# Circumcision in the Elderly



## wildflower18 (Jul 22, 2007)

I've decided not to circumcise, but in a conversation with friends who are new parents yesterday, they sited the concern that when their child gets old and is unable to care for himself that circumcision may become necessary for health issues. They gave a specific example of someone they knew this happened to. This isn't really something I had considered when making my decision and wanted to hear others thoughts on the issue. I'm not regretting my decision in anyway...but again, just wanted to hear others views about the uncircumcised penis as a person ages.


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## carriebft (Mar 10, 2007)

Three points to think about:

1) in noncircumcising countries, doctors are educated in intact care and also in alternative methods for curing the common reasons for adult circumcision (phimosis, for example). For example, Finland's adult circumcision rate is something like .06% or less.

2) If you are in the USA, the best way to avoid pressure for circumcision for an older child or adult is to keep yourself educated and seek out educated care providers.

For example, know that the foreskin is fused to the glans and separation will occur on its own anywhere between birth and late puberty. If separation fails to occur (phimosis a possibility) then there are other methods for curing this besides circumcision...stretching, creams, etc.

Also, premature retraction/forced retraction can cause issues that lead to the spiral of pressure to circumcise.

*3) When speaking of the elderly population, many will bring up the idea that "many men have to be circumcised in nursing homes" which is just not true. Seek out homes that have staff which are dedicated to the health and hygiene of their population. Cleaning an intact man's genitals is very much like cleaning a female's genitals in that there are some folds to be dealt with. ANy home that seeks to circumcise an adult for ease of cleaning should be avoided like the plague.*


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## carriebft (Mar 10, 2007)

In addition, if an elderly intact man is having repeat infections and their caregiver has not properly treated this infections (or is not washing him properly) they should be investigated...surgery is not the answer...definitely would be finding a new care giver.


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## Ruthla (Jun 2, 2004)

Besides- even if circ is "needed" when a man is 85 years old- why should he have the surgury 85 years earlier? Why shouldn't he have a lifetime to enjoy an intact penis? By the time a man is having infections because nursing home staff isnt' cleaning his penis properly, it's doubtful that he's still sexually active. I'm not saying that no 85yo men are having sex- but I'd guess that the men who are still active at that age are capable of washing themselves properly!

In no way are these geriatric health concerns a reason to circ a newborn.


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## mntnmom (Sep 21, 2006)

And by the time our boys are that old, it will be THEIR children and grandchildren who are doctors and nurses. With about 50% of US boys being intact now, I'm sure that knowledge of intact care will improve by then!!


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## nd_deadhead (Sep 22, 2005)

My grandfather needed a catheter when he was 90. Should my sons get catheters now?

My other grandpa had leukemia. Should I be giving my sons regular infusions of platelets, since their great-grandfather needed them in his 80's?

My MIL had two hip replacement surgeries. Should my sons get hip replacements now, so they don't have to go through the mainful surgery later?

I have gold crowns on two teeth. Should my sons get crowns on their teeth now instead of later?

Many members of our family (DH, my Mom, Dad, and grandfather) all had acute appendicitis, requiring emergency appendectomy. Should my sons get their appendixes out now, just in case?

If those examples sound ridiculous (and I hope that they do), why would it make sense to cut off a baby boy's foreskin, on the off chance that he might have a problem with his penis in 80 years?


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## thixle (Sep 26, 2007)

Quote:

This isn't really something I had considered when making my decision and wanted to hear others thoughts on the issue.
Many people do have this worry. NOCIRC.org has a very nice handout:
http://www.nocirc.org/publish/pamphlet8.html


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## ulla (Feb 3, 2007)

That's not something his parents need to worry about. Once their child is an adult, his penis is none of their business. And to state the obvious, they will be dead by that time and it will be their grandchildren who willing be dealing with any elder care issue that may arise.

These cases of circumcision of elderly men that people sometimes cite are extremely rare. The penis is just another body part a caregiver needs to clean for a bed-ridden patient.

It's pointless to worry about the far future. It may turn out to be a lot different than they imagine. Not everyone ends up helpless in a nursing home.


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## Etay005 (Jul 12, 2005)

It would be like cutting off your baby's toe just in case it got a terrible hangnail infection and had to be amputated when she was 80.


