Circumcision

Circumcision . It is the process by which the foreskin (the skin that covers the penis ) is cut, leaving the glans exposed, without protection. It is performed through irreversible surgery . This can be total (when only the constrictive tip of the foreskin is removed) or partial (so that the penis slides freely, a small part of the tip of the foreskin is cut off or a dorsal cut is made).

Summary

[ disguise ]

• 1 Origin
• 2 Circumcision and religion
• 3 Reasons why it is practiced
• 4 Phimosis
• 5 Risks before the surgical procedure
• 6 Medical indications
• 7 Balanoposthitis
• 8 Neonatal circumcision
• 9 Foreskin plasty
• 10 Frenulectomy
• 11 Phallic hygiene
• 12 Fonts

Origin

Circumcision is an ancient and sacred cut. As it is assumed that Abraham ‘s foreskin was cut by divine imperative, circumcision is, according to The Torah , obligatory for all Jews for 5,700 years: at first, rabbis cut the foreskin with their own teeth from eight-day-old children. , although over time the cutting began to be made with more civilized instruments. The same occurs in other religions (such as Muslim) and in most African tribes, for which circumcision is a rite of passage to adulthood.

Curiously, although it is known that the baby Jesus was circumcised at birth, the Catholic religion does not comment on the issue. However, the origin of circumcision is much older than Christ : the Aztecs and other pre-Columbian cultures already did it (until the Spanish arrived) and Herodotus traces it back to the Egyptians: not in vain, there is an ancient engraving of the tomb of Ankhamahor in which a man can be seen undergoing a foreskin operation with a flint stone . Nowadays, teeth and knives have been replaced by aseptic scalpels .

Circumcision and religion

Circumcision is cited numerous times in the Tanakh (for Jews) or Old Testament (for Christians) of the Bible . According to this text, Abraham and his family were the first to be circumcised, after God appeared to him and indicated the conditions of his alliance with the Jewish people (Genesis, XVII): “Here is my covenant with you: you will be the father of a multitude of people, from whom kings will come forth. You, on your side and your descendants, circumcise every male, circumcise the flesh of your foreskin and that will be the sign of my covenant between me and you. At eight days old Every male among you will be circumcised, from generation to generation, whether born in your home or bought for money from any foreigner who is not of your lineage.” Brit Mila ceremony.

At 99 years old, Abraham would have been circumcised, imposing the practice on his firstborn Ishmael , as well as all the men and boys in his house. He would repeat the operation on his little son Isaac eight days after his birth.

In the New Testament , only one of the four evangelists clearly names the circumcision of Christ. This is Luke (2:21) “When the eight days had been completed to circumcise the child, they gave him the name Jesus, imposed by the angel before he was conceived in the womb . ” It is believed that January 1st coincides with the circumcision of Christ according to the Catholic religion, although it has been proven that Jesus was not born on Christmas Eve.

And Luke himself comments that Elizabeth and Zechariah took their son John (the future Baptist) to be circumcised: “After eight days they took the boy to be circumcised. They wanted him to be called Zechariah, like his father. But his mother said: ‘No.’ “He will be called Juan . ” On the contrary, in most of his epistles, Saint Paul of Tarsus , who lived in diaspora and in the Hellenic environment, frequently indicates that circumcision is not necessary (Corinthians, VII:19): “Circumcision is nothing, nothing is foreskin, but the keeping of the precepts of God.”

Circumcision was the subject of a dispute between Hellenists or Hellenized Jews and Orthodox Jews. This dispute had been launched by the coronation of the Seleucid king Archelaus IV Epiphanus, who advocated extreme Hellenization with:

• The ephebia or military preparation that involved naked gymnastics in the arena.
• Abandonment of circumcision among the Greeks, against the Jews.
• The adoption of the Greek language to the detriment of Aramaic.

This attempt stalled, but gave rise to the War of the Maccabees to which two books of the Old Testament (according to the expanded Roman Catholic canon) and two apocryphal books refer. One of its authors was Jason of Cyrene, a Hellenized Jew of the diaspora.

• Judaism: faithful to the tradition of the Hebrews, most Jews continue to practice circumcision on the eighth day after the birth of the child, except in cases of medical contraindication. The father is responsible for preparing the ceremony, which must take place early in the morning and is preceded by a vigil dedicated to prayers. Circumcision is called milah in Hebrew, but the full expression is brit milah, the first word of which means ‘covenant’. Indeed, this circumcision is performed to remember the covenant established between Yahweh and Abraham, in which he would be made “father of a multitude of nations” (Gen. 17:4). The gentile person who has completed his preparation with a view to entering the Jewish family, and who has been approved by a competent bet-din (a type of court with three rabbis), must also necessarily perform three ceremonial steps (two if he is a woman). ): Circumcision (only men), Immersion in a ritual pool, Offering in the Temple (this step is currently omitted, since there is no Temple in Jerusalem, the offering of sacrifices is prohibited).
• Christianity: Saint Paul of Tarsus was the first Christian who proposed the abandonment of circumcision, against the Judeo-Christians. However, circumcision continued to be practiced among the Coptic churches of Egypt and Ethiopia . Among Christians, it stands out anecdotally that in England, Queen Victoria believed that the royal family descended from King David. She had her children and grandchildren circumcised, the custom continuing until the end of the 20th century, when Princess Diana opposed the circumcision of her children. A Catholic-majority country, the Philippines, has a 100% circumcision rate. It seems that this cultural practice dates back to pre-Hispanic origins and was strengthened by North American colonization (1898-1946).
• Islam: Circumcision is practiced by the majority of Muslims, although its practice comes from tradition and is not mentioned in the Quran. It is a tradition of biblical origin, which was already practiced in pre-Islamic times. Only one of the four Sunni schools, the Shafiite, considers it mandatory, but for the rest of the Muslims it is not obligatory. The age at which circumcision should be performed is debated and varies from place to place. In some places, such as Iran, it often takes place at the moment of birth. However, in other places you can wait until seven years old, an age that many consider more appropriate. The most important thing is that the operation is performed before puberty. The circumcision of a boy is celebrated with a family party in which the circumcised person receives gifts. Uncircumcised adults who convert to Islam do not have, from a doctrinal point of view, any reason to undergo this operation, although there is a deep-rooted popular belief that it is necessary.

