The highest incidence was in South America, but there was also a alarming increase, expecially among younger men (under 49). It had formerly beem regarded as only a disease of elderly men. Iceland (a country which opposes circumcision) had the highest increase (doubling) but the UK also showed a large increase. Curiously, smoking seemed to have some protective effect. Read the abstract at PubMed or the full paper (open access) at BJU International.
Thanks to JH for both of these.
It appears that they are quite useful.
They can be used in research and medical treatment, but there are obvious ethical questions, so a team in Saudi Arabia set out to investigate parental willingnes to give consent after infant circumcision. 61% of parents were willing to donate the foreskin. Reasons for not agreeing included fears that if parents consented the hospital might remove too much, and that it might be used commercially. (One wonders what for).
Read the abstract at PubMed or the full paper (open access) at Plos One. Thanks to JH for the linl.
Take-home message - India is a very bad place to have your son circumcised.
This paper is truly horrific. The study site is in Kashmir, a mostly Muslim area, so we are probably largely dealing with religious circumcisions. Most circumcisions were done by non-surgeons and 17% were done by unqualified quacks without anaesthesia. An astounding 40% required subsequent surgical correction. Indian readers please note - if your son needs to be circumcised please take him to a specialist paediatrician or urologist. It will probably save you money in the long run, and will certainly make things less traumatic.
Read the abstract at PubMed or the full paper (open access) at the Journal of Indian Association of Pediatric Surgeons. Thanks to JH and BM for the link.
Oops, we gave them the wrong pamphlet!
This US study looked at the factors affecting the circumcision decision. They wanted to know what effect the American Academy of Pediatricians guidelines had on parental choice. In fact 85% of parents found the guidelines helpful. In the end the factors in favour of circumcision were 63% the health of the child and 34% the circumcision status of the father. OK, but, embarassingly it turned out that they had used an out of date version of the AAP guidelines! A correction had to be published. We featured the original paper in December 2021.
Read the original paper at Cureus and the correction at the same journal. Thanks to JH for the links.
oh it hurts so nice!
This seems to be the year of weird and wacky papers, but this one absolutely takes the biscuit. A brief paper in Sexual Medicine Reviews claims that orgasm is actually a form of pain, just one that we like. Their whole case is predicated on these photographs of people purportedly experiecimg orgasm.
>Apparently they appear to be in pain. Understand no partners are visible so I suppose they were just supposed to masturbate in front of a camera. What can I say? I've had several girlfriends before I was married (and none since!) Some were very vocal when they climaxed, others were more self controlled. But none looked to be in pain - blissful ecstasy would seem a more apt description. As to the men. the left-hand one seems to have severe toothache, the middle one seems to be having real trouble getting there in the artificial envireonment in which he's placed, amd the right hand one just seem to be hamming it up for the camera. Now I waa educated at an all-boys boarding school so I have seen many ejaculations but none with any weird facial expressions. Maybe an arching of the back and a blissful sigh when he finally shoots his load, but nothing more.
The authors attempt to support their case with vague diagrams of brain pathways but, honestly, the idea that the brain is divided into different compartments for different functions has been dead for at least 20 years. They also have two diagrams of bathroom wash basins, the significance of which totally eludes me. The paper is short and behind a paywall bur a substantial abstract is available at Sexual Medicine Reviews. Thanks to Brian Morris for the link.
pediatric circumcision in Spain
Neonatal circumcision is not common in Spain, but some boys will still suffer from phimosis and/or redundant prepuce. A team in Madrid decided to compare traditional manual circumcision with one of the new 'all in one' devices. Boys were divided into two groups, those under 12 and those 12 or older. In the latter group boys are going into puberty so erections will be rearing their head. In both groups operation times were shorter with the 'Presurg' device but the striking difference occurred in the older group. Almost a quarter of the over-12s had problems with the cut line coming apart after manual circumcision compared with absolutely none done with the mechanical device.
You can read the abstract at PubMed but the full article is open access in 'Cir. Pediatr.' (I cannot find the full name of the journal). Thanks to JH for the link.
a seriously weird respomse to Villanueva and Salevitz.
