Male circumcision an assault - surgeon

Routine circumcision in male infants is a potentially dangerous and unnecessary procedure, according to a Dublin surgeon, who has dismissed the rationale for the procedure as unproven and without medical justification.

Dublin consultant plastic surgeon Mr Matt McHugh said circumcision was a form of genital mutilation that exposed patients to a number of health risks.

However, a representative of the Jewish community in Ireland has defended the procedure, stressing that it is safe when performed correctly.

Writing in the latest issue of Modern Medicine, the Irish journal of clinical medicine, Mr McHugh said: "There is no rationale for carrying out this extremely painful, traumatic and potentially dangerous procedure on male infants.

"While female genital mutilation (FGM) is banned in Ireland and regarded as a serious assault, circumcision, which is a form of male genital mutilation, is not illegal, with the procedure still undertaken by some doctors."

Complications that can arise from circumcision include haemorrhage (bleeding) and infection, Mr McHugh said.

"Circumcision, like any other operation, is subject to the risk of haemorrhage and sepsis. Infection is also fairly common. Occasionally, infection may lead to more serious complications such as partial necrosis of the penis, or it may be a source of septicaemia."

Meatal stenosis, which causes symptoms of painful urination, increased urinary frequency and inability to control urination, is a potential late complication of circumcision, according to Mr McHugh. Loss of penile skin may also occur.

Mr McHugh said the reasons put forward for circumcision are "unproven and have no scientific basis of fact". In cases of clinically significant and persistent ‘phimosis' - a condition where the foreskin cannot be fully retracted, and the most common indication for non-religious circumcision - simple measures can be taken to correct the problem.

There is a common belief that the circumcised man runs a lessened risk of venereal infection, particularly AIDS and syphilis, but there are few figures to support this, Mr McHugh said.

"The prepuce (foreskin) of the young infant should be left in its natural state," he concluded. "Some time between nine months and three years, as soon as the prepuce becomes retractable, the young boy should be taught to keep his prepuce clean as he is with other structures, such as the ears, which have a propensity to retain dirt. If such a procedure became customary, the routine circumcision of children would become uncommon and unnecessary."

However Rabbi Zalman Lent, of the Dublin Hebrew Congregation, claimed that circumcision was safe when performed correctly and has been proven in medical studies to confer a number of health benefits on patients.

Many of these are cited on www.circinfo.net and include decrease in risk of invasive penile cancer, substantial protection against thrush and sexually transmitted infections, significant reduction of the risk of the female partner getting cervical cancer, and significant reductions of the risk of contracting HIV.

These claims are strongly disputed by many medical professionals.

In the context of a synagogue or home circumcision, Rabbi Lent said: "When a circumcision is performed properly the incision takes a split second, the entire procedure takes just a few minutes, and the healing is rapid and painless."

"Of course it goes without saying that medical best practice must be observed at all times. Circumcision must be performed in a clean and sterile environment, and only when the baby is in the best of health. If there is any indication that the baby is not in perfect health, the circumcision will be delayed or, if necessary, not performed."

Modern Medicine is published by MedMedia Group, publishers of Irishhealth.com.


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