supporting education on new site : Phimosis.cloud

ARC Forum Welcome

Written by Robin on 20. February 1999 at 17:59:07:

Hello All,

This forum is primarily intended for unbiased research, to revise our understanding of the ancient tradition of routine circumcision from the perspective of modern medicine. (This means, early monitoring and prevention when possible, accurate diagnosis previous to treatment, information and education).

In the modern world it seems to me that much of our traditional male identity and values are inappropriate and outmoded.

I would welcome an open minded exchange of personal experience and ideas, and I would like your help to stimulate and encourage an appropriate modern initiation into manhood.

Robin Stuart

To join a discussion list - ARC (The Association for Research on Circumcision) please see: http://www.male-initiation.net/arc.html



Re: Gross Misnomer of "ROUTINE" Circumcision

Written by Gerald N. Weiss,M.D. on 05. August 1999 at 02:23:58:

In Reply to: ARC Forum Welcome written by Robin on 20. February 1999 at 17:59:07:


>Hello All,

>This forum is primarily intended for unbiased research, to revise our understanding of the ancient tradition of routine circumcision from the perspective of modern medicine. (This means, early monitoring and prevention when possible, accurate diagnosis previous to treatment, information and education).

>In the modern world it seems to me that much of our traditional male identity and values are inappropriate and outmoded.

>I would welcome an open minded exchange of personal experience and ideas, and I would like your help to stimulate and encourage an appropriate modern initiation into manhood.

>Robin Stuart

I heartily endorse this attitude and commend Robin for his outstanding work which
serves to elaborate so well the COMPLICATIONS of those who have not been fortunate
enough to have been PROPHYLACTICALLY circumcised neonatally. The following is
an attempt to explain NEONATAL CIRCUMCISION in the framework of a response to the
American Academy of Pediatrics 1999 discussion of the subject.
Response to the AAP Task Force on Circumcision 1999 Report
by Gerald N. Weiss, M.D.
Manuscript Word Count=1712
As a retired surgeon and sole author copyright transfer is extended to interested party
Address: 5630 Wingfoot Drive Phone: 970-204-0927
Fort Collins, CO 80525 E-mail: gnweiss-at-frii.com

ABSTRACT
The 1999 American Academy of Pediatrics Task Force on Circumcision bears little
difference from previous reports. The two most stricking differences address cost
factors and procedural analgesia while performing the operation. Though the
current evidence does not substantiate neonatal circumcision as a routine
procedure, the study does indicate potential medical benefits.