On 31st August we reported on a paper by Villanueva and Salevitz "Gomco circumcision in the office in patients heavier than 5.5 Kg and/or older than 3 months" which suggested that criteria for infant Gomco circumcission could be relaxed a bit without causing complications. Good news for parents who might not be able to afford circumcision under general anaesthetic. Now two Turkish (!) pediatricians, one in Turkey and one in Moscow, have published a letter in the same journal objecting, under the title above. It s partly behind a paywall but you can read some of it at Science Direct. They say "Like all pediatric surgeons of a certain age who rely on their own professional experience and know how to think outside the box, we believe that circumcision is an unnecessary operation that should be avoided and considered a mutilating tradition from ancient times." OK, let babies have UTIs and schoolboys have balanitis - etc. So much for being caring medical professionals.
In the rest of the letter (sorry, we can't post it all here for copyright reasons) they get even more extreme: "Circumcision should not be the subject of scientific investigation" - well take that! One can only assume that being "of a certain age" means suffering from senile dementia. Thanks to JH for the link.
but they do give multilingual information on choosing a provider.
To get to their page click on Birmingham NHS - Urology and then click the link 'Male Circumcision' at the top of the page. It states circumcision "is mostly done in babies and young children" and then goes on to list a string of reasons why they make this almost impossible.
They have pamphlets in 9 languages advising on choosing a religious or cultural circumciser. Amusingly, the one listed as Yiddish is in fact in Hebrew - so much for cultural sensitivity. Thanks to our NHS contributor JLC for the information.
Cavite Province provides it free of charge.
Boys in the Phillipines are traditionally circumcised between age 7 and 10. This is a very ancient practice, long predating both Christianity and Islam. (See our Phillipines page). The Phillipines do not have a mass public health system but beacuse of the importance of this operation (and to avoid dodgy operators) many organizations offer free, medically-performed circumcisions.
August was the tuli season and the the Province of Cavite is celebrating a very successful season last month. Very many circumcisions at many centres around the province, all free of charge, all provided under proper clinical conditions. And many images to prove it! (Follow the link to see them.) Thanks to JH for the link.
Maybe not.
For some time there has been an unofficial consensus in the US that babies older than three months or heavier than 5kg are not suitable for office Gomco circumcision. A recent paper by Villanueva and Salevitz challenges this view. They found that extending the bounds had minimal, if any, extra complications. This should make many parents able to get their sons circumcised when they wouldn't have been able to afford the procedure under a general anaesthetic.
The paper, in Journal of Pediatric Urology, is behind a paywall but you can read a substantial abstract at PubMed. Thanks to JH and BM for the link.
Once again, DON'T!
 |
An 18-year-old Indonesian boy wanted a bigger penis, so he had candlenut oil injected under his shaft skin.
A year later he presented at the emergency room with this sorry-looking member. The oil had caused lipogranulomas - malignant growths - to form under his skin. Fortunately it hadn't spread, but they had to pretty much skin his penis to remove the granulomas. Then they reconstructed his skin using, in part, skin from his scrotum. He hadn't been circumcised before, but he was afterwards. Read the abstract at PubMed or the full paper (including photos) at International Journal of Surgery Case Reports. Thanks to JH and BM for the link. |
Quotes recent study on the penile biome.
Most of the items featured in this section derive from medical journals or news items in newspapers. So what a welcome surprise to see circumcision featured in the German Health and Fitness magazine Fitbook. The brief article describe how the human biome found at the glans and sulcus is modified after circumcison, and lists the benefits of this. The article is based on a previously published research paper (see Ref. 6 in the article). Indications are that more and more Germans are discovering the benefits of MC, especially among the younger generation.
Regular bi-lingual correspondent Tom sent us this post. See our news item of 30th March this year for more about the penile biome.
Cultural, religious, preference all OK.
