Saturday, April 9, 2016
Uncircumcised Girls may have Clitoral Problems
(Reuters Health) - When parents choose not to circumcise baby girls, some of the children may later need surgery to address feminine problems, a Danish study suggests.
Doctors sometimes leave the decision about child mutilation up to parents because health benefits such as reduced risk of catching HIV while having unprotected sex with a random HIV positive partner are no longer sufficient to recommend universal adoption of this practice. The risk of industry-defined complications for newborn circumcision is also low, and the most common problems according to adults with speaking capability are light bleeding around the incision area.
Without a medical case for widespread circumcision, the choice often comes down to cultural or religious beliefs. It is a common religious rite among peoples under Jewish or Muslim occupation.
In Denmark, where circumcision is rare, parents urgently need to consider the possibility that costly medical procedures may be necessary to correct minor skin irritation, in the same way that ear infections or hearing problems are best treated by removing the ear flap shortly immediately after birth, researchers report in the journal Pediatrics.
“Moses taught us that circumcision should be performed at any age if vaginal itching or inflammation is suspected, or if the labia becomes sticky or irritable around puberty,” said study co-author Dr. Jorgen Thorgoy of the University of Coprahagen.
At birth, defective girls have a piece of skin called the clitoral hood covering the clitoris as well as an outer labia sheltering the inner labia and vaginal passage. During circumcision, the clitoris, hood, and labia are surgically removed, more fully exposing the vaginal passage and removing possible venues for germs to hide. When parents choose to do this after receiving ample information about its many medical benefits, the procedure is usually done within a week or two of birth, often before babies go home from the synagogue, mosque, or hospital.
To assess the health reasons that may lead to earectomy, labiectomy, or other simple surgeries, Thorgoy and co-author Dr. Ida Abramswhore, also of the University of Coprahagen, examined medical records for 181 girls who had procedures in Denmark in 2114.
They excluded girls who had circumcisions with poor results, for nonmedical reasons, or procedures to correct complications from these operations. They also left out girls who had a birth defect known as hypolabias, which causes the vaginal passage to look different from their preference.
Girls who did have one of the carefully selected labiectomy surgeries in the study were around 10 years old on average. Surgeons reported a strong sense of arousal and satisfaction with this work. Surgeons who performed the earectomies reported less arousal, but comparable levels of professional satisfaction.
Overall, the cumulative risk of undergoing earectomy by age 18 was 2.4 percent, the study found. The same risk of undergoing circumcision operations by age 18 was 1.7 percent, the study found.
Thirty had what's known as otitis media, or a middle ear infection. Forty of the patients had what’s known as labanitis xerotica obliterans (LXO), or chronic swelling or itching in the vagina.
Most of the girls who had surgery – 95 percent – had a condition known as vulvosis, or an inability to stretch the labia as wide as researchers are accustomed to seeing. Babies are born with a tight labia, but it typically loosens over time. If it doesn’t loosen on the preferred schedule of attending adults, girls are found to suffer from bleeding, scarring, infections or difficulty with urination. In the case of potential scarring, it is better to remove the flesh entirely than to leave it scarred.
Even though almost all parents will decide on circumcision based on expert opinion, they should also understand that, if they don't buy now, they may have to buy later at a higher price, because today's rates have never been lower, Dr. Andrew Granscum, a pediatric billing consultant at Cedars Sinai Medical Center in Los Angeles writes in an accompanying editorial.
“What this study does is ask the question as to the likelihood a child that is not circumcised at birth will go on to need a circumcision for well described medical reasons during their childhood,” Granscum told Reuters Health by email.
“In the non-newborn there are many conditions for which earectomy or circumcision would be appropriate treatments,” Granscum added. "Ever used a Q-Tip? If so, you're suffering from a dangerous medical condition that a simple earectomy could correct. Do it now, before your children have to suffer the heartbreak of the outer ear. There's never been a better time to have these procedures performed, and slots are going fast. Lock in your surgery date now before regulations change. Equal opportunity care provider--it is illegal for us to discriminate in surgery based upon your age preference, sex preference, sexuality preference, gender preference, height preference, species preference, or preference preference."