Saturday, September 4, 2010

If Circ Rates Are Dropping, Time for AAP & CDC to Act

I took a little hiatus over the summer break, so I have no idea if I lost all the wonderful posters -- both pro and anti-circumcision -- during that time. Most of the medical news over the last few months continues to support the benefit of a foreskin-free society, both to protect the health of the male and the health of his partners.

But the most worrisome report, trumped up or not, was this notion that circumcision rates have dropped to one-third of male newborns in the USA. Now the statistics have been debunked by many as way off -- and in this part of the world, nobody I talk to thinks that the circ rate is anything below 80% -- but any drop at all is troubling as a matter of public health.

I've heard that the theory that a lot of these uncircumcised future disease-promoters are illegal aliens from south of the border. It's true that many Hispanics do not circumcise until they become "Americanized" in the second or third generation. It's bad enough that illegals are sneaking into the country -- it's even worse if they are refusing to raise clean-cut boys.

The other theory I've heard is that the refusal of 16 states, including California, to cover circumcision under Medicaid (health care for the poor) has contributed to the growing number of uncircumcised boys. That would particularly hurt the Black community, along with Hispanics, and the refusal to cover circumcisions for these groups is obviously a form of racism.

Whatever the reason for any drop, this makes it all the more urgent for the Centers for Disease Control and the American Academy of Pediatrics to release their 2010 statements calling for the circumcision of all boys. The so-called "neutral" stance of the CDC and the AAP is causing great long-term damage, and we need that more positive statement right now.

Most parents want to do what is right for their sons. If the CDC and the AAP said that circumcision was an appropriate and healthy procedure with a great many benefits, I know that the circ rate -- assuming it even is dropping -- will return to historic high levels of 90%-plus. A foreskin-free America and the health of both males and females is in the balance.

Monday, June 7, 2010

Want to Avoid Penis Injuries During Sex? Get Circumcised!

Perhaps it's as obvious as a clean-cut penis, but still another study -- reported below by Reuters Health -- confirms more problems caused by the useless foreskin: penis injuries. Circumcised dudes are not as likely to have injuries to their male organ during sex as uncircumcised men.

To me this is pretty obvious. If you have a piece of useless skin flapping around and getting in the way of good sex (yes, there lot's of studies on that, too), it is bound to get injured -- cuts, abrasions, and minor injuries is the way the report notes it. I don't know about you but sex should never be painful, and it certainly shouldn't cause harm to your penis.

You can't help but feel sorry for these uncircumcised dudes. Not only are they at much higher risk for the transmission of HIV, HPV, STD, cancer, and the like -- but now they have to put up with a greater risk of penis injury during sex. Given all this, why would any parent allow their son to leave the hospital at birth with a filthy, disease-proned, and (now we know) injury-inducing foreskin?

Here's the full Reuters Health report:

"(Reuters Health) - A new study finds that circumcised men appear less likely to sustain cuts, abrasions and other minor injuries to the penis during sex -- which may help explain why circumcision lowers the risk of HIV transmission from heterosexual sex.

"For the new study, researchers used data from an HIV clinical trial in Africa, where nearly 2,800 men between the ages of 18 and 24 were randomly assigned to undergo circumcision or remain uncircumcised. In 2005 and 2006, that trial and two others in Uganda, South Africa and Kenya showed that circumcision can reduce a man's risk of HIV infection through heterosexual sex by up to 60 percent.

"In the current study, the researchers found that, over two years, circumcised men were 39 percent less likely than their uncircumcised counterparts to report any type of penile injuries during sex.

"This raises the possibility that lower injury risk is one reason that circumcision lowers the odds of HIV transmission, according to the researchers, led by Dr. Supriya D. Mehta of the University of Illinois at Chicago.

"Exactly why circumcision may protect against HIV during sex is unknown, Mehta and colleagues report in the Journal of Urology. There are a few theories: One is that, by reducing the amount of mucosal tissue exposed during sex, circumcision limits the virus' access to the body cells it targets. Another theory is that the thickened skin that forms around the circumcision scar helps block HIV from gaining entry.

"But there is also a possible role for mild penile injuries -- cuts, scratches and tears in the skin that could serve as a portal of entry for HIV. In some past studies, uncircumcised men have reported higher rates of such injuries than circumcised men.

"At the outset of the current trial, 64 percent of the men said they had sustained some form of penile injury during sex in the past six months -- most often general soreness, scratches, cuts or abrasions. Seventeen percent said they had bleeding.

"Six months into the trial, that rate was on the decline. By year two, 31 percent of circumcised men said they'd had a sex-related penile injury in the past six months.

"Men in the uncircumcised group also reported a reduction in injuries, though it was less significant -- with 42 percent saying they'd sustained a penile injury in the past six months. That decline, according to Mehta's team, is likely due to the general improvements both study groups showed in their sexual health practices -- including greater condom use and fewer sex partners.
Men who said they had had multiple sex partners in the past month were more likely to report sex-related penile injuries than those who had been monogamous. On the other hand, condom use and the habit of washing the penis within an hour of having sex were both linked to decreased risks of penile soreness and other injuries.

