Thursday, November 15, 2012

Circumcision - is it cleaner? Don't they get infections?

American doctors seem to place no value on the anatomy and functions of the foreskin and seem clueless about its proper care - I would say due to lack of personal experience of it.

The American Academy of Pediatrics new statement on circumcision gives bad advice when it comes to caring for the intact (uncircumcised) penis.

The Pediatric Association of New Zealand has a page on CARE OF THE FORESKIN (notice the language, not care of the uncircumcised penis, care of the foreskin, meaning that circumcision is not normalized there; they are caring for the body, not for the body that has not been operated yet)

This is their page: Foreskin care

Key points to remember about foreskin care

  • the foreskin is the loose skin that covers and protects the end of the penis
  • the foreskin and penis of an infant or child need no special care
  • a child’s foreskin should never be retracted (pulled back) by force
  • there is no need to clean inside the foreskin in young boys; just wash the penis the same as any other part of your son’s body and be careful to wash off any soap
  • once the foreskin is ready to be retracted, your son will most probably discover this for himself
  • once the foreskin is easily retracted, your son should learn to do this as part of normal washing in the bath; make sure he rinses off any soap and pulls the foreskin back over the head of the penis afterwards
For lots of more detail, visit

As to what the AAP says:  
This review found no systematic studies in infants and children on the care of the uncircumcised versus circumcised penis.

Parents of newborn boys should be instructed in the care of the penis at the time of discharge from the newborn hospital stay, regardless of whether they choose circumcision or not. The circumcised penis should be washed gently without any aggressive pulling back of the skin.24 The noncircumcised penis should be washed with soap and water. Most adhesions present at birth spontaneously resolve by age 2 to 4 months, and the foreskin should not be forcibly retracted. When these adhesions disappear physiologically (which occurs at an individual pace), the foreskin can be easily retracted, and the whole penis washed with soap and water.

The problems with this:

* Suggesting that the "adhesions" should resolve by 2 to 4 months. The adhesions are actually called synecchia or balanopreputial membrane (I guess saying that would require acknowledging something that is destroyed by circumcision), and its function is to keep the glans and foreskin sealed for protection. Quite often this membrane can take up to puberty before it dissolves. Trying to retract the foreskin forcefully (whether by parents OR BY DOCTORS) hurts this membrane and causes open wounds inside the foreskin - which can get infected or can develop scar tissue that may adhere to both the foreskin and the glans - making retraction even more difficult. Because of this parents should not retract the baby's or the child's foreskin. Leave it alone. He will discover it.

* They recommend using soap and water but make no mention of the importance of rinsing it properly, not leaving any soap, and if using soap using soft soaps. The foreskin has its own normal bacterial area or microscopic flora that should be unharmed. It's important to use only mild soaps outside, and if possible no soap at all inside the foreskin, only warm water and a gently massage, and this only by the owner of the penis himself. See:

SOAP WARNING: All soaps, shampoos, and bubble baths can irritate the sensitive inner foreskin, and are entirely unnecessary for cleanliness anyway. Even worse, they also destroy the beneficial pH balance and “friendly flora.” 8 

8. Bollinger D. The Penis-Care Information Gap: Preventing Improper Care of Intact Boys. Thymos, 2008;1(2), 205-219.


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