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## quarteralien (Oct 4, 2006)

I have a friend who said she had her son circ'ed because her 90-something-year-old grandpa "had to be circ'ed" in a nursing home, they used unsterile equipment, and he died of an infection. I waved my arms for fully a minute deciding where to start on that totally fallacious argument. To me, that even more reason _not_ to circ, the idea that unsterile equipment might also be used on a delicate newborn who can also die from an infection. And the fact that this man lived to be 90 with no problems (and likely didn't have as severe problems as truly needed surgery) should speak volumes as well. And let's face it, despite the fact that lifespan generally improves, there is no guarantee that a child will grow up to _need_ a nursing home. He could die before then, and then that circ was useless for the original purpose.

I don't buy the argument.


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## tlh (Oct 10, 2007)

i talked to someone online that told me 90% of elderly men and women will get phimosis because the elasticity of skin goes away and becomes too tight.

but i have known many people 80 and older and none of them have been circumcised.my grandparents are all in their 80's and middle 90's and a few have pacemakers and cataracts but no circumcisions.


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## GoodMomma (Aug 6, 2006)

I worked as a CNA in 2 different nursing homes for 4 years before becoming a SAHM and I never once ran into an intact man that had any problems. 99% of the men were intact. The women were the ones with the occasional UTIs.


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## angelcat (Feb 23, 2006)

Interesting thread. I have never heard of an elderly person having to be circed, actually, but neither of my grandfathers ended up in nursing homes. It worries me, as my father may end up in a nursing home at some point in the next 20-30 years, or sooner. (not that I want to even think of that aspect of his care *shudder*)

I have a friend who works in a nursing home, and she has chosen to have her baby circed, (if her baby is a boy) because it is difficult to deal with as a care aide. She says it's just nasty and not clean. (uncirced, in the elderly). She didn't mention any elderly men being circed for that reason, so I hope that doesn't happen where I live.

I can't argue on whether it is hard to clean, as I have never worked in a nursing home. I just know I wouldn't spend the money and put my baby thru that for the comfort of their care aides in 80-90 years.


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## fruitful womb (Nov 20, 2004)

My Grandfather, who is intact, went in today for a painful procedure to treat his prostate cancer. While my sister took him to his appointment, my 103 yr (no dementia, all there and healthy) Great grandmother, whom I was watching over, said to me, "Grandpa is really scared, I think they're going to circumcise him." She knows how I feel about non-consenting genital reduction surgery (the owner of his attached genitals to should be the only one allowed to consent!). Anyways, I called my sister freaking out! I know my Grandfather doesn't want a circumcision, ever! He made himself clear, to us: his family. He doesn't question the doctor's "authority", which is frighting b/c a pro-circ doctor could easily take advantage of him.









Well, my sister told him what I did - said, while driving him home from his procedure and he laughed, as she puts it: Really hard!







Rest assured.

Before any lurkers get the wrong idea, please realize that prostate cancer is not caused by a foreskin! In fact, my best friend's dad is in his late 50's with advanced prostate cancer and he was circ'd at birth. Whereas my grandfather is 80. He just started having problems with his prostate. His cancer isn't nearly as aggressive either.

Wondering... Grandfather has to have a catheter in place for three days, with a foreskin you can seal the catheter to protect the meatus - making infections less likely but when its absent... do they just tape the catheter to the meatus? That sounds _really_ uncomfortable.


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## MommytoB (Jan 18, 2006)

my gpa is in a nursing home the staff is not into cleaning it would be like saying lets make them teethless as in pull out their teeth-gpa eating mushy foods and barely talks his teeth are disgusting looking but still has them-i am 30 i wear dentures-funny my wisdom teeth were removed because mom had terrible pains with her and when my teeth had problems took 5 yrs to get rid of them


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## krankedyann (May 28, 2005)

Quote:


Originally Posted by *fruitful womb* 
Wondering... Grandfather has to have a catheter in place for three days, with a foreskin you can seal the catheter to protect the meatus - making infections less likely but when its absent... do they just tape the catheter to the meatus? That sounds _really_ uncomfortable.

I asked my dad, who has a med background, and he said that the prostate muscles hold the catheter in place, so it doesn't matter if they're circumcised or not. For women, they have a small inflatable balloon that holds it in place.


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## Frankly Speaking (May 24, 2002)

There is one thing certain and indisputable: Those pushing circumcision are not reluctant to lie. Anytime circumcision is discussed, someone always posts about an old man in a nursing home that had to be circumcised. The fact is that the chances of ending up in a nursing home is very rare. Much more rare than these cases of elderly men who had to be circumcised.

In my hometown of about 40,000 people, there is a single nursing home with about 15 beds which means that there will be on average 7 or 8 men in the facility out of about 20,000 men in the city. That's an incredibly rare chance! Far rarer than the reports of men who had to be circumcised in nursing homes. The vast majority of these reports have to be made-up lies to convince parents to circumcise their babies.

