md4doctor2000
JF-Expert Member
- Jun 19, 2012
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This question was asked by Jaluo_Nyeupe in another thread. It worth posting as a new thread...!
Male Circumcision (MC) [Tohara kwa Wanaume], and when is is performed to the young male infants it is called Early Infant Male Circumcision (EIMC) [Tohara ya mapema kwa watoto wachanga wa kiume].
Introduction:
Male circumcision (MC) is one of the oldest known surgical procedures on Earth. Egyptian records show that male circumcision was being performed as early as 2300 BC. The procedure has been adopted independently by different cultures all over the world for various medical and non-medical reasons. Since the mid-1980s, three famous studies conducted in South Africa, Kenya and Uganda have shown that circumcised men have a lower prevalence of HIV infection than uncircumcised men.
By definition male circumcision (MC) is the surgical removal of all or part of the foreskin tissue (prepuce) that typically covers the tip or head of the penis (glans of penis). The word is derived from the Latin word circumcido, means, cutting around.
Why doing MC?
Male circumcision is widely practised for:
Decision to circumcize:
The decision to have a newborn male circumcised is very personal and should be made after careful consideration of the risks and benefits and cultural, religious, and personal preferences. Usually the decision is made by parents and others in the family.
Infancy Vs adolescence/adulthood circumcision:
MC can be performed at any age. However several factors should be considered when determining its timing, including advantages of EIMC
Advantages of Early Infant Male Circumcision (EIMC) is that:
Other advantages for EIMC are:
Timing of male circumcision during infancy:
Male circumcision can be performed as early as 12 to 24 hours after birth, before that it is not advisable. 12 to 24 hours period after birth can ensure the infant is stable and also complete assessment of the neonate to identify abnormalities or contraindications can be done.
It is also advised to delay circumcision to:
· A male infant of low birth weight (less than 2500 gm)
· A male infant whose penile shaft length is less than 1 cm
· A preterm infants
Benefits of Male Circumcision: (These are the general benefits and not limited to EIMC alone):
Risks of Male Circumcision:
Risks associated with male circumcision include:
When male circumcision is performed by well-trained, adequately equipped and experienced health-care personnel, these complications are minor and rare.
Male Circumcision (MC) [Tohara kwa Wanaume], and when is is performed to the young male infants it is called Early Infant Male Circumcision (EIMC) [Tohara ya mapema kwa watoto wachanga wa kiume].
Introduction:
Male circumcision (MC) is one of the oldest known surgical procedures on Earth. Egyptian records show that male circumcision was being performed as early as 2300 BC. The procedure has been adopted independently by different cultures all over the world for various medical and non-medical reasons. Since the mid-1980s, three famous studies conducted in South Africa, Kenya and Uganda have shown that circumcised men have a lower prevalence of HIV infection than uncircumcised men.
By definition male circumcision (MC) is the surgical removal of all or part of the foreskin tissue (prepuce) that typically covers the tip or head of the penis (glans of penis). The word is derived from the Latin word circumcido, means, cutting around.
Why doing MC?
Male circumcision is widely practised for:
- Religious and traditional reasons, often within the first two weeks after birth
- At the beginning of adolescence as a rite of passage into adulthood.
- As a medical procedure to treat problems involving the foreskin and as a means to help prevent some diseases.
Decision to circumcize:
The decision to have a newborn male circumcised is very personal and should be made after careful consideration of the risks and benefits and cultural, religious, and personal preferences. Usually the decision is made by parents and others in the family.
Infancy Vs adolescence/adulthood circumcision:
MC can be performed at any age. However several factors should be considered when determining its timing, including advantages of EIMC
Advantages of Early Infant Male Circumcision (EIMC) is that:
- The procedure is simpler than that performed on older boys and men because the penis is less developed and the foreskin is thinner and less vascular.
- Healing is quicker and complication rates are lower.
- Healing period after early infant male circumcision (EIMC) is generally 5−7 days and most wounds heal completely within 14 days.
Other advantages for EIMC are:
- The wound typically does not need to be sutured
- The procedure is not complicated by erections, which can be problematic in adolescent boys and adult men
- Infant male circumcision ensures that the wound will be healed before sexual activity begins.
- Sexual activity can complicate circumcision in adolescents and adult males and can put older patients who engage in such activity before the wound has healed at higher risk for HIV transmission.
- Early infant male circumcision (EIMC) reduces risk of urinary tract infections (UTI) in the first 6 months of life.
Timing of male circumcision during infancy:
Male circumcision can be performed as early as 12 to 24 hours after birth, before that it is not advisable. 12 to 24 hours period after birth can ensure the infant is stable and also complete assessment of the neonate to identify abnormalities or contraindications can be done.
It is also advised to delay circumcision to:
· A male infant of low birth weight (less than 2500 gm)
· A male infant whose penile shaft length is less than 1 cm
· A preterm infants
Benefits of Male Circumcision: (These are the general benefits and not limited to EIMC alone):
- Decreased risk of HIV infection male circumcision has been proved to help prevent female to male transmission of HIV, reducing the risk of transmission by 60−70%.
- Decreased risk of urinary tract infections (UTI) male circumcision decreases the risk of such infections in infants and adult men. UTI is 10 times less common in circumcised male infants than uncircumcised.
- Prevention of phimosis the foreskin is tight and can not be retracted over the glans of penis (head of penis)
- Prevention of paraphimosis the foreskin is pulled back or down below the glans of penis (head of penis)
- Under certain circumstances, dirt, sand and other irritants can collect under the foreskin and cause inflammation of the glans (balanitis) and foreskin (posthitis). MC helps to prevent these conditions by making it easier to keep the head of the penis clean and clear of possible irritants
- Decreased risk of other sexually transmitted infections male circumcision has been shown to help protect against contracting genital herpes simplex virus (HSV) and human papillomavirus (HPV).
- Decreased risk of cancer of the penis, which, in some populations, occurs in 1 per 100 000 people and is much more common in men who are uncircumcised.
- Decreased risk of cancer of the cervix (Kansa ya Shingo ya Uzazi) in female sexual partners cervical cancer occurs less commonly in women with male sexual partners who are circumcised. Sex with either uncircumcised men or men circumcised after infancy increases a womens risk of cervical cancer
- Decreased vaginal infections caused by Trichomonas vaginalis and decreased bacterial vaginosis in female sexual partners.
Risks of Male Circumcision:
Risks associated with male circumcision include:
- Pain - there are drugs which can be given to control pain
- Bleeding - a patient is advised to go back immediately to the hospital for assessment of the wound and proper management
- Infection
- Injury to the penis and surrounding structures, including the urethra, glans and scrotum
- Poor cosmetic outcome
- Adhesions, buried/concealed penis, removing an excess or an insufficient amount of foreskin may be this is what have been referred as Kibamia by some of the people, it is a rare complication and may results if the procedure have been done by inexperienced health care provider.
When male circumcision is performed by well-trained, adequately equipped and experienced health-care personnel, these complications are minor and rare.