"Further studies, Mehta's team writes, should look at the role penile injuries may play in the transmission of HIV or other sexually transmitted diseases."

Saturday, May 29, 2010

Crazy Dutch Want to Ban Male Circumcision

At a time when much of the world is embracing the life-saving and healthy practice of male circumcision, Radio Netherlands is reporting that the Royal Dutch Medical Society wants to ban all male circumcisions in that country.

What's wrong with these Dutch doctors? What studies have they failed to read? What recommendations of the World Health Organization do they reject? What makes them incapable of seeing the benefits of a clean-cut penis?

My own view is that they have a deep cultural bias against the clean-cut penis, given that circumcision is so rare in that country. Now I know the anti-circ fanatics in USA will say this mirror our own cultural biases in favor of newborn circumcision, but the situation here is more nuanced than that. After all, we do have a strong anti-circumcision propaganda machine here that exerts inordinate pressure on medical societies and government agencies. In short, the USA has a national debate -- at least among the passionate -- on male circumcision.

That is apparently not true in Holland, where the uncircumcised doctors are simply rejecting, for their own cultural reasons, all the medical studies and evidence from around the world that support male circumcision. Forget the evidence. They want everyone to be uncircumcised because they are.

This blog supports the universal circumcision of all males, not because of any cultural norm, but because it is a medically proven way to protect not only the male but all his partners. If all males were circumcised, we would see a reduction in HIV, HPV, cancer, and so many other ailments directly linked to the useless foreskin. This is not a cultural argument; it's a medical one.

Here is an except from the Radio Netherlands report:

"The circumcision of boys is reportedly almost always unnecessary and medically risky. The Royal Dutch Medical Society (KNMG) has published recommendations advising doctors to discourage parents from having their sons circumcised. Jewish and Islamic organisations have reacted angrily."

"The KNMG would really like to ban the circumcision of boys altogether, but the organisation feels a legal ban would only lead to circumcision going underground, increasing the risks."

"More than 46,000 Dutch doctors and trainee doctors are members of the society. They call circumcision for non-medical reasons “an infringement of a child’s right to autonomy and the right to bodily integrity”. And they say there are unnecessary risks."

"However, the doctors are willing to take the cultural and religious sensitivities of parents into account. Which is why doctors, parents and religious groups plan to engage in a dialogue. And yet, Rasit Bal, chairman of the interest group Muslims and Government, was unpleasantly surprised by the advice of the medical community:

“I have noticed that it is becoming increasingly difficult to publicly display one’s religious identity. Things like this make it difficult. This is one of those issues that make life difficult for people who practice a religion”

"About 10,00 to 15,000 circumcisions are performed each year, most of them on Jewish and Muslim boys. Rabbi Raphael Evers says this figure includes about 80 Jewish boys. He argues peer pressure does not play a role in the decision to have one’s son circumcised. The rabbi says it’s the wish of the parents. He brushes aside any medical risks and even claims the surgery brings health benefits."

“Agitation against circumcision as a perceived threat against public health has been going on for quite some time, and it’s just nonsense. I have personally made extensive inquiries into both the physical and psychological problems of circumcision but never heard about any.”

"The growing number of circumcisions among boys has not led to any kind of serious discussion in the Netherlands, in marked contrast with the circumcision of the daughters of African immigrants. The excision of girls’ labia minora and/or clitoris is almost universally condemned as genital mutilation.

"So now the doctors have set their sights on the circumcision of boys. Medical ethicist Gert van Dijck says doctors will invoke children’s rights to emphatically discourage parents from requesting the procedure."

“We are asking doctors to actively and urgently warn parents that there are no medical advantages to circumcision and that there is a risk of complications. This way, we are hoping to achieve a culture change via the parents, so that they will eventually stop doing it.”

Friday, May 7, 2010

US Pediatrician Group Okays "Minor Circumcision" of Girls

Anti-circumcision fanatics have long argued that if female circumcision is outlawed, then male circumcision should be, too. Of course, this argument assumes that both types of circumcision are the same -- which they are clearly not.

Female circumcision has never been proven to offer any health advantage to the circumcised girl. It is solely a cultural tradition embraced by many around the world. In contrast, in one medical study after another, male circumcision offers positive benefits to the male and his partners. That should end the discussion, but it never does with the anti-circs.

Sure to complicate the debate is an apparent position change by the American Academy of Pediatrics in support of a "nick" or "minor circumcision" of a girl, as a means by which to discourage a full-scale removal of female genital parts. The New York Times below reports the story, and I invite your comments.