I ask, how many people have you known in your entire life that went to a nursing home? I'm probably older than most here and in my entire life, I have not known a single person who ended up in a nursing home. In fact, I've only been acquainted with one, the aunt of a friend.

But it really gets down to another point. The nurses in these institutions are being well paid to do their job in taking care of patients and a part of that job is bathing both male and female patients including the genitals. If they don't want to do that part of their job, they should be working elsewhere. If they refuse to do this part of their job and refuse to leave the job, they should be fired on the spot. There is someone else that is serious about their profession that will do their duty.

.


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## Frankly Speaking (May 24, 2002)

Oops! Double post.


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## krankedyann (May 28, 2005)

Quote:


Originally Posted by *Phoenix Rising* 
I ask, how many people have you known in your entire life that went to a nursing home? I'm probably older than most here and in my entire life, I have not known a single person who ended up in a nursing home. In fact, I've only been acquainted with one, the aunt of a friend.

VERY good point. I've only known two people who were in a nursing home, both in my family because they had a genetic disease that was more than what my family could care for at home.

I have, in the past, done nursing home ministry with my church. I've never heard of it happening. In discussing it with my dad this evening, the first thing he said was that if they can't care for an intact man, then the women there are in as bad or worse trouble as the men! If that be the case, they're in a bad nursing home and the foreskin isn't the problem, it's the lazy employees!


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## angelcat (Feb 23, 2006)

I actually know many people who have ended up in nursing homes, and there are many nursing homes aorund here. So I think it's fairly likely, but not a guarantee.

As I said, I've never heard of an elderly man being circumcised, though.


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## fruitful womb (Nov 20, 2004)

Quote:


Originally Posted by *krankedyann* 
I asked my dad, who has a med background, and he said that the prostate muscles hold the catheter in place, so it doesn't matter if they're circumcised or not. For women, they have a small inflatable balloon that holds it in place.

Thats good to know.

Thank you. I appreciate you asking.


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## eepster (Sep 20, 2006)

Quote:


Originally Posted by *Phoenix Rising* 
In my hometown of about 40,000 people, there is a single nursing home with about 15 beds which means that there will be on average 7 or 8 men in the facility out of about 20,000 men in the city.

I'm guessing you've never gone to visit a nursing home. My GM and my mother's cousin both spent sometime in some. Between visiting and checking out a bunch to make sure they were decent I've seen a fair amount. When you walk in there are a dozen old ladies sitting in their wheel chairs or shuffling along with their walkers and one or two men. In a facility that only had 15 beds I would be really surprised to find 3 men.


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## DJay (Sep 10, 2006)

My dad was being treated for prostate cancer in his late 60's. He was uncircumcised. Due to the 'roto-rooter' procedure, he had a 'leaking' problem. The solution was to 'circumcise in case there might be a problem'. Sounds like the same excuse for RIC. (in case there might be a problem).

He told me it was one of the worst things that he had ever done. The exposed glans was 'too sensitive' to feel comfortable. Never did adjust to it.

As was posted earlier, circumcision is not the solution to prostate cancer.

DJay.


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## Bm31 (Jun 5, 2005)

Quote:


Originally Posted by *eepster* 
I'm guessing you've never gone to visit a nursing home. My GM and my mother's cousin both spent sometime in some. Between visiting and checking out a bunch to make sure they were decent I've seen a fair amount. When you walk in there are a dozen old ladies sitting in their wheel chairs or shuffling along with their walkers and one or two men. In a facility that only had 15 beds I would be really surprised to find 3 men.

Yep, exactly. I recently had to put my mother in a nursing home. I believe there are about 30 beds and I would be hard pressed to find more than 6 or 7 men there. Women generally outlive men and the chances that a man will end up in a nursing home are pretty small.

Regardless, circ'ing an infant to make some aide's job easier 80 years down the road is ridiculous.


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## sg784 (Dec 19, 2004)

Quote:


Originally Posted by *Bm31* 
Regardless, circ'ing an infant to make some aide's job easier 80 years down the road is ridiculous.

It doesnt make the job any easier when the resident is circ'd or not.

I have worked as a Nursing assistant for the last 3 years and Ill tell you theres no complicated way to clean any kind of penis. they all get the same care, and its simple.

the same areas have to be cleaned and dried whether you have to move some skin to do it or not. yk?

And in my experience, I see WAY more intact old men than circ'd old men. I have been in a 190 bed facility for the last 2 years.