A newspaper headline reporting on the American Academy of Pediatrics’
(AAP) Task Force on Circumcision stated “PEDIATRICIANS NOT PROMOTING
CIRCUMCISION, NOT AGAINST IT”. This is a fair analysis and actually differs
little from the 1989 conclusions reported by this same organization. The opening
statements reflect the Committee’s opinion:
“Existing scientific evidence demonstrates potential medical benefits of newborn
male circumcision; however, these data are not sufficient to recommend routine
neonatal circumcision.”
An accompanying footnote clearly states:
“The recommendations in this statement do not indicate an exclusive course of
treatment or serve as a standard of medical care.”
Two aspects in the 1999 Report are emphasized that were not in the earlier
Task Force conclusions. As would be expected the cost factor is addressed in the
opening paragraph and then concludes with the recommendation for procedural
analgesia when performing the operation. Both of these considerations are of major
public concern and controversy.
Although for years the cost factors from an over all monetary point of view
have favored prophylactic neonatal circumcision (Warner E & Strashin E 1981;
CMAJ: 125;973 and Wiswell, T 1990;AFP:41;862), there are other cost
considerations. The real costs to patient and public involve aspects that to a large
extent remain unresolved. Until such time as data becomes available including
longitudinal studies of penile problems over a male’s lifetime and costs of neonatal to
late circumcision surgery, it is not possible to debate this issue scientifically. A study
by Lawler, FH et al (FM 1991:23;587-593) concluded:
“... that there is no medical indication for or against circumcision.
...The decision regarding circumcision may most reasonably be made on
non-medical factors such as parent preference or religious convictions.”
Cost considerations from the pediatric and surgical viewpoints are revealing.
In the 1970s it became apparent that the power of insurance payments was directing
health care. LR King, a member of the 1975 AAP Task Force on Circumcision
reported that the reason for the statement “there is no absolute medical indication
for circumcision of the newborn” was due to two factors (Weiss GN Int Surg
1986:71;62):
“1) a concern about needless surgery causing pain and suffering, and
2) the thought that insurance dollars spent on neonatal surgery would cover the
cost of neonatal intensive care .”
The advances and expenses of the Neonatal Intensive Care Units have now been
taken to task by insurers, government and general public. Survival of the afflicted
“one-pounders” has become an ethical issue. Furthermore, expenses for genito-
urinary care of the uncircumcised infant, child and young adults (not to mention
later life penile problems), contrasted to the circumcised neonate, presents a
pediatric, as well as adult, cost dilemma. The 1999 AAP Task Force Report
conclusion only adds to the confusion:
“Although the relative risk of UTI (Urinary Tract Infection) in uncircumcised
male infants is increased from 4- to as much as 10-fold during the first year of
life, the absolute risk of developing a UTI in an uncircumcised male infant is low
(at most, ~1%). “
Compounding a scientific cost analysis is data availability and manner of
presentation. The Report acknowledges the greater frequency of STD, AIDS and
penile cancer in the uncircumcised. The low frequency of penile cancer and
significance of other considerations leads the Task Force to state:
“Nevertheless, in a developed country such as the United States, penile cancer is a
rare disease and the risk of penile cancer developing in an uncircumcised man,
although increased compared with a circumcised man, is low., and
“However, behavioral factors appear to be far more important risk factors in the
acquisition of HIV than circumcision status.”
And, of course, the real “bottom line” to all such statements is the fact that:
“The true frequency of these problems [penile] is unknown.”
The other consideration as to cost is the surgical one. As a retired surgeon I
can speak with experience and more objective critical analysis. As late as the 1980s,
when serving in the US military, neonatal circumcision was not even listed as a
surgical procedure. It was performed but not recorded as “surgery” on our Report
of Operations. Even to this day, this attitude may be reinforced by current
malpractice insurance companies. Pediatricians and Family Practitioners,
approved as qualified and performing circumcisions in the first year of a child’s life
may do so with no special increase in rates. However, if performed after the first
year of life, circumcision falls in the category of major surgery and thus premium
rates increase!
It is recognized that the majority of American neonatal procedures of this
type are done by nurses, medical students, physician assistants, interns or residents
who have little or no surgical expertise, training and often no supervision. The most
common neonate and male surgery is often performed by non-surgeons!! There is
an explanation.
In the United States of America our country was founded on the distinct
separation of State and Church. Following this direction, surgeons as a group
attributed the procedure to the Hebrew ritual. As the advantage of the secular
prophylactic surgical measure reached a height, prompted by military conflicts and
scientific confirmations (Weiss, GN and Harter, AW, Circumcision: Frankly
Speaking, 1998, Wiser Publications, Fort Collins, CO), neonatal circumcision
became a norm for 80% to 90% of newborns during mid century in the U.S. The
simplicity and safety of a surgical procedure, not basically considered surgery but
ritual, was enhanced with new metal and plastic gadgetry. The Gomco Clamp and
Plastibell devices for neonatal circumcision substituted for the trained surgeons’
hands. Hebrew Mohels (i.e., ritual circumcisers), who for centuries were guided by
compassion and procedural speed for the eight day old Jewish infant, were rigidly
trained for the delicate procedure. They were relegated to the ritual category.
Others meantime were to be assured of a safe circumcision, by virtue of technology,
even though the operators lacked or had minimal training. Surgeons of the time felt
the common and important procedure to be in a ritual and safe category. As for
safety of those in the non-ritual group, it depended more on technological safeguards
than on trained operators. The warnings of a prominent English surgeon, P.
Bousfield (St Bartholomew’s Hospital Journal 1916:24;5) almost a century ago went
unheeded:
“The newly qualified surgeon or the advanced student who is called upon to
perform some minor operation has in very many instances never seen that
operation performed by any member of the senior staff; often his only
experience of it may have been a textbook. ... One is inclined to approach
circumcision in a somewhat light-hearted manner; it is simple, with but little
danger and appears to be very easy. ...this simple little operation is in reality
a delicate and by no means to be despised work of art...”
Failing to learn the lessons of the past, cited by this Member of the Royal College of
Surgeons, the rare complications can be attributed to those inexperienced operators.
Known to me personally is one outspoken anti-circumcision advocate who suffered
at the hands of someone apparently untrained for the operation. Slowly, very slowly,
others than those in the surgical sphere (Stang, HJ et al PEDIATRICS 1997:100;6)
have come to recognize the need that:
“Further study of the procedures utilized in the Jewish brit is warranted.”
The above author is recognized by the AAP 1999 Task Force report relative
to his neurologic research pointing toward “a more humane circumcision”. It seems
reasonable and incumbent upon members of the surgical profession to recognize the
extreme importance of this neonatal surgery and to begin education of medical
students. An E-mail message received from a medical student in Germany this past
month illustrates the point:
“Congratulations on your research on circumcision! I find it really deplorable that
this uncomplicated but thus so beneficial operation is losing population so rapidly
in our days. I am a 24 year old medical student from Germany and I have spent 18
years of my life with a foreskin...and with it with a great many problems. I am
circumcised now and more than happy about it. I wish circumcision was the norm
here in Germany, because it is - as you might know - very unpopular here. In my
med school here circumcision is not even taught. Wish you all the best for your
research, Signed”
It is distressing and depressing for me as one who spent a lifetime in surgical
care of many thousands of patients while in medical training, private and clinic
practice, military and governmental service to see a secular prophylactic health
measure be so neglected by my surgical colleagues. Neonatal circumcision is safe
preventive surgery that is a viable option in maintaining and promoting quality
genital health for males of all ages.
In the meantime, the AAP 1999 Task Force conclusion is justified:
“Existing scientific evidence demonstrates potential medical benefits of newborn
male circumcision; however, these data are not sufficient to recommend routine
neonatal circumcision.”
Long term scientific research will confirm the evidence of hygienic, aesthetic,
health preventive and perhaps sociologic aspects of neonatal circumcision. Only by
adequate training of pediatricians, family practitioners, urologists, obstetricians --
for that matter ALL in the medical community--in the positive and negative
concerns of this preventive neonatal surgery will the benefits be fully realized by the
American public. It is then that the newborn’s parents will be equipped to give an
unqualified informed consent on scientific grounds and not for religious reasons
only. Of even greater significance is the need of the surgical profession to take on the
responsibility of so vital and delicate an operation that is not below an American
surgeon in spite of its simplicity and safety. Rather, “this simple little operation is in
reality a delicate and by no means to be despised work of art.”