While I find female circumcision abhorrent as a practice because it has no medical benefits, I recognize the cultural myopia that we Americans have on this issue. Maybe the AAP is right. If a nick or little cutting makes parents feel comfortable that they do not need to remove the clitoris, labia, or whatever else is involved in full female circumcision, I suppose it is an option that should be considered carefully -- without American cultural blinders affecting our vision.

One thing is certain. The anti-circumcision fanatics will try to use this debate over female circumcision to denounce the obviously beneficial removal of the foreskin from males. Watch my words. I guarantee it.

NewYorkTimes: Group Backs Ritual ‘Nick’ as Female Circumcision Option
Published: May 6, 2010

"In a controversial change to a longstanding policy concerning the practice of female circumcision in some African and Asian cultures, the American Academy of Pediatrics is suggesting that American doctors be given permission to perform a ceremonial pinprick or “nick” on girls from these cultures if it would keep their families from sending them overseas for the full circumcision."

"The academy’s committee on bioethics, in a policy statement last week, said some pediatricians had suggested that current federal law, which “makes criminal any nonmedical procedure performed on the genitals” of a girl in the United States, has had the unintended consequence of driving some families to take their daughters to other countries to undergo mutilation."

“It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm,” the group said.

Wednesday, April 14, 2010

HPV Last Longer in Uncircumcised Males

The evidence keeps adding up for all males to shed that disease-entrapping foreskin as soon after birth as possible. This latest study comes from the May 2010 edition of the Journal of Infectious Diseases, as reported by Reuters Health news service today.

The good news for the uncircumcised, according to this study at least, is that they are no more likely to acquire human papillomavirus (HPV) than their clean-cut counterparts. But -- and here's the bad news for foreskin lovers -- it takes the uncircumcised a whole lot longer to get rid of HPV than circumcised dudes. The study found that clean-cut males can shed HPV in 91 days, compared to 154 days in uncircumcised males. The researchers concluded, "Circumcision may protect against HPV‐associated disease by enhancing the resolution of infection."

Here's the Reuters story:

Sex virus lasts longer in uncircumcised men
Wed Apr 14, 2010 2:27pm EDT

NEW YORK (Reuters Health) - While uncircumcised men don't seem to be at higher risk of acquiring human papillomavirus (HPV), it takes them longer to clear the virus from their bodies, new research shows. Because HPV causes genital warts and certain cancers, the finding, say researchers, could help explain why uncircumcised men have a higher risk of such penile cancers.

It could also play a role in how likely their partners are to develop infections.

"Our study demonstrates that the apparent protective influence of circumcision against genital HPV infection may not involve a reduction in new infections but rather the enhanced ability to resolve existing HPV infections," Dr. Brenda Y. Hernandez of the Cancer Research Center of Hawaii in Honolulu and her colleagues write.

But why this might be, and whether circumcision would be a good way to help prevent the spread of HPV-related disease, remains unclear, according to the researchers.

Some HPV strains cause cervical cancer in women, and are the targets of the vaccines Cervarix and Gardasil. Some strains may also be associated with penile cancer in men.

There's evidence that circumcision lowers a man's likelihood of developing cancer of the penis and contracting HPV infection, as well as HIV infection, in some populations. Because partners of uncircumcised men face a higher risk of cervical cancer, it's possible that circumcision could affect the spread of the virus as well, Hernandez and her team note.

The researchers had previously found that circumcised men were less likely than their uncircumcised peers to be infected with HPV at a given point in time. To determine if circumcision might influence a man's risk of acquiring HPV infection, as well as how readily he could clear the virus from his body, the researchers followed 357 men for an average of about 14 months. Every two months, the men, 290 of whom were circumcised, underwent HPV testing.

During the study, the researchers identified 536 different HPV infections, with no difference in risk between the circumcised and uncircumcised men. However, the researchers did find that HPV infections of the head, or glans, of the penis lasted 154 days, on average, in the uncircumcised men, compared to 91 days in the men who were circumcised. The increased duration was seen for both cancer-associated and non-cancer-associated HPV strains.

Cancer of the penis most commonly develops in the glans, Hernandez and her team point out, and the fact that infection with cancer-related strains lasted longer in uncircumcised men "has clinical significance."

It's possible, they add, "that transmission of HPV to sex partners is more efficient among circumcised men because of the greater duration of their infection." However, they add, "whether circumcision is an effective means of facilitating HPV clearance has yet to be demonstrated."

Sunday, April 11, 2010

South Africa to Circumcise Two Million Men

This amazing headline -- "South Africa to Circumcise Two Million Men" -- must drive the anti-circumcision fanatics crazy. After all, their goal is to keep the foreskin just where it is, thank you, free to infect the sad guy (or his partner) unfortunate to have one with STDs, HIV, and other diseases, to say nothing of his bad genital odor.

But this headline was prominent this past week as the South African government in one of its provinces committed to increase the health of its nation through the removal of that useless piece of ugly skin that has caused so much harm over the years.

