dxjnorto said:
Here's some cartoon responses to this oft asked question:
http://www.stopinfantcircumcision.org/toon.htm
Fathers are often strangely competitive with their sons. Sometimes it comes down to I don't want that little upstart to have anything I don't (or can't) have.
Also, sometimes it is a way of validating what happened to the adult. Many men have a difficult time internalizing that otherwise circumspect and loving parents would subject them to a harmful and unnecessary genital surgery. The parents may have had the child's best interests in mind, but the medical industry did NOT.
Fortunately this is changing in the U.S. As circumcision is now in the single digits in all other English speaking societies, can we be far behind?
Thank you for your thoughtful response. It disturbs me that parents (not just dads) are competitive with their kids. My mother was competitve with me when I was a child and it has been extremely damaging. Still...it had nothing to do with my genitalia!
Myspacers against circumcision might want to add as a friend or subscribe to blog:
http://www.myspace.com/not_sircumsized
He posted this on his blog, which I thought would be of interest to others here:
Pain From Circumcision Being Treated More Seriously By Doctors
Main Category:
Pain / Anesthetics News
Article Date: 22 Jul 2006 - 8:00am (PDT)
One of the first things most little boys in the U.S. experience is something they'll never remember - circumcision - but that doesn't mean it isn't a painful experience. The debate over whether infants feel pain has ended, and the positive conclusion is catching up with obstetrical, pediatric and family physician training programs, 97 percent of which now learn effective pain relief techniques for circumcision. Just 10 years ago, only 71 percent learned how to ease pain during the brief surgical procedure.
"This is a large leap ahead in how physicians are trained to perform circumcisions, which at 1 million annually, is the most common surgical procedure," said Daniel Yawman, M.D., M.P.H., a pediatrician at Golisano Children's Hospital at Strong and Rochester General Hospital. Yawman, also a clinical instructor at the University of Rochester Medical Center, is the author of a study on the subject in Ambulatory Pediatrics today. "There is no reason a newborn should have to endure the pain of circumcision without a local or topical anesthetic."
Based upon the overwhelming evidence of the safety and benefit of effective analgesia, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics released recommendations since 1999 calling for the universal use of local or topical anesthetics to provide pain relief for neonatal circumcision.
A previous study on circumcision training techniques, which shared author Cynthia Howard, M.D., M.P.H., associate professor of pediatrics at the University of Rochester Medical Center and pediatric director of the mother-baby unit at Rochester General Hospital, was published in 1998, prior to the new pain relief recommendations.
The two most effective and most commonly used pain relief techniques are the dorsal penile nerve block and the subcutaneous ring block. Both techniques involve the injection of the painkiller lidocaine at the base of the penis which decreases pain sensation prior to circumcision. Topical anesthetic creams are less effective but they are safe and do provide some pain relief. Any of these techniques can be used in combination with the Mogen clamp, the Gomco clamp and the Pastibell method, the three most common surgical methods of circumcision.
"The decision whether or not to have their baby boy circumcised is a decision that parents must make after weighing the risks and benefits of the procedure. If parents decide that they would like to have their baby boy circumcised, it is the duty of the physician to make the procedure as painless as possible," Yawman said. "For more than 100 years, physicians have been talking about using pain relief during circumcision, and it's encouraging that the next generation of doctors is learning how to make circumcision more comfortable for their patients."
www.medicalnewstoday.com
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[FONT=Arial, Helvetica, sans-serif]Pain relief for neonatal circumcision (Cochrane Review)[/FONT]
[FONT=Arial, Helvetica, sans-serif]Brady-Fryer B, Wiebe N, Lander JA[/FONT]
[FONT=Arial, Helvetica, sans-serif]
ABSTRACT [/FONT]
[FONT=Verdana, Arial, Helvetica, sans-serif]A substantive amendment to this systematic review was last made on 01 May 2004. Cochrane reviews are regularly checked and updated if necessary.