AGAIN, Robin and others are to be congratulated on revealing the degree of COMPLICATIONS and
outright misery and discomfort so many males suffer as a result of penile problems
related to phimosis, paraphimosis and an entity few physicians are even aware of-- frenulum
brevae. Continue your signal, outstanding and promising studies. I intent to learn with
you and contribute as my 50+ years of surgical experience has taught me.
With best wishes for continued success of this project, GN Weiss, MD

routine neonatal circ. : no scientific basis.

Written by RS on 13. August 1999 at 23:23:14:

In Reply to: Re: Gross Misnomer of written by Gerald N. Weiss,M.D. on 05. August 1999 at 02:23:58:

Hello Gerald,

I`m glad you wrote to the public FORUM.


>>This forum is primarily intended for unbiased research, to revise our understanding of the ancient tradition of routine circumcision from the perspective of modern medicine. (This means, early monitoring and prevention when possible, accurate diagnosis previous to treatment, information and education).

>>Robin Stuart


>I heartily endorse this attitude and commend Robin for his outstanding work which
>serves to elaborate so well the COMPLICATIONS of those who have not been fortunate
>enough to have been PROPHYLACTICALLY circumcised neonatally.

I completely distance myself from this conclusion. My
suggested modern methods of PREVENTION (which you answered
to above) have nothing to do with "PROPHYLACTIC" circumcision.

The modern medical attitude and the conclusion of my study is
that children must be checked and these conditions prevented.

I can only think that you have been involved for too long
with the anti - pro circumcision debate.

To move with the modern world it is necessary to free yourself
from this irrelevant and closed minded question which suggests
only two alternatives: routine circumcision or nothing at all.