Back on March 13th 2022 we reported that in Scotland, unlike England, infant 'non-therapeutic' circumcision was available on the National Health Service. Most NHS trusts offered it (under general anaesthetic) between the ages of 6 and 9 months. An exception was Glasgow and Clyde, which only offered it after 12 months - but they announced that they were planning to introduce a nurse-based programme of Plastibell circumcision under local anaesthetic for babies under 8 weeks. At the time, with Covid, elective surgery was pretty much on hold, but our Scottish correspondent JLC informs us that the programme is now in operation at the Royal Hospital for Children, Glasgow.
The basic information is available at RHC Glasgow - plastibell which doesn't say much but gives links to very explanatory pre-op and post-op leaflets.
A West Australian agony aunt replies.
"My girlfriend has asked me to get circumcised, she says she believes she'll enjoy sexual activity with me more and believes that it'll create better pleasure for me, too. Is this a common request that women have for men?" So wrote a man to "Bestie' (Amanda Lambros) in the Perth Now section of the Western Australian newspaper.
Amanda's reply was nicely nuanced though she did go on a bit about phimosis even though the man had never suggested that he had that problem. Read it at Perth Now. Thanks to CL for the link.
The Novaglan device.
A team at two hospitals, one in Sydney, one in Brisbane, reports on a trial of a new non-surgical approach for phimosis. The Novaglan has a series of balloons which you inflate under your prepuce to stretch it (see picture). It is done twice daily over a few weeks. This small trial (20 patients) suggests that it works reasonably well. However a very worrying feature was that 35% of the patients were infected with lichen sclerosus. This absolutely has to be treated by circumcision or it will lead to cancer (see our news item for 31st July, below.) The authors make no mention of this.
You can read the abstract (with illustrations) at PubMed or the full paper (open access) at Translational Andrology and Urology. Thanks to JH for the link.
"God has a foreskin" he said
Andrew Lye, mayor of Neyland in Pembrokeshire, was forced to resign after the council was informed of some virulent anti-circumcision rants he had posted on social media. He claimed that "God created man is his image so God must have a foreskin". Well, I'm not remotely a creationist but if you do take the Bible literally surely you also have to also accept that (Genesis, Chapters 16-21) God commanded us to cut it off! It was clearly anti-semitic and anti-Islamic racism, pure and simple.
Read the story at BBC Wales. Thanks to Tom for the link.
often undiagnosed, and a serious cancer risk
Lichen sclerosus et atrophicus (LS) otherwise known as balanitis xerotca obliterans (BXO) (really, couldn't they invent a more convenient name?) is an inflammatory condition which leads to the inner foreskin becoming hard and non-retractable. Even the most die-hard anti-circumcision activists regard this as a condition requiring circumcision. The trouble is that it seems clinical diagnosis misses 50% of cases, which are only subsequently recognized, post-circumcision, by histological analysis of the prepuce. The condition peaks in boys aged 7-8 and if not treated seems to lead to cancer in adulthood in 50% of cases. This is not the usual penile cancer, caused by the HPV (genital wart) virus, but a different one called SCC (spinocellular carcinoma).
This study, by Arena and others at the University of Messina in Italy, carried out histological examinations of foreskins removed in circumcision from young children in 3 groups (A) religious circumcision, (B) circumcision for phimosis and (C) diagnosed LS (diagnoses confirmed by more that one specialist). They found clear pre-malignant signs in all the LS cases. The take-home message is clearly 'if in doubt circumcise' - you could be saving your son's life. Read the abstract at PubMed or the full paper (open access) in Biomedicines. Thanks to JH for the link.
Possibly it does
The idea that circumcision would reduce the risk of HIV infection in men who only practice insertive sex, never receptive sex, has been floating around for ages - but are there any such men? (Maybe those who only patronise male prostitutes?) Anyway, without answering that question a small Chinese study has looked at the effect of circumcision on homosexual men. In a randomized prospective trial 124 gay men were assigned to undergo circumcision and 123 were in the control group. (Did they have a choice, one wonders?) There were no seroconversions in the circumcised group during the 12 months of the trial, while five men among the 123 in the control group became infected with HIV (P=0.025). Question answered.
This was a presentation at the International AIDS Society Conference on HIV Science in Brisbane, Australia. Read a report at Medpage Today. Thanks to Brian Morris and JTT for the link.