[/FONT][FONT=Verdana, Arial, Helvetica, sans-serif]Background: Circumcision is a painful procedure that many newborn males undergo in the first few days after birth. Interventions are available to reduce pain at circumcision; however, many newborns are circumcised without pain management.[/FONT]
[FONT=Verdana, Arial, Helvetica, sans-serif]Objectives: The objective of this review was to assess the effectiveness and safety of interventions for reducing pain at neonatal circumcision.[/FONT]
[FONT=Verdana, Arial, Helvetica, sans-serif]Search strategy: We searched Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2004), MEDLINE (1966 - April 2004), EMBASE (1988 - 2004 week 19), CINAHL (1982 - May week 1 2004), Dissertation Abstracts (1986 - May 2004), Proceedings of the World Congress on Pain (1993 - 1999), and reference lists of articles. Language restrictions were not imposed.[/FONT]
[FONT=Verdana, Arial, Helvetica, sans-serif]Selection criteria: Randomised controlled trials comparing pain interventions with placebo or no treatment or comparing two active pain interventions in male term or preterm infants undergoing circumcision.[/FONT]
[FONT=Verdana, Arial, Helvetica, sans-serif]Data collection and analysis: Two independent reviewers assessed trial quality and extracted data. Ten authors were contacted for additional information. Adverse effects information was obtained from the trial reports. For meta-analysis, data on a continuous scale were reported as weighted mean difference (WMD) or, when the units were not compatible, as standardized mean difference.[/FONT]
[FONT=Verdana, Arial, Helvetica, sans-serif]Main results: Thirty-five trials involving 1,997 newborns were included. Thirty-three trials enrolled healthy, full term neonates, and two enrolled infants born preterm.Fourteen trials involving 592 newborns compared dorsal penile nerve block (DPNB) with placebo or no treatment. Compared to placebo/no treatment, DPNB demonstrated significantly lower heart rate [WMD -35 bpm, 95% CI -41 to -30], decreased time crying [WMD -54 %, 95% CI -64 to -44], and increased oxygen saturation [WMD 3.7 %, 95% CI 2.7 to 3.7]. Six trials involving 200 newborns compared eutectic mixture of analgesics (EMLA) with placebo. EMLA demonstrated significantly lower facial action scores [WMD -46.5, 95% CI -80.4 to -12.6], decreased time crying [WMD - 15.2 %, 95% CI -21 to -9.3] and lower heart rate [WMD -15 bpm, 95% CI -19 to -10]. DPNB, compared with EMLA in three trials involving 139 newborns (133 of whom were included in the analysis), demonstrated significantly lower heart rate [WMD -17 bpm, 95% CI -23 to -11] and pain scores. When compared with sucrose in two trials involving 127 newborns, DPNB demonstrated less time crying [MD -166 s, 95% CI -211 to -121], and lower heart rate [WMD -27 bpm, 95% CI -33 to -20]. Results obtained for trials comparing oral sucrose and oral analgesics to placebo, and trials of environmental modification were either inconsistent or were not significantly different.Adverse effects included gagging, choking, and emesis in placebo/untreated groups. Minor bleeding, swelling and hematoma were reported with DPNB. Erythema and mild skin pallor were observed with the use of EMLA. Methaemoglobin levels were evaluated in two trials of EMLA, and results were within normal limits.[/FONT]
[FONT=Verdana, Arial, Helvetica, sans-serif]Authors' conclusions: DPNB was the most frequently studied intervention and was the most effective for circumcision pain. Compared to placebo, EMLA was also effective, but was not as effective as DPNB. Both interventions appear to be safe for use in newborns. None of the studied interventions completely eliminated the pain response to circumcision.[/FONT]
[FONT=Verdana, Arial, Helvetica, sans-serif]Citation: Brady-Fryer B, Wiebe N, Lander JA. Pain relief for neonatal circumcision. The Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD004217. DOI: 10.1002/14651858.CD004217.[/FONT]