___________________________________

>The 1999 AAP Task Force Report
>conclusion only adds to the confusion:
> Although the relative risk of UTI (Urinary Tract Infection) in uncircumcised
> male infants is increased from 4- to as much as 10-fold during the first year of
> life, the absolute risk of developing a UTI in an uncircumcised male infant is low
> (at most, ~1%).
>Compounding a scientific cost analysis is data availability and manner of
>presentation. The Report acknowledges the greater frequency of STD, AIDS and
>penile cancer in the uncircumcised.

Rather than just repeating the confusion how about clearing
it up .... Do the problems you are talking about among the
uncircumcised occur in 1% or in 0.1% of the population?

In debate.html, I repeat information from Vernon Quaintance
who hosts your pages, and gave me permission to quote him.

... "UTIs happen 10% more in uncircumcised boys."
Are we talking about a difference between 1 in 600 and 1 in 6,000?

... "Its AIDS, penis cancer etc. all added together."
How often do these complaints actually occur?? Do these occur more than 1% of the time?

.... "Parents should be aware of the danger."
Even if its 1% I would agree, but then isn't it even more important to inform them that...

Phimosis occurs in 8.8% when flaccid, most pro circers will
easily accept 10% when erect. Consider in Britain where
checking is not performed: population 70 million - 1 million
a year - 2,740 a day - 1,370 men - 10% of this means that
approximately 137 boys a day arrive at puberty and start
their path to manhood with an anatomical inhibition.

Surely if care for children is foremost in your thinking it
would be appropriate to help make our culture aware that
these common conditions can be checked for and to help
educating about any and all of the many different options
there are on prevention and treatment.

Isn't it time to think about practical obvious necessities?
You can continue your arguments about circumcising every
child or none for further centuries once these common actual
problems have been resolved.

My question to the anti and pro circ. activists concerns
the priority of helping children in a practical way. ----
Is "checking for individual problems" a middle ground which
may resolve a number though not all of your differences?
and then if we could all pull together, maybe the internet
community could also help a number of children.


___________________

THE FOLLOWING SEEMS A VERY GOOD "APOLOGY" TO THE ANTI CIRC. GROUPS -
(though have you ever heard of abstracts and short summary versions?)

>As a retired surgeon I
>can speak with experience and more objective critical analysis. As late as the 1980s,
>when serving in the US military, neonatal circumcision was not even listed as a
>surgical procedure. It was performed but not recorded as ìsurgery on our Report
>of Operations. Even to this day, this attitude may be reinforced by current
>malpractice insurance companies. Pediatricians and Family Practitioners,
>approved as qualified and performing circumcisions in the first year of a child´s life
>may do so with no special increase in rates. However, if performed after the first
>year of life, circumcision falls in the category of major surgery and thus premium
>rates increase!
> It is recognized that the majority of American neonatal procedures of this
>type are done by nurses, medical students, physician assistants, interns or residents
>who have little or no surgical expertise, training and often no supervision. The most
>common neonate and male surgery is often performed by non-surgeons!! There is
> an explanation.
> In the United States of America our country was founded on the distinct
>separation of State and Church. Following this direction, surgeons as a group
>attributed the procedure to the Hebrew ritual. As the advantage of the secular
>prophylactic surgical measure reached a height, prompted by military conflicts and
>scientific confirmations (Weiss, GN and Harter, AW, Circumcision: Frankly
>Speaking, 1998, Wiser Publications, Fort Collins, CO), neonatal circumcision
>became a norm for 80% to 90% of newborns during mid century in the U.S. The
>simplicity and safety of a surgical procedure, not basically considered surgery but
>ritual, was enhanced with new metal and plastic gadgetry. The Gomco Clamp and
>Plastibell devices for neonatal circumcision substituted for the trained surgeonsí
>hands. Hebrew Mohels (i.e., ritual circumcisers), who for centuries were guided by
>compassion and procedural speed for the eight day old Jewish infant, were rigidly
>trained for the delicate procedure. They were relegated to the ritual category.
>Others meantime were to be assured of a safe circumcision, by virtue of technology,
>even though the operators lacked or had minimal training. Surgeons of the time felt
>the common and important procedure to be in a ritual and safe category. As for
>safety of those in the non-ritual group, it depended more on technological safeguards
>than on trained operators.
>the rare complications can be attributed to those inexperienced operators.