Circumcising two million men sounds daunting, and would have never been necessary had routine neonatal circumcision been practiced throughout South Africa. It is so much better to snip a baby than to subject an adult male to a healthy circumcision. But it may take a generation or two before South Africa joins America in leaving the foreskin behind at the maternity hospital.

In the meantime, congrats to South Africa for setting an ambitious goal. You have a lot of fans in the USA rooting you on.

Here's the whole newspaper article:

"South Africa to circumcise two million men

Durban: In an effort to combat the scourge of HIV and Aids, over two million men will be circumcised in South Africa's eastern KwaZulu-Natal province, BuaNews reported on Friday.
The premier of KwaZulu-Natal province, Zweli Mkhize, said on Thursday this initiative had received overwhelming support from HIV activists and the medical fraternity.

The process will begin on April 11.

In late 2006, two randomised controlled trials on whether male circumcision reduces HIV transmission were halted because interim results showed an overwhelming protective effect, validating the results from an earlier South African trial conducted in Orange Farm.

Based on the weight of the evidence from both observational studies and randomised trials, public health leaders have concluded that male circumcision when performed by well-trained and well-equipped health professionals can significantly reduce the risk of HIV infection among adult men.

"We now have our task cut out for us to circumcise over two million males using the safety of professional techniques and encourage HIV pre-testing," he said.

Monday, March 15, 2010

Actress Thanks Congress for Strong Circumcision Support

Actress Debra Messing, better known as Grace Adler in the TV sitcom "Will & Grace," told members of Congress last week that circumcision was a key to reducing HIV/AIDs. Messing testified before the House Foreign Affairs Committee on behalf of PSI, a global health organization, after she returned from Zimbabwe which has an aggressive circumcision program.

Here's what Messing told legislators:

"I would like to tell you today about two prevention tools that could make a difference if there is continued investment: male circumcision and HIV testing and counseling.

"First, voluntary adult male circumcision. There is now strong evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by about 60 percent, yet only about one in ten Zimbabwean adult men are circumcised. PSI and its partners run circumcision clinics in Zimbabwe and other countries, with support from PEPFAR and other donors.

"I was invited to observe the procedure, which is free to the client, completely voluntary and according to the young man I spoke with who underwent the procedure, painless. The cost of the procedure at that clinic—including follow-up care and counseling—is about $40 U.S. dollars.
UNAIDS and the World Health Organization have issued guidance stating that male circumcision should be recognized as an important intervention to reduce the risk of heterosexually acquired HIV infection in men.

"Even with no demand creation, the clinic I visited serves upwards of 35 clients per day. It is estimated that if male circumcision is scaled up to reach 80 percent of adult and newborn males in Zimbabwe by 2015, it could avert almost 750,000 adult HIV infections—that equals 40 percent of all new HIV infections that would have occurred otherwise without the intervention—and it could yield total net savings of $3.8 billion U.S. dollars between 2009 and 2025. Male circumcision programs get robust support from the U.S. government in Zimbabwe and other countries, but greater resources would yield greater results."

Zimbabwe does have a massive commitment to circumcise 1.3 million males over the next few years, and the country is beginning efforts to encourage newborn circumcision. In the long run, countries recognize that achieving universal 100% circumcision rates is best obtained by circumcising baby boys before the leave the hospital.

What is ironic to me is that while Messing thanks Congress for its "robust support" for the male circumcision programs in Africa, nobody says anything about America? It's time for government leaders to speak out with just the same passion on the value of circumcising every male in this country.

Sunday, March 14, 2010

Newborn Circumcision: An Old Tried & True Friend

I like old books, so take me to a flea market and I am sure to find something that interests me. Not long ago, I bought for an original red-covered book for $1 entitled "Modern Home Medical Adviser." It was first published in 1935 but updated seven times until its last publication in 1953, still way long before I was born. The book was designed for parents to consult on just about any ailment in the body. Of course, I looked in the index under "circumcision" and it was a treasure trove of good advice.

I don't know how popular newborn circumcision was back in the 1930s, but these docs sure liked it. "The baby boy should be carefully examined to see if he needs circumcision. If the foreskin can be completely and easily retracted most authorities think circumcision should not be done, but when there is the least doubt about the matter decision should be made in favor of the operation, which is a trivial one when done within the first week or two of life."

Back in the 1930s, people did worry more about boys masturbating. These docs were modern. "Masturbation is probably far less harmful than has been supposed." But they certainly didn't recommend it, and observed the obvious: "When the foreskin is tight or adherent there will accumulate under it secretions which will produce bad odors and cause pain and itching. Such a child is likely to get into the ugly habit of pulling at and handling the genitals." We know that all boys play with their penises, but uncircumcised boys clearly have more reasons for doing that than clean-cut boys.

