Circumcision is the surgical removal of the skin (preputium) covering and protecting the head of the penis, in part or full, thus leaving the glans penis (penis head) exposed. It is applied to men in many religions and cultures for different reasons such as religious, cultural, or health. Although less common, female genital mutilation, which is still practiced especially in some parts of the Middle East and Africa, will not be discussed in this article since it is never practiced in our country.
History of Circumcision
Circumcision is one of the oldest surgical procedures that has been used in the history of humankind. There are many theories about the origin of the circumcision practice. However, it is certain that the circumcision practice started before written history and its origin got lost in the depths of history. The oldest available source on the origins of circumcision is ancient Egyptian hieroglyphs dated 2400 BCE. In Ancient Egypt, the male sexual organ was thought to be a symbol of abundance and power. A small piece of this organ was cut and given to the goddesses as a sign of devotion to the god.
Circumcision has been widely practiced as a ritual for transition from childhood to adulthood in African communities.
In the Torah, the holy book of the Jews, circumcision is obligatory for the descendants of Prophet Abraham. It is even rumored that Prophet Abraham was circumcised at the age of 80 after this revelation.
Also in the Christian belief, born among the Jews, circumcision was a subject of discussion, but it did not become a religious necessity as it was seen as unnecessary by some apostles. However, some Christian groups in Africa, such as the Coptic community in Egypt, consider both male and female circumcision to be religiously necessary, while some Protestant denominations in the United States and Catholics in the Philippines consider male circumcision to be religiously necessary.
Circumcision is accepted as the symbol of Islam although there is no verse about it in the Qur’an. The words of the Prophet Muhammad praising and recommending circumcision have been transferred to the present day.
Who should be circumcised?
Today, the vast majority of circumcisions are performed for cultural and religious reasons. Almost all Muslims and Jews all over the world are circumcised. Also, circumcision is a widely practiced procedure in the United States of America for cultural and health reasons.
However, there are also medical conditions in which circumcision should be applied as a treatment method. The most important one of them is phimosis. This is when the foreskin cannot be stripped enough to expose the glans penis. While this is a normal situation in newborns and small babies, it can become a problem with the advancing of age. Sometimes it may develop later due to infections, and the primary method in the treatment of this condition is circumcision.
The strangulation of the glans penis and the inability to restore the foreskin after the foreskin is forcibly stripped is called paraphimosis and may need to be treated by performing emergency circumcision.
Circumcision is also a necessary procedure if the child has recurrent urinary tract infections or recurrent infections on the foreskin and tip of the penis.
Circumcision is required in some children with congenital urinary system anomalies (such as congenital hydronephrosis, and vesicoureteral reflux). Moreover, circumcision may be necessary for some penile traumas (such as the foreskin being stuck in the zipper).
Is circumcision a painful procedure?
The foreskin is an area where nerves are highly populated, and circumcision can be a very painful procedure if appropriate pain relief methods are not applied. Since pain is considered a natural part of the circumcision ritual, circumcision has been practiced for centuries without any measures against pain. However, from a medical point of view, pain is a problem that needs to be cared for and solved. It is also known that severe pain experienced during circumcision may have negative effects on the child’s life in the future.
Circumcision, which is the most frequently performed surgical procedure in boys, should be performed under the best possible conditions, considering the well-being of the child. Today, modern medicine offers us many alternatives to perform the circumcision operation painlessly. In the circumcision procedure, which can be performed comfortably with local anesthesia techniques in infancy, general anesthesia methods are preferred, which allow a safer circumcision in older ages. It is important that the method to be used here is determined by the joint decision of the family, child, and physician.
The circumcision performed within the first month after the birth is called newborn circumcision. Widely practiced in Jews and in the United States, newborn circumcision has been practiced more and more frequently in our country recently. The advantages of this procedure can be listed as the fact that it can be applied with local anesthesia, it does not leave any negative psychological scars on the child, and it heals quickly.
The World Health Organization has stated that circumcision can be applied to babies over 2.500 gr, and 12 hours later after birth.
Before the newborn circumcision, the baby must be examined by a pediatrician. Afterward, the physician who will perform the circumcision should evaluate whether there is a condition in the penis and testicles that may prevent circumcision. It should be noted that circumcision is not a mandatory procedure, a very careful evaluation should be made, and possible complications should be minimized.
Although circumcision is an operation that has been widely performed for centuries since the time of primitive societies, complications seen today are gradually decreasing as the possibilities of modern medicine are used more and more in this operation.
Although circumcision is a small and simple procedure, it should be kept in mind that this procedure is a surgical intervention. The procedure should be performed under sterile conditions, if possible, in operating room conditions, and without causing the child to experience pain. It should also be noted that sexual or functional problems that the child may experience in the future will be minimized if the circumcision is performed by an experienced physician.