My comment (from a letter last week) "the pro circers. of this
world have devised and designed any number of clever simple
efficient methods of performing a full circumcision, and these
have simply flooded the market, ... it would not suprise me if
the last time anyone did any research into partials was some
Jewish Mohel, before Christ, (partial circ was the original
Jewish cut)"

I would like to know if this is true: Are you aware of any
research on partial circumcision? --- Have you ever performed
one yourself?


Are you suggesting that neonatal circumcision in the USA is
a question of the cost?


___________________________________

>An E-mail message received from a medical student in Germany this past
>month illustrates the point:
> ìCongratulations on your research on circumcision! I find it really deplorable that
> this uncomplicated but thus so beneficial operation is losing population so rapidly
> in our days. I am a 24 year old medical student from Germany and I have spent 18
> years of my life with a foreskin...and with it with a great many problems. I am
> circumcised now and more than happy about it. I wish circumcision was the norm
> here in Germany, because it is - as you might know - very unpopular here. In my
> med school here circumcision is not even taught. Wish you all the best for your
> research,

I am not suprised that "In my med school here circumcision is
not even taught." However the importance of this anecdote
cannot be overlooked - This potential doctor suggests a
routine procedure ("I wish circumcision was the norm") on
account of his personal experiences. We see very clearly
here how personal prejudice on this subject can influence
medical opinion and practice.

BTW I would bet that he had frenulum breve ... a condition
which the German checks overlook ...

____________________________________________________________

> In the meantime, the AAP 1999 Task Force conclusion is justified:
> ìExisting scientific evidence demonstrates potential medical benefits of newborn
> male circumcision; however, these data are not sufficient to recommend routine
> neonatal circumcision.î
> Long term scientific research will confirm the evidence of hygienic, aesthetic,
>health preventive and perhaps sociologic aspects of neonatal circumcision.

I have responded to this in private mail, please get on with
doing the necessary research instead of speculating on what
this may show in advance. ... It is fully illogical to put
the results of any research before doing the research.

____________________________________________________

>AGAIN, Robin and others are to be congratulated on revealing the degree of COMPLICATIONS and
>outright misery and discomfort so many males suffer as a result of penile problems
>related to phimosis, paraphimosis and an entity few physicians are even aware of-- frenulum
>brevae. Continue your signal, outstanding and promising studies. I intent to learn with
>you and contribute as my 50+ years of surgical experience has taught me.
> With best wishes for continued success of this project, GN Weiss, MD

Thank you for your good wishes, and I respect your life long
committment in this field. However if you want to join or
support this research project it will be necessary for you to
chuck overboard any opinions or preconceptions which cannot be
proved.

Please search for and find fault in my study!!! ...

If you cannot criticise any of the thinking on my site, or answer
my criticism of your letters then it is never too late for a
change of opinion and consider: someone in your position with
your contacts could really help make the breakthrough on this
century long debate.

yours sincerely
Robin Stuart


BTW your referal to a gross misnomer in terminology was
unexplained, however I am against both routine circumcision
and neonatal circumcision in the present so called civilised
world.

I must comment on your referal to "frenulum brevae" ... As VQ
said some 3 years ago: anyone using the name frenulum breve
would be copying my terminology. I in fact copied the current
word and spelling used by German Urologists.

To suddenly bring a change in terminology at this point without
any explanation of why you want to use this new confusing
spelling would be irresponsible, so I hope this was merely a
typing mistake.


Re: neonatal circ. : a realistic perspective

Written by Gerald N. Weiss, M.D. on 31. August 1999 at 00:45:28:

In Reply to: routine neonatal circ. : no scientific basis. written by RS on 13. August 1999 at 23:23:14:

>Hello Robin:

>I`m glad to be corresponding with you in a truly scientific endeavor.