While the medical reasons for circumcision have certainly grown with the advance of medical science, back in the 1930s there were many more uncircumcised fathers in America and many more parents in general who did not have access to the latest medical developments. This is where the authors of "Modern Home Medical Adviser" get interesting, urging parents of the day to get informed about the latest medical advances and to take responsibility for their children's health.

"It is said that in times of old, parents had the power of life and death over their childrend and could make away with them or sell them into slavery. Atrocious! Nevertheless, parents still have the power of life and death over their children. Parents can neglect their young, and frequently do neglect them, so that they die of the results. We have in mind parents who are probably ruining a child by refusing to have him circumcised. . . . ."

Seventy-five years later, we still have parents who not only refuse to circumcise their sons but also make outrageous claims about the 'dangers' of circumcision and the 'benefits' of a foreskin. I find this all very ironic because the prescient doctors of the 1930s did not have all the medical studies of today. But they knew circumcision was valuable and recommended it. Today, with much more evidence of this "trivial" procedure's medical value, the medical organizations representing today's doctors (like the American Academy of Pediatrics and the Centers for Disease Control) are much more timid than their ancestors.

As we await some definitive conclusions from the AAP and the CDC, perhaps they might consult the docs of an earlier era -- and add a little backbone to taking a strong stand for newborn circumcision. Just saying . . . .

Saturday, February 20, 2010

Circumcision Makes Comeback in Australia

Once upon a time, boys in Australia were as clean-cut as their American cousins. Then the national nannies stepped in to discourage and not pay for this important neonatal procedure. But even during the "bad times" a number of Australian parents opted to circumcise their sons. Now, the growing evidence of the medical benefits of circumcision are reaching parents, despite the reluctance of some in the Australian medical bureaucracy.

Under the headline -- "More boys go under knife as parents opt for kind cut" -- the Sydney Morning Herald reports a resurgence in newborn circumcision in New South Wales. It's still a long ways from American standards, but the good news is that trend is upward. One doctor predicts it will grow quickly to 30% over the next decade.

The headline is also a sign of the change in times. After some used to call circumcision "an unkind cut," how refreshing to see this simple health-giving procedure call what it is: a "kind cut" -- in fact, it's the kindest cut of all a parent can do for a newborn baby boy.

Here's the full story below:

CIRCUMCISION is making a comeback as a new generation of parents arm themselves with medical research to justify their decision.

The rate of circumcision for baby boys in NSW rose from 13 per cent in 1999 to 18 per cent last year, according to Medicare figures.

It's a long way from the 1950s when boys were routinely circumcised but Sydney paediatric surgeon Dr Anthony Dilley predicts the rate will keep rising. This is despite NSW Health banning circumcisions from public hospitals in 2006, except in cases of medical emergency.

"By the time today's baby boys are in kindergarten, it will be 30 per cent," Dr Dilley said.

Dr Dilley said parents were asking for circumcision because they thought it would benefit their child – "to look like dad", be more hygienic and reduce risk of disease – rather than for cultural or religious reasons."My own gut feeling is that there are parents who didn't get it done 20 or 30 years ago because they were bullied out of it," Dr Dilley said. "Most parents now don't stand for being told: 'Don't do it.' They will do their own research."

Proponents of circumcision such as Professor Brian Morris from the University of Sydney school of medical sciences say it is a kind of "surgical vaccine", pointing to studies showing it reduces the incidence of urinary tract infections, sexually transmitted diseases, penile cancer and penile inflammatory disorders, as well as being more hygienic.

It has also been shown to reduce the incidence of cervical cancer in female partners.
"At birth it's a very simple, safe procedure that gives immediate benefit through infancy and continues through life," he said.

The Royal Australian College of Physicians recently softened its opposition towards circumcision. Its 2004 position statement said there was no medical indication for routine neonatal circumcision and that benefits needed to be weighed against a complication rate of 1 to 5 per cent but its interim statement released last year was more nuanced, saying parental choice should be respected.

The college's paediatric and child health policy committee chairman Professor David Forbes said: "We have stepped back and said: 'Yes, there are ethical issues around circumcision but ultimately we have to have a policy that fits with society's practice and acknowledging parents' role in the decision-making process, while recognising the potential benefits and risks'."

But the statement recommends parents should wait until their boys are old enough to make their own decision on circumcision – the subject of a petition by pro-circumcision clinicians led by Professor Morris, who say infancy is best for the procedure.

Royal Australian College of General Practitioners national spokesman Dr Ronald McCoy said he didn't believe there was any reason to circumcise except for a handful of medical indications but agreed the debate was not going away.

"It certainly is a real issue. Parents want to find out what's best for their kids," Dr McCoy said.
General Practice NSW chairman Dr Ken Mackey said circumcision was generally safe but there were still slight risks of infection or deformity of the penis. "As always, fully informed consent is important," he said.