You wouldn't want to wear these pearls!
A Haitiian man presented at the emergency department in Winston-Salem, NC, with a severe abcess on his penis. It turned out that he had implanted multiple objects (by an incision) under his shaft skin. Clearly one of these had caused the abcess. He wanted to be circumcised but he also wanted to be able to keep as many as possible of his 'pearls'. The team drained and treated the abcess and removed four plastic squares and three glass beads through the circumcison incision, while still leaving several objects behind.
You can read the abstract, including the illustrations (you'll need a strong stomach) at PubMed or the full case report (free acccess) at Cureus. Thanks to JH for the link.
Maybe a pictorial atlas of normal healing will help.
A group of medical researchers at the University of Michigan were concerned that parents of circumcised boys were getting worried about what were in fact normal stages of healing, and calling medical help lines or attending emergency departments needlessly. (The paper has 12 authors!) So they prepared a photographic atlas of the normal progess of healing and gave it to new parents, hoping it would reduce the problem.
In fact, not only did it make no difference, it seemed to show that the problem had never existed in the first place! The paper, in Journal of Pediatric Urology, is behind a paywall but you can read the abstract at PubMed. Thanks to JH for the link.
how do they resolve the problem? Comment.
Ali M. Ziada published a comment on the paper we ran on 24th June. You can read part of it at Journal of Pediatric Urology but the rest of this one page letter is (ridiculously) behind a paywall. His key point is "Despite neonatal circumcision or circumcision in general represent a large volume of procedures performed yearly, the knowledge provided to families is often lacking or not easy to understand leaving non-medical or non specialized resources as a primary source of information. Because shared decision making is important, this study provides a valuable addition to the literature and gives insight in how we can improve in the future." (The poor grammar is his, not ours.)
Thanks to Brian Morris and JH for the link
factors involved in male satisfaction.
Until 1995 circumcision was routine in Taiwan (see our Taiwan ROC page). A change in health insurance system affected this. Now there are many men reaching adulthood uncircumcised - and of course many who have been circumcised when it was no longer universal. Not too surprisingly men who had sufferend phimosis or balanitis were most likely to be satisfied. Somewhat surprisingly, increase in penis length was also a reason for satisfaction. Change in masturbation technique was also assessed but had no effect on satisfaction.
The paper, by Cheng, Cheng, Fan and Chang is in Scientific Reports, and you can read the abstract at PubMed or the full paper (free access) at Scientific Reports. Thanks to Tom for the link.
how do they resolve the problem?
A small, but significant, group of American parents disagree on whether or not to circumcise their newborn son. This study looked at the reasons for this conflict. It was a fairly small sample and in the end, while the factors involved were predictable, it did not come to any common ground as to which were more important. But most parents ended up choosing circumcision. The paper is in the Journal of Pediatric Urology but is behind a paywall - you can read the abstract at PubMed. It is a bit confusing but actually the full paper isn't much better since there really wasn't much common ground. Thanks to BM for the link.
leads to a string of problems later.
A recent paper in Urology has looked at the consequences of state de-funding of RIC. Medicaid is a US health insurance program for low-income people, and is funded jointly by the Federal and state governments. As discussed in several previous News items, some states decided to remove coverage for RIC. This study shows that those states have higher rates of foreskin-related problems (with twice the incidence of balanitis) than found in 'covered' states and have many more childhood circumcisions (which are covered by Medicaid).
The authors suggest a cost-benefit analysis should be done - they clearly lean towards the idea that defunding RIC costs more than it saves, but do not prove it. Maybe that will be their next paper. The paper is behind a paywall but you can read a comprehensive abstract at PubMed. Thanks to JH and BM for the story.
which is the kinder way to circumcise?
There have been many papers from China comparing techniques, but most involve very small cohorts. Now we have a substantial meta-analysis of many studies comparing ring devices (Shang Ring and similar) with conventional surgical techniques. Amusingly, two of the authors are called Wang. (For non-native English speakers, this is a slang term for penis). Their conclusions? Ring circumcision had a lower rate of wound infection and of bleeding, but there was no difference in overall healing time, oedema (swelling) or wound dehiscence (coming apart).