I agree with your basic scientific endeavors, but years of medical practice are
punctuated with the fact that Medicine/surgery is an INEXACT science. That,
however, should not prevent study and research from being an on- going condition.
My belief is that there are 3 kinds of circumcision: ritual, med/surgical type for
pathology or cosmetic reasons and prophylactic. "Routine" is and should be a
MISNOMER. Until QUALIFIED circumcisers are available to ALL-- there should never be
ROUTINE surgery!! Those Orthodox Jews who believe in ritual as well as
other countless millions in this world of other persuasions do so by FAITH. My
thesis is that RITUAL beliefs have often have good scientific basis-- as the
Hebraic circumcision (please review and comment on my article Prophylactic
Neonatal Surgery and Infectious Diseases). Prophylactic (neonatal or older)
attempts to PREVENT the problems you are so clearly defining!
Hebraic neonatal circumcision done by qualified Mohels is both ritual AND
prophylactic. True med/surgical circumcisions are done for pathologic conditions
not amenable to medical therapy or for cosmetic purposes.
You should read the excellent book by P.C. Remondino, M.D. entitled HISTORY OF
CIRCUMCISION from the earliest times to the present. "Moral and physical reasons
for its performance." Anyway its a pleasure to be able to discuss rationally a
mutually interesting subject that only expands my knowlege and convictions by your
work and findings.
"Techniques in Large Animal Surgery", Second Edition by A.S.Turner et al. recom-
mend prophylactic circumcision in the bull-- an old veterinarian practice in this
country. The recommended oblique rather than transverse amputation of the pendu
lous sheath results in oval rather than circular scar (this seems to be the phi-
mosis problem you have so identified in post-adult circumcisions.)

>
>>I heartily endorse this attitude and commend Robin for his outstanding work which
>>serves to elaborate so well the COMPLICATIONS of those who have not been fortunate
>>enough to have been PROPHYLACTICALLY circumcised neonatally.

>I completely distance myself from this conclusion. My
>suggested modern methods of PREVENTION (which you answered
>to above) have nothing to do with "PROPHYLACTIC" circumcision.

TRUE-- BUT IMAGINE HOW MUCH MISERY WOULD BE PREVENTED IF PROPER
NEONATAL CIRCUMCISION HAD BEEN DONE!! ON THE OTHER HAND YOUR
EFFORTS FROM A VERY PRACTICAL VIEWPOINT ARE TO BE CONGRATULATED!!

>The modern medical attitude and the conclusion of my study is
>that children must be checked and these conditions prevented.

ROUTINE circumcision or nothing at all = this is a total fallacy!
GNW
>
>___________________________________

Re: Lucky bulls and your silly neonatal ideas

Written by RS on 18. September 1999 at 17:49:13:

In Reply to: Re: neonatal circ. : a realistic perspective written by Gerald N. Weiss, M.D. on 31. August 1999 at 00:45:28:

Hi Gerald,

it was a nice little phone chat the other day, I even feel you could be quite a pleasant human being despite you`re life long hobby ... I mean I think we´d probably get on quite well if we were discussing earthquakes in Turkey or the taste of wine, who knows maybe even music or communism.

Now there is also a private letter from you in my mail box which I will ignore and invite you to send it here, you see, Gerald, I`d trust you with my kidneys my hands and legs and even probably my brain - heart, but youre not getting near my genitals, - Now I realise this is highly disrespectful for a man in your position but on this subject I dont trust you.

>I agree with your basic scientific endeavors, but years of medical practice are
>punctuated with the fact that Medicine/surgery is an INEXACT science.

This applies to livers enzymes or nerves ... foreskin problems are an absolute exception in the degree of inaccurate plain mis-information about the physiological movement of an external part of the anatomy. - I`m sure you agree, ...


>"Routine" is and should be a
>MISNOMER. Until QUALIFIED circumcisers are available to ALL-- there should never be
>ROUTINE surgery!!

This is the English language: and I`m not changing the language to fit the theories ... Routine is NOT a MISNOMER it is simply and plainly wrong and irresponsible. --- as you say ---

--- To follow this to a logical conclusion you should go touring medical colleges teaching the subject for several years before continuing with your advice to parents on neonatal cirucmcision ...

------------------------------
> My
>thesis is that RITUAL beliefs have often have good scientific basis

I believe this is generally accepted anthropological thinking ... I certainly have far more respect for the other Jewish traditions since discovering the reason for this one ... I mean "primitive" peoples often had a better *feeling* for what makes sense - the modern civilised jungle, sigh ... in this respect read http://members.tripod.co.uk/songs/breakfast.html

-- as the
>Hebraic circumcision (please review and comment on my article Prophylactic
>Neonatal Surgery and Infectious Diseases).