Sunday, February 7, 2010

Tim Tebow, Superbowl, Abortion & Circumcision

Tim Tebow, the awesome quarterback for the University of Florida 'Gators, is getting a lot of flack because he and his mom are "out front" in the anti-abortion campaign. That will be highlighted in a Superbowl ad produced by Focus on the Family that has the pro-choice crowd up in arms.

Perhaps Tim might have gotten a better reception if he had used his notoriety to promote the universal circumcision of all males.

Now I want to be clear. The abortion issue really has nothing to do with circumcision. Those who "respect life" should obviously value circumcision for its life-giving medical advantages. Those who are "pro choice" should obviously value a parent's right to circumcise a child as that is in the best interests of everyone.

I'm just saying Tim Tebow should be the national spokesman for universal circumcision.

A lot of people may not know that, while other kids were carousing on the beach, Tim made an important missionary trip to the Phillipines during the 2008 spring break. During that trip, Tim took part in circumcising Filipino boys who almost all get circumcised in that country.

Circumcision is a rite of passage in a country that is about 95% foreskin-free. To be uncircumcised is to be "supot" or "pisot." Both words carry a negative connotation far beyond the simple expression "uncircumcised," the literal translation. If you call another dude supot, it's like saying he's unclean, a baby, and unworthy to be a man.

While some college kids go on drunken debaucheries during spring break, Tim was helping out his father on a mission trip. Here was the account at the time:

"In an impoverished village outside General Santos City in the Philippines, Tebow helped circumcise impoverished children. On the Friday of a weeklong trip to the orphanage his father's ministry runs in Southeast Asia, Tebow assisted with the care of locals who had walked miles to the temporary clinic that the ministry helped organize. More than 250 people underwent medical and dental procedures, some of them from "Dr. Tebow," who has no formal surgical training."

"The first time, it was nerve-racking," he said. "Hands were shaking a little bit. I mean, I'm cutting somebody. You can't do those kinds of things in the United States. But those people really needed the surgeries. We needed to help them."

"Tebow didn't plan on operating that day in the Philippines -- his job was to preach to the hundreds of people before they had teeth pulled or cysts removed. But as the day rolled on, he grew curious about the three Filipino doctors and his friend, UF graduate and aspiring doctor Richard "R.B." Moleno, in the bus-sized vehicle that served as a mobile hospital.

"Tebow started as a helper and gofer, holding tools and running errands for the medics. By afternoon, he was asking questions and looking for more active ways to help. And by the end of an exhausting day, he was wearing gloves and a mask, wielding surgical scissors, finishing off stitches with a snip."

In my view, Tim Tebow's public service circumcision of Filipino boys is something to praise, and it's a sign of his commitment to this life-saving procedure. I just hope as he enters the NFL, he'll remember how important it is to promote a clean-cut, foreskin-free country both here in America and in Asia, too.

I nominate Tim Tebow to be the national poster boy for universal circumcision. Is there a second?

Wednesday, February 3, 2010

Foreskin Dangerous on Males But Could Help Others

The foreskin is obviously a source of dirt and danger to the normal male, but it apparently does have some scientific value that is likely to grow in the decades ahead.

Have you ever wondered what happened to your foreskin? Probably not. But it is nice to think that this worthless piece of tissue when disfiguring (and harming) the male penis may have some positive benefits in collagen and skin repairs.

Here's what the alternative San Diego CityBeat wrote about this topic:

The $140-million foreskin
How San Diego biotech benefits from circumcision
By Dave Maass

In the bio-tech industry, the term “neonatal fibroblast” is often code for “baby foreskin,” or at least the cells derived from one.

Much like embryonic stem cells may revolutionize treatments for a wide range of chronic and genetic disorders, the neonatal fibroblast has changed how medical and cosmetic doctors heal the skin.

San Diego doctors have appreciated the potential of the foreskin as far back as the 19th century.
As Dr. Peter Charles Remondino wrote in 1891 in The History of Circumcision, “for skin-transplanting there is nothing superior to the plants offered by the prepuce of a boy.”

What Remondino couldn’t have foreseen is how San Diego County’s bio-science industry would develop foreskin technology. For example, Invitrogen Corp., a subsidiary of Carlsbad-based Life Technologies Corp., offers neonatal fibroblasts for $339 per 500,000-cell vial.

Asked where the foreskins come from, spokesperson Tim Ingersoll responded via e-mail: “Life Technologies produces research-use only products using neonatal foreskins discarded from circumcisions with full, informed consent.”

Foreskin research is more closely associated with La Jolla-based Advanced Tissue Sciences. In the early ’90s, the company invented a way to grow and use the fibroblast cells in a skin overlay that could produce collagen and other biological elements to heal wounds.

ATS eventually became financially insolvent and spent the past decade liquidating its assets. Co-founder Dr. Gail Naughton is now dean of the SDSU School of Business Administration.