The paper is in English and you can read the abstract at PubMed or the full paper (open access) in the International Wound Journal. Thanks to JH for the link.
Increasing demand for circumcision on aesthetic grounds.
This is the title (translated) of an article published in the Swiss magazine GHI. It is about the increasing number of teenagers who want to be circumcised because it looks better. The article is in French but here are some translated snippets. "Circumcision is, it seems, on the way to changing its status in our society." "All the girls these days prefer a circumcised penis, writes 'Julien', aged 19, from Lausanne, who is about to take the plunge. My girlfriend is very happy that I'm doing it, she thinks it is more hygienic and nicer for her, particularly in oral sex."
The article goes on to discuss the history of circumcision and its medical benefits. Thanks to Tom for the link.
circumcised in his 60s
A fun article in the Health and Fitness section of the Guardian on May 6th. Stuart Jeffries finally discovered in his 60s that he had phimosis! (He was married). We are spared the cutesy photo of a banana only to get a similar one of a cucumber. At least that is a common euphemism for the male organ. ("I don't care if he is common, so long as he's all cucumber and hooves" - Dylan Thomas, Under Milk Wood)
The imminent operation inspires him to research the procedure, including that you don't actually see anything in Old Master paintings of the Circumcision of Christ. He references " Miles Kington's droll Channel 4 documentary In Search of the Holy Foreskin. In the programme, he toured Italy trying in vain to find everybody's Top 10 favourite holy relic, Jesus's foreskin, which has been venerated for centuries as a religious icon." (For more information on this go to our News 2019 page and scroll down to 18th December.)
Anyway, it all went well, and the article is a great read. Thanks to JH for the link,
silicone replica of the body reconstructed.
The shroud of Turin - purportedly the grave-cloth in which Christ's body was wrapped - was first revealed in northern France in 1354. It bears a very faint image of a man. (Detail below left). As early as 1392 it was condemned as a fake by the bishop of Troyes which didn't stop it being venerated and next century it was acquired by the royal house of Savoy, who moved it to Turin (Torino) in Italy. Modern research has confirmed that it is a fake - radiocarbon dating shows that the linen fabric is mediaeval, and chemical analysis shows that the image is painted. Nevertheless it remains on display in Turin Cathedral, and last year a Spanish team decided to recreate a silicone replica of the body it depicts. It went on display in Salamanca last October. See below.
Whether this was a stunt, a money-making venture or a genuine act of devotion I do not know. But the funny bit is that, as you can see, Christ's hands were placed over his crotch in the shroud image. The reconstructors have lifted them to reveal a generously-proportioned and thoroughly circumcised penis. The shroud didn't show that!
Thanks to Hungarian correspondent Andras for the information. You can see a video of the reconstruction on Youtube. Shroud image courtesy Wikimedia Commons, reconstruction image courtesy Associated Press.
- protection from penile and cervical cancer.
This will not be totally new to regular Circlist readers, but a new popular article, based on a recent major review, explains the topic very clearly. The article, by Dr. Sanchari Sinha Dutta, is in News-Medical. The original paper, in Clinical Microbiology and Infection, is behind a paywall but you can read an abstract here.
Thanks to JT for the link.
A review of the evidence.
Our last news item, last year, was about the penile microbiome, before and after circumcision. This topic has now been reviewed by Dr. Liji Thomas, MD in the medical newsletter News - Medical. She looked at four different studies, including the one we featured, and came to the same conclusion - circumcision hugely reduces the mumber of nasties. My favourite quote: (circumcision has the effect of) "turning the post-circumcision PMB into something closely resembling the healthy skin microbiome." This is not an academic paper - it is easy to read and fully open access. Highly recommended.
Thanks to JT for the link.
Yes, there is almost no difference.