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## perspective (Nov 3, 2007)

Quote:


Originally Posted by *wildflower18* 
I've decided not to circumcise, but in a conversation with friends who are new parents yesterday, they sited the concern that when their child gets old and is unable to care for himself that circumcision may become necessary for health issues. They gave a specific example of someone they knew this happened to. This isn't really something I had considered when making my decision and wanted to hear others thoughts on the issue. I'm not regretting my decision in anyway...but again, just wanted to hear others views about the uncircumcised penis as a person ages.

All these "rationalizations" for circumcision fail to make sense, and can be proved by using the same (seemingly obvious points)

1. Most of the issues they talk about being a problem, are already issues that women deal with, yet no parent worries about their daughters, so there is no reason to worry about their sons. (like in this case, their daughters are going to get old in nursing homes and they will have to have people clean their genitals)

2. Parents are presented with all these issues, with the pressure placed on them that they need to deal with it now or never. Which is completely crazy. Even if any of these rationalizations were true, they could be dealt with at any point in their sons life. And most of the time, its not even logical to deal with these "problems" at birth. (who would rationally look at their newborn son and think "well, we better circumcise him now, because he may have some problems when he hits 90." Or, who looks at their new born with thoughts on their sex life!!

How people are able rationalize these things, I simply do not know.


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## SleeplessMommy (Jul 16, 2005)

You can talk about the "number needed to treat" (NNT) Would you circumcise 1000 infants to avoid or prevent one or two "adult" outpatient circumcisions in elderly men?


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *eepster* 
I'm guessing you've never gone to visit a nursing home.

Well, as a matter of fact, I have. With my friend, I visited her aunt in the nursing home and in my business, I worked with nursing homes as a supplier.

Quote:

When you walk in there are a dozen old ladies sitting in their wheel chairs or shuffling along with their walkers and one or two men. In a facility that only had 15 beds I would be really surprised to find 3 men.

Well now, this is not something I can say I noticed. That's not to say it's not the case but that I just didn't notice such a wide difference in males and females in those nursing homes. I suspect that it's because I just didn't pay attention. It makes me wonder why the residents of nursing homes would be 80% female?

.


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## My2Matthews (Aug 9, 2004)

I'm an RN in a cardiac unit and so I have experience with a lot of elderly patients. Most male patients I have taken care of have been intact (at least, the ones who I had any reason to even see their penis..meaning, they couldn't take care of that area themselves, or needed a catheter inserted, etc.). I have only ever seen a problem three times-- all 3 times it was paraphimosis, where someone (likely another nurse or an aid) retracted the foreskin for whatever reason and didn't pull it back over the glans when they were finished, and the foreskin swelled and stuck. There is a simple way to fix the problem (squeeze the glans to make it smaller in size and then pull the swollen foreskin foreward) but it is very painful for the patient. I educate everyone I work with whenever the opportunity arises to always put foreskins back in place. Still, like I said, I've only seen this 3 times, and I would never, ever, ever put my child through that OR, more importantly, violate his human rights to avoid an uncomfortable episode that MIGHT happen 90 years down the road. No way, no how.


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## My2Matthews (Aug 9, 2004)

Quote:

I asked my dad, who has a med background, and he said that the prostate muscles hold the catheter in place, so it doesn't matter if they're circumcised or not. For women, they have a small inflatable balloon that holds it in place.
Hmm.. never heard of that one. We always inflate a balloon, no matter the gender of the patient. In fact, I've had confused patients rip catheters out of their penis, with the balloon inflated.. (ouch, I know). If the prostate held the catheter in place, how would the catheter even get by the prostate, or how could the catheter be pulled out for that matter? In both male and female patients, once the balloon is deflated, it slips right out.
Catheters are also difficult to insert, sometimes, in men with enlarged prostates.


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## Bm31 (Jun 5, 2005)

Quote:


Originally Posted by *Phoenix Rising* 
Well now, this is not something I can say I noticed. That's not to say it's not the case but that I just didn't notice such a wide difference in males and females in those nursing homes. I suspect that it's because I just didn't pay attention. It makes me wonder why the residents of nursing homes would be 80% female?

I just visited the mother tonight and asked one of the employees. I was off in my earlier estimates. They told me there is actually about 90 residents there and could only think of about 13 males. I don't think there is anything demographically unusual about this nursing home. I think the disparity comes from men having shorter lifespans, so they tend to get cared for at home by the spouse when they decline. However, the wife tends to outlive the husband and there is no one there to help care for her at home in her last years.