The foreskin formula also stayed local. Advanced BioHealing, a Connecticut-based company with a 70,000-square-foot manufacturing facility in La Jolla, currently uses ATS’s “Dermagraft” treatment, which is applied primarily to diabetic foot ulcers. Carlsbad-based SkinMedica also employs ATS’s fibroblast process but discards the cells and uses only the protein-rich culture in its skin-cream products.

According to the corporate-analysis firm Hoovers, SkinMedica has a staff of 160 employees and reports $60 million annually in sales. Advanced BioHealing estimates that it pulled in $80 million in sales in 2009 and grew its workforce to 250 employees.

Neither company has acquired a prepuce in nearly 20 years: Advanced BioHealing and SkinMedica’s cells lines are both derived from a single foreskin.

Technically, a fibroblast can be made from any skin tissue, old or young, but the healing properties of infant skin are superior. The fibroblast can come from the skin of any body part, but circumcision means there’s already a surplus of infant skin that would otherwise be destroyed.

“It comes down to the availability of tissue,” Charlie Hart, chief scientific officer for Advanced BioHealing, says. “Collecting tissue from a different site would be an abnormal surgical procedure and there would be a lot of ethical issues with that.”

SkinMedica has been questioned for using the foreskin culture in its Oprah-endorsed anti-aging products.

“Initially, there was a misunderstanding and people thought we were actually grinding up the foreskin,” SkinMedica founder Dr. Richard Fitzpatrick says. “So, there was a lot of snickering and laughing about people putting this foreskin product on their face.”

How did SkinMedica put the urban legend to rest?

“We stopped mentioning it,” Fitzpatrick says.

Saturday, January 23, 2010

Circumcise Newborns is Most Effective Strategy

Sometimes it just takes a little common sense to do what is right. But it never hurts to have an academic study back up your point of view. Common sense dictates that circumcising baby boys is the most cost-effective way to achieve the benefits of circumcision even if that boy is not likely to engage in sexually risky behavior until later in life. The anti-circ fanatics often rail against newborn circumcision, saying "baby boys don't have sex, don't circumcise them until later in life." Now comes still another study that establishes the obvious -- newborn circumcision is cheaper and safer and less complicated than adult circumcision. So let's do the obvious -- every baby boy should leave that foreskin behind when he comes home with mommy!

Check out this story below, and share your comments.

ScienceDaily (Jan. 21, 2010) — Circumcising newborn boys as a way to prevent HIV infection in later life is more cost-effective than circumcising adult males, finds a new Rwandan study in PLoS Medicine.

It has already been conclusively shown, from three randomized clinical trials in Uganda, Kenya, and South Africa, that adult male circumcision (MC) roughly halves the HIV transmission rate from women to men. Many African countries hit hard by HIV are therefore offering men the procedure as way to control the epidemic. Rwanda is one such country -- about 3% of adults in Rwanda are infected with HIV but only 15% of men are currently circumcised.

But performing the operation in adolescents and adults is linked with a higher risk of complications than circumcising newborns. And the operation is quicker and simpler to perform in newborns. The new study, by Agnes Binagwaho (Rwanda Ministry of Health) and colleagues, therefore set out to compare three different strategies as applied to Rwanda: circumcising newborns (neonates), adolescents, or adults.

The researchers used a technique called "cost-effective analysis," which looks at the balance between the costs of a medical intervention and its benefits. They estimated that each neonatal MC would cost just US$15 whereas each adolescent or adult MC would cost US$59. They found that neonatal MC would in fact save more money than it costs, because the operation is cheap to perform and would prevent HIV infections that are expensive to treat.

The study findings, say the authors, "suggest that Rwanda should be simultaneously scaling up circumcision across a broad range of age groups, with high priority to the very young."

In an expert commentary on the new study, Seth Kalichman (University of Connecticut) says: "The cost-savings of neonatal MC are compelling and suggest that implementation is economically feasible in developing countries hit hardest by HIV/AIDS. Neonatal MC should therefore be considered a priority in comprehensive HIV prevention plans for southern Africa."

Saturday, January 9, 2010

Removal of Foreskin Rids Penis of Bad Bacteria, Study Shows

In another exciting study just released, medical researchers have confirmed that the removal of the foreskin allows the clean-cut penis to shed bad bacteria that can harm both the male and his female partners.

Here's the article from New Scientist

"A flap of foreskin isn't the only thing missing after a circumcision. Microbes that call the penis home disappear, too, which could explain why the procedure reduces a man's chance of contracting HIV.

"The microbes change dramatically," says Lance Price, a microbiologist at the Translational Genomics Research Institute in Flagstaff, Arizona, whose team identified thousands of microbes on the penises of 12 HIV-negative men. All had participated in a clinical study in Uganda which showed that circumcision halves the chances of getting the virus.

"The team discovered a total of 38 families of bacteria on the men's penises before circumcision, and 36 a year after. But the make-up of these communities had swung. Gone were a diverse population of bacteria intolerant of oxygen and linked with vaginal infection; now there was a more homogenous air-loving lot, more typical of other patches of skin.