An impressive group of ten US academics has carried out a very comprehensive study of sexual sensitivity and response in US males. The study was limited to white, English-speaking men over 18 so they really did the best they could to elininate ethnic bias. 510 men were recruited, matched carefully to the general population. 46 of them, while male at birth, no longer had male genitalia, and so were excluded. Another 62 were excluded because they had never had sexual relations. This left 402 adult men,of whom 227 were circumcised and 175 were uncircumcised.
Diagrams divided the penis and scrotum into 12 different zones, and participants were asked to rate them for erotic sensitivity. There were some minor differences but of course the glans won out in both groups. The only substantial differences were that circumcised men rated the tip of the glans as more sensitive, and also rated more highly the middle area of the shaft (maybe the Gomco scar, since they were Americans). They were also asked to rate, qualitatively, ease of reaching orgasm and orgasm quality - no difference.
The paper, in Journal of Sexual Medicine, is open access at JSM. Thanks to JH for the link. Sadly, while it was open access when we posted this, it no longer is. Must have been a glitch.)
and is reunited with his family 25 years later.
A 13-year-old Indonesian schoolboy was supposedly preparing for his circumcision in the town of Klaten. Instead, on the day of the operation he disappeared, terrified of what was to happen. For 25 years, nobody could find him. Recently, an officer from the local district's social welfare coordination team, Joko Prayitno, managed to locate the man in the town of Bantul, with the help of a YouTuber. (Good to have something nice to say about YouTube). Last week he had a very emotional reunion with his family, after more that 20 years of homelessness.
The best story is at Singapore Uncensored but you can see other pictures at Juice. Thanks to our regular Indonesian correspondent EC.
Yes, he is circumcised .
But then, we knew that already - Ingrid Seward, a palace insider, told us that in her book 'The Two Princes' - see our UK page. What we didn't know was that having a foreskin might have saved him from frostbite of his dick!
This is where things get messy. Clearly the same handful of excerpts have been passed from source to source by "chinese whispers" getting more and more inaccurate along the way. So, many accounts say his member got frostbitten in the Antarctic, while others say it was on a trek to the North Pole. Since Harry was involved with a fundraising trek to the North Pole for wounded servicemen, and joined it for four days (see the BBC report) I am inclined to believe the latter version.
The most amusing variant is in Harry's account of losing his virginity to an older woman. "She liked horses, quite a lot, and treated me not unlike a young stallion. Quick ride, after which she'd smacked my rump and sent me to graze." This rings true, but many versions have her smacking his "ass" which not only destroys the horsey metaphor, it's an Americanism which Harry would never use.
There are many links but here are 3 7 News, Daily Mail, Page 6. Thanks to AG, BM and LX for the links.
I think we can assume that Meghan and Harry's son Archie is circumcised, so I guess media speculation will now centre on whether Willam and Kate's sons George and Louis are also circumcised.
The UK page has now (Jan 20th) been updated with accurate information from the actual book.
The Jew's penis: circumcision and sexual pathology in eighteenth-century England.
This paper, by Noelle Gallagher, is based on a cartoon by Hogarth. Now, if you were writing a piece of social history about the presnt century would you take a cartoon as fact? Hardly! Hogarth's cartoons were satires, intended to amuse.
Read this paper for a laugh, but don't take it seriously. It claims that Jews were effeminate, sexually inadequate and prone to sexually transmitted disease. All the serious literature contradicts this. Medical studies showed that Jews were much less prone to sexually transmitted diseases - the controversy was whether this was a benefit of circumcision or because Jewish men were less likely to stray in their married life. (Answer - probably both but until circumcision of gentiles became routine that question could not be answered.) And in popular literature circumcised men were regarded as so potent that a woman who had once experienced one could never be content with an uncircumcised one again (also nonsense, of course, but very few women had that experience). One final point - Gallagher quotes Robert Darby as a reliable source, which puts her firmly out in the lunatic fringe.
The abstract is available on PubMed but that really doesn't tell you much, you need to read the whole paper in Medical Humanities which is open access. Thanks to JH for the link.
Click here go to Circlist’s Home Page, or use the 'Back' button of your browser to return to the previous page that you were viewing.
Copyright © 1992 - 2023, All Rights Reserved CIRCLIST.