You keep giving me these long texts to plough through, now I dont mind looking at them as long as once I`ve smattered them to illogical fragments you`d be so good as to acknowledge it ... wot? - no answer to the statistics on AIDS UTIs and cancer ... ? well I guess it was only the first time I asked.

--------------------------------


>"Techniques in Large Animal Surgery", Second Edition by A.S.Turner et al. recom-
>mend prophylactic circumcision in the bull-- an old veterinarian practice in this
>country. The recommended oblique rather than transverse amputation of the pendu
>lous sheath results in oval rather than circular scar

Now here is a subject which you win me on. So we`ll forget that you never answered (for the 4th. time) if you`ve ever done a partial circ. ... obviously some part of your nervous system has been scanning for possible ways of sidetracking me, well, success ! --- well done sir ! ... I`ve been dimly considering oblique cuts to get over stretching problems for only the last couple of weeks, and you have crystalised the idea, ... well done that is a definate advancement and it will be fed straight back into the site

can you quote me a page no. in the book? or even FAX the page to me c/o 0049-40-442236

And dont bulls have it good, not only pre puberty checks, for frenulum and phimosis but now super stylish modern oblique shaped half circs, ... one thing I still find many hours amusement puzzling over is why bullocks have their eyesight checked as part of the "Breeding Soundness Examination"? - maybe you can tell me

----------------------------------------

>>>I heartily endorse this attitude and commend Robin for his outstanding work which
>>>serves to elaborate so well the COMPLICATIONS of those who have not been fortunate
>>>enough to have been PROPHYLACTICALLY circumcised neonatally.
>
>>I completely distance myself from this conclusion. My
>>suggested modern methods of PREVENTION (which you answered
>>to above) have nothing to do with "PROPHYLACTIC" circumcision.
>
>TRUE-- BUT IMAGINE HOW MUCH MISERY WOULD BE PREVENTED IF PROPER
>NEONATAL CIRCUMCISION HAD BEEN DONE!!


So you think this is wonderful absolute logic. - just hang on, look at it, - The only absolute logical conclusion is if I`d have been born a bullock I wouldn`t have had the problems ... !

First: if I´d received a neonatal circ - if it left any inner foreskin I`d still have had the short frenulum and as objective research indicates (AS. Griffin and RL. Kroovand "Frenular chordee: implications and treatment" Urology 1990 Feb;35(2):133-4)
"Persistent frenular chordee after circumcision may result in deformity
of the penis on erection making sexual intercourse difficult or uncomfortable."

So, I`m surprised that any modern doctor, would suggest operating on anyone previous to giving a complete and accurate diagnosis, this seems totally contra modern medical practice. ...


So next, how are you going to decide who is neonatally circd? are you going to screen them, humm how are you going to screen them without checking them huh? ... remember checking them was my theme but,:

HOW CAN YOU CHECK NEONATES? with the epithelial adhesions jamming the whole area up, and even it were free, many infant phimotic rings are soft they will stretch, particularly it seems if encouraged early, (and I mean encouraged rather than forced by a doctor or parent), ... but it takes a couple of years ...

My research indicates that the only possible wise routine neonatal step is to non-forcefully release the adhesions so that the foreskin could be allowed to develop in a healthy way, ... unfortunately there seems no research (apart from my own) on how to dissolve these ahesions

http://www.male-initiation.net/dissolve.html

.... think about it ... wouldn`t this also satisfy some of your suggested approach?

So next point I feel your other papers have made it clear that your neonatal circ is also intended as a routine measure - so lets have it straight and stop debating with me.


>>The modern medical attitude and the conclusion of my study is
>>that children must be checked and these conditions prevented.
>
>ROUTINE circumcision or nothing at all = this is a total fallacy!
> GNW

Yes this is my conclusion ... hummm which makes me suspicious when I hear it coming from you (what a curiously twisted approach one develops after talking with people for a few years on this subject!) ... so what are you "debating" here?

I`m getting to know your devious ways, -- I hope you allow me the pleasure of uncovering your desperate ploys in future missives ---

happy days,
Robin