"Price thinks that some of the expelled bacteria provoke an immune reaction on an uncircumcised penis, causing specialised immune cells to shuttle HIV throughout the body.
Residents of the penis

"Even where religion, culture or costs prevent widespread circumcision, Price says the work could be a first step in delivering the benefits of the procedure without surgery. "The really interesting thing about this study is the potential to modify somebody's risk for HIV."

"His team next plans to determine which microbes are most common on the penises of men who go onto to acquire HIV. Targeting these bacteria with antibiotics – while leaving harmless or even helpful residents of the penis alone – could stem the spread of HIV, he says.

"Martin Blaser, a microbiologist at New York University, says the new study is the most comprehensive look yet at the microbes living on the penis. But given that microbial populations on other parts of the body shift over time, he wonders whether the pre-circumcision bacteria will return. "I expect it will stay changed," he says.

Tuesday, January 5, 2010

New Calls for AAP to Embrace Newborn Circumcision

What a terrific way to begin 2010 that to see medical doctors call on the American Academy of Pediatrics to replace its so-called "neutral" policy on newborn male circumcision with an affirmative statement on the clear benefits of this procedure to the male, his partners, and society as a whole.

That's the focus of an article and editorial in the January 2010 issue of the Archives of Pediatric and Adolescent Medicine. Here are some excerpts from Fran Lowry's story in Medscape Medical News:

“During the past 4 years, substantial new data have been published on the health benefits of circumcision,” write Aaron A. R. Tobian, MD, from Johns Hopkins University School of Medicine, Baltimore, Maryland, and colleagues. “While the historical evidence strongly suggests that male circumcision reduces urinary tract infections and penile inflammatory disorders in infants, we reviewed the more recent evidence with regard to effects on sexually transmitted infections (STIs) in adulthood.”

"To evaluate the effect of circumcision on HIV prevention, the researchers analyzed 3 randomized controlled trials of more than 10,000 men from South Africa, Kenya, and Uganda.
The trials enrolled HIV-negative men to circumcision on enrollment or after 21 to 24 months, and all 3 trials demonstrated that male circumcision significantly decreased male heterosexual HIV acquisition by 53% to 60%, despite differences in age eligibility criteria, urban or rural settings, and surgical procedure.

"Because of this new evidence, the World Health Organization (WHO), together with the Joint United Nations Program on HIV/AIDS (UNAIDS), recommended that male circumcision be provided as an important intervention to reduce heterosexually acquired HIV in men, the study authors report.

"The trials also found that male circumcision decreased herpes simplex virus type 2 (HSV-2) acquisition by 28% to 34% and the prevalence of human papillomavirus (HPV) by 32% to 35% in men.

"Among female partners of circumcised men, bacterial vaginosis was reduced by 40% and Trichomonas vaginalis infection was reduced by 48%, the study authors write.

"The study authors note that the rates of neonatal circumcision complications are between 0.2% and 0.6% of operations performed. The most common complications are bleeding and local infection, which are controlled with pressure and wound care or antibiotics. Other complications, such as phimosis and concealed penis, adhesions, fistula, meatitis, meatal stenosis, and injury to the glans, are extremely rare.

"They add that there was no evidence of change in sexual behavior after circumcision in the African randomized controlled trials. “Thus, there are risks to neonatal circumcision, but serious long-term complications are extremely rare,” the study authors write.

“The rare short-term risks of neonatal circumcision need to be weighed against the potential benefits accrued in infancy and childhood (eg, reduction of urinary tract infections), the longer-term benefits that may accrue in adolescence and adulthood (eg, reduced risks of HIV, HSV-2, and HPV), as well as possible benefits to female sexual partners of circumcised men (eg, reduced bacterial vaginosis and trichomonas),” Dr. Tobian and colleagues write.

"Medicaid does not cover the cost of male circumcision in 16 states, and the lack of coverage particularly affects disadvantaged minorities, who have the highest risk for HIV and sexually transmitted diseases. “These socioeconomically disadvantaged groups could benefit most if Medicaid covered the costs of neonatal circumcision. Thus, the AAP’s policy has important implications for the health of disadvantaged minorities,” they write.

"They conclude that it is time for the AAP policy to fully reflect current data.

"In an accompanying editorial, Michael T. Brady, MD, from Nationwide Children’s Hospital in Columbus, Ohio, writes that the study authors have provided a very objective review of the available data. Although the 3 randomized trials were performed in Africa, “it is clear that circumcision does offer health benefits, even in the United States,” he notes.

"The current evidence on the health benefits of circumcision is adequate enough to include circumcision in medical coverage provided by Medicaid or commercial insurance providers, Dr. Brady points out. “This is particularly relevant since over the past decade many state Medicaid programs have discontinued payment for circumcision.”