pratiques circoncision
August 25, 2022

What Are the Best Practices for Circumcision

What is circumcision?

Circumcision, also known to urologists as post-excisional resection, is a surgical procedure that involves removing all or part of the foreskin, or in other words, “the covering of the foreskin covering the foreskin of the penis”. It can be practiced for cultural or religious reasons known as “personal convenience” during childhood or before puberty, however it can also be performed for medical reasons, at any age of life.

Historically, male circumcision was practiced in ancient Semitic communities, including Egyptians and those of the Jewish faith, the earliest paintings mentioning the head of circumcision in a temple and on Egyptian wall paintings dating from about 2300 BC.

With the progress of surgery in the 19th century and the increase in mobility in the 20th century, this intervention was introduced into some cultures that did not practice it before, for health and social reasons.

According to current estimates, about 30% of men in the world – about 670 million men – have been circumcised. Of these, about 68% are Muslim, less than 1% Jewish and 13% are non-Muslim and non-Jewish Americans.

Religious Practices

Islam is the largest religious group that practices male circumcision. As in the Abrahamic faith, Muslims practice circumcision to confirm their relationship with God; this practice is also known as tahera, which means purification. With the worldwide popularity of Islam from the 7th century AD, male circumcision was widely adopted among people who did not practice it until that time. The age of circumcision is not clearly defined in Islam, but the Prophet Muhammad recommended doing so at an early age – his own sons were circumcised 7 days after being born. Therefore, many Muslims perform the ritual at this age, however a Muslim can be circumcised at any age, from birth to puberty.

In the Jewish religion, male infants are traditionally circumcised on the eighth day after birth, as long as there are no medical contraindications. Circumcision is justified in the Jewish Holy Book The Torah, by the covenant signed between Abraham and God, an outward sign of circumcision for all Jewish men. The Torah declares: “This is the covenant which you must keep, a covenant established between you and me, and your descendants after you: every male among you must be circumcised” (Gen. 17:10). Male circumcision is still common in the Jewish community.

Coptic Christians in Egypt and Ethiopian Orthodox Christians – two of the oldest surviving forms of Christianity, the practice of male circumcision that is not prescribed in other forms of Christianity. Discussions on male circumcision in focus groups in sub-Saharan Africa have failed to reach a clear consensus on the compatibility of male circumcision with the Christian faith.

What medical reasons can motivate posthectomy?

In a medical setting, this operation must be performed by a surgeon, ideally a urologist. It may be indicated in certain malformations or pathologies of male genitals. For example, in case of the “inability to retract, pain in the foreskin, skin condition of the foreskin causing significant discomfort, or even urethritis causing difficulty in urinating”.

An anostomy can also be practiced in case of functional stenosis of the foreskin, this condition of the penis caused during an erection where the foreskin cannot be retracted easily or painfully.

Note: It is normal for a boy not to remove his “hat” before the age of 2-3 years. The adhesive on the foreskin will peel off over time. In most cases, the situation resolves itself.

What happens during surgery?

This surgery is performed on an outpatient basis, under a brief period of local or general anesthesia. The patient goes home a few hours after the procedure, after urination, dressings and local hygiene instructions (apply an antiseptic ointment, for example).

This is not a very painful procedure and until the wound is completely healed, baths, saunas or steam baths, baths and sexual intercourse must be avoided during the healing period.

Is circumcision a risky procedure?

The loss of sensation or sensitivity in the glands is actually a complication of the operation, not a consequence. This desensitization can be linked to damage to the nerves of the penis. It is quite rare, but it can happen.

When surgery is performed in a medical setting, “complications are of a particular nature”. Bleeding or a hematoma, infections, urinary tract damage, or accidental circumcision are virtually invisible complications of medical surgery.

What are the advantages of circumcision?

Several studies, relayed by health authorities around the world, recommend this procedure as a preventive measure. Circumcised men are less likely to be infected with certain sexually transmitted diseases or viruses, such as HIV. This is due to the removal of a wetland (foreskin), which creates conditions conducive to the survival and reproduction of the virus. However, this does not replace safety protections such as condoms.

Therefore, total or partial circumcision will offer more benefits than risks, which will facilitate the operation. However, despite these recommendations, there is no obligation or need for this procedure, the operation remains an intimate and private subject whose decision is up to everyone.