Circumcision

Circumcision, first of all, is a surgical procedure to be performed by the physician under sterile conditions following a preliminary assessment (examination) which will be done personally same physician. In this procedure, the foreskin covering the head of the penis is removed. Different methods to do this are described in the medical literature. Whichever method is used, the purpose is to obtain both functionaly and cosmetically the best result without causing psyco-sexuel trauma. Below, you can find some explanations according to the available scientific data that may answer some mind borned questions about circumcision.

Benefits and Risks!

Major medical benefits of circumcision are decreased incidence of urinary tract infection in children and reduced risk of penile cancer, and sexually transmitted diseases in adults. However, during the period of infancy, and especially in the newborns, circumcision has a injury (complication) rate ranging between 0.02% and 3%. Unsuitable conditions, and especially between the ages of 2-6 should be noted that circumcision may lead to psychosexual trauma. In addition circumcision should not be done in the early period in those cases of hypospadias, sex development disorder and buried penis, and they should be examined by an expertr doctor.

Because children focuses on parts of the psychosexual aspects of gender in 2-6 years old, to do circumcision or other surgical interventions on penis without providing favorable conditions for this age group may adversely affect the child’s psycosexuel development. This situation in this age period originates from the fear of genital mutilation or damage to sexual organs. This perception can be in higher levels if circımcision performed under local anesthesia and psychosexual trauma may have an adverse effect on future sexual life.

 Local or General Anesthesia?

Circumcision is performed using sedatives, local anesthesia (sedation) or general anesthesia (narcosis). As one of the methods can be combined with each other, each of these approaches can be applied in different ways. Today, the implementation of technics/equipments for general anesthesia (narcosis) is quite sophisticated and could lead to a very low risk of life threatening, contrary to popular belief, it has not more risk than the other methods. On the other hand, general anesthesia has significant advantages especially to prevent some surgical problems that may occur during or after circumcision

Timing!

Today, there are different opinions and practice related to the timing of circumcision, or age at circumcision. If the child has a medical indication for circumcision, it should be done as soon as possible without considering the age. Otherwise, we recommend that the child can be circumcisized at the age when he was able to declare his family that phrase “I want to be circumcised.” This is usually occurres older than 6-7 years of age, after he will be informed and convinced. Although some proponents recommend circumcision for the age group of 0-2 year, in this age period, conditions such as subsequent meatal stenosis, infection, tearing, and crusting is higher than normal. Therefore, during infancy (0-2 years), these problems need to be considered after circumcision. However, if the child will undergo surgery under general anesthesia for another disease, in this case, circumcision can be made simultaneously at any age.

 Mass Circumcision!

Increasing mass circumcisions in Muslim countries, especially with the arrival of summer, brings with it some risks. Every year, some cases of wrongful circumcision are admitted to our hospital, especially in applications of mass circumcision or circumcision under local anesthesia. Unfortunately, their treatment becomes much more difficult, and sometimes children may be required to undergo major surgery.

 Which conditions?

From a scientific perspective, circumcision is a surgical procedure necessarily done by a physician and in the conditions in which rhe risk of child’s psychosexual trauma is lower i.e. under general anesthesia and sterile conditions. In such an environment, the complication rate is minimal.

 Brief Messages!

• According to recent scientific data on circumcision that we tried to explain above, some brief tips are listed below.
• Our primary recommendation is that circumcision should be performed under general anesthesia (narcosis).
• The patients who has severe risk for general anesthesia because of accompanying diseases, circumcision can be deleyed or done under local anesthesia in an operating room conditions.
• Children-to be circumcised without any medical necessity, pre-informed about the process and must agree to be circumcised. This is usually after the age of 5-6.
•  If there is a medical necessity, circumcision can be done at an early age when appropriate conditions are established
• If the child will undergo an elective surgery due to another disease under general anesthesia (narcosis), a simultaneous circumcision mayt be done at the same.