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## zerby (Mar 28, 2004)

I work in surgery for a group of Urologists, and I can safely day that I have seen more than my fair share of elderly penises. Many are uncirced. No problems there. Many have catheters placed. No problems regardless whether or not they have been circ'ed. We would never circ a patient unless they needed it, ie dead tissue. We can remove or reduce a prostate whether the man has a foreskin or not. And as far as long term care, prior to my entering the medical field I worked in a long term care facility for mentally retarded and medically sick adults. It didn't matter to me whether they were cut or not...perinial care was the same regardless....I was more concerned about getting poo on me than a little smegma. I would have never considered referring a client for mutilitaion for my ease!!!


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *My2Matthews* 
I have only ever seen a problem three times-- all 3 times it was paraphimosis, where someone (likely another nurse or an aid) retracted the foreskin for whatever reason and didn't pull it back over the glans when they were finished, and the foreskin swelled and stuck. There is a simple way to fix the problem (squeeze the glans to make it smaller in size and then pull the swollen foreskin foreward) but it is very painful for the patient. I educate everyone I work with whenever the opportunity arises to always put foreskins back in place.


I have read one case history of this happening. I had posted there was no case history of a man dieing simply because he had a foreskin and a pro-circ poster offered the case history to refute me. It turned out that the nurse knew well what she was doing and did it on purpose apparently in an effort to make a circumcision on the man inevitable. In fact, it did and even resulted in part of the penile shaft and the glans being amputated but it got even worse. The man was in fragile health and couldn't stand the rigors of the surgery and a few days later, he died. He didn't die because he had a foreskin but because of a psychopathic nurse who wanted to avoid her responsibility. The nurse, the attending doctor and the care facility were all sued and the plaintif won their case. That's as it should have been but I think it was short of what should have happened. I think the nurse should have spent some time in The Cross Bar Hotel at the state's expense. What she did was manslaughter and she should have paid a price other than money.

.


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## fruitful womb (Nov 20, 2004)

Quote:


Originally Posted by *Phoenix Rising* 
..........What she did was manslaughter and she should have paid a price other than money.

.









:


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## KBecks (Jan 3, 2007)

My MIL worked in a nursing home and said that is why she circed her sons, b/c the old men had problems. She was young and I'm sure it was gross cleaning anothers genitals. I think over cleaning may have happened though and incorrect care could have happened (in the late 60's)


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## mntnmom (Sep 21, 2006)

My FIL had prostate cancer a few years ago. My in laws are pretty private folks, but I'm sure if he'd gotten circumcised at 70+ yrs old I would have heard about it!!!
And the other day my MIL was talking about some med. they put him on. The doc warned him it might lessen his libido. My MIL says "well its about time!" :LOL


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## GooeyRN (Apr 24, 2006)

I have seen several penises that had infections from poor hygiene in the elderly. All it takes is a round of antibiotics to clear it up, and a reminder to the CNA's to retract the foreskin, wash, replace the foreskin once a day, or as needed if soiled with feces. The problem is usually easily solved. Never have I seen someone need to be circ'd from that. Just make sure the CNA's/caregivers know how to take care of an intact penis and there should be no problem. I don't see possible infections as a geriatric enough reason to circ. as a baby, thats for sure. Why not give every woman bilateral mastectomies at puberty to prevent breast cancer? To me its the same kind of logic.


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## CanadianMaple (Dec 29, 2007)

Quote:


Originally Posted by *GooeyRN* 
I have seen several penises that had infections from poor hygiene in the elderly. All it takes is a round of antibiotics to clear it up, and a reminder to the CNA's to retract the foreskin, wash, replace the foreskin once a day, or as needed if soiled with feces. The problem is usually easily solved. Never have I seen someone need to be circ'd from that. Just make sure the CNA's/caregivers know how to take care of an intact penis and there should be no problem. I don't see possible infections as a geriatric enough reason to circ. as a baby, thats for sure. Why not give every woman bilateral mastectomies at puberty to prevent breast cancer? To me its the same kind of logic.


Ditto that. I'm an RN and have never seen anyone circ'd for those reasons. Many women get vag infections when they're older too but we don't think about removing their labias or anything.









I think that as our kids age, the medical community will have so much more experience with the intact penis. Not many people here circ now and people are already much more aware.


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## njeb (Sep 10, 2002)

Another thing to remember is that as the Baby Boomers age, there will be many more circumcised men in nursing homes in the future. The boomer generation was the first to have the majority of men circ'ed as babies. I wonder if we'll get complaints about those dirty circumcised elderly men from their caregivers?


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