Reasons why it is practiced

Frenulum circumcision is performed when the frenulum is too short or tight. On these occasions, the affected person may notice discomfort or even pain when having an erection or during sexual intercourse. It is advisable to circumcise it in these cases, since it is very common for the frenulum to break and bleed profusely.

The operation is simpler than phimosis and normally after two weeks the affected person is completely recovered.

Circumcision for medical reasons is mainly performed when the foreskin is too narrow and does not allow the glans to slide during erection (phimosis), causing pain, or when it is too long (redundant foreskin) and maintains poor hygiene conditions in the glans.

Phimosis

It is called Phimosis when the foreskin is too narrow and/or has a “fibrous ring” that prevents the passage of the penis, causing pain and making penetration difficult, we are facing a case of phimosis. If the phimosis is partial, that is, there is an opening but it is too small to facilitate the passage of the glans, the problem can be solved through progressive stretching and manipulations, application of steroids or partial circumcision (see “foreskin plasty”). . But if the “little hole” is very closed, it will be inevitable to cut corners to facilitate sexual relations.

The vast majority of modern urologists believe that it is not advisable to systematically operate on children, and it is preferable to wait to see the evolution of the penis to gauge whether or not the intervention is necessary. There are phimosis that are born and others that are created: therefore, it is not good to practice forced retractions on the skin of the foreskin in the first years of a boy’s life, as doctors did before.

In children, phimosis occurs when it prevents the child from urinating properly because the skin closes the urine outlet. In older people, it is operated on when it is difficult to have sexual relations since the glans cannot be discovered or it is difficult to do so. In elderly people it is possible that their phimosis becomes very narrow so that it also prevents them from urinating properly.

It is an intervention that is performed on an outpatient basis, that is, it does not require admission to the hospital as a rule. It is performed with local anesthesia, which is placed on the skin of the penis. It consists of removing the skin of the foreskin that does not allow the glans to be revealed. Once removed, stitches are given around it with a special thread that will fall off in 7-10 days. The intervention usually lasts between 30 and 45 minutes, depending on the situation.

Risks before the surgical procedure

Surgical process of Circumcision

It is a surgical procedure and therefore has some risks:

• Hemorrhage: as a rule it is not usually important and is controllable by the surgeon.
• Infection: which may require the use of antibiotics.
• Hematoma: requiring drainage.
• Rejection of points.

Medical indications

Among the main medical indications for circumcision are:

• Chronicbalanoposthitis .
• Viral infections.

There are no other truly effective ways to treat phimosis, treatments that avoid circumcision and aim to preserve the foreskin end up maintaining only tissue that becomes infected again and again.

Balanoposthitis

Balanoposthitis is an inflammation of the glans that also affects the foreskin and can degenerate into phimosis that requires complete circumcision. It can be due to an infection, a lack of hygiene and also an excess of it: excessive use of irritating soap in the area can cause this cumbersome inflammation.

Neonatal circumcision

Neonatal Circumcision is if the parents want and the baby’s penis does not present anomalies that require future interventions, circumcision can be done without anesthesia shortly after the child is born. The reasons are usually hygiene and health, although they are also given for religious reasons. In countries like the United States, Mexico, the Philippines or South Korea it is applied indiscriminately. Today, most doctors believe that it is an unnecessary measure, since only 10% of men have problems with phimosis, balanoposthitis or infections that justify such an annoying intervention.

Foreskin plasty

The Foreskin Plasty is a partial circumcision that is performed on individuals who suffer from phimosis and wish to widen the hole to slide their penis as desired. To do this you only have to cut the end of the foreskin. It is a much simpler operation than total circumcision, in which the foreskin is trimmed in such a way that the glans is always exposed.

Frenulectomy

Frenulectomy is when the frenulum of the penis is too short, there is a great risk of it hurting , breaking and bleeding during sexual intercourse. Therefore, it is advisable to go under the knife and cut it so that things flow well. Frenulectomy or circumcision of the frenulum is a much simpler intervention than that for phimosis, with a postoperative period that lasts only a couple of weeks.

phallic hygiene

Utensils

Another of the great reasons that motivated circumcision. For centuries, the belief has survived that the glans of a circumcised man is “cleaner” than that of a man with a foreskin. Reality shows us that this is not necessarily true: although a smelly white secretion called smegma (commonly known as “cottage cheese”) is produced under the skin, if a man washes the area well daily, removing the foreskin, it will keep it as clean as possible. except from infections and edema like that of a circumcised man.