# Rant: Partial "natural" circumcision?? ARRRGH!



## beachrock (Apr 26, 2003)

My SIL adopted a newborn who was born with a retractible foreskin. Thanks I hope in part to my DH and I they did not circ (although their firstborn son was cut, "like his father"







. The docs told her that this condition in a newborn is called a partial natural circumcision!! I just about flipped! That "natural" and "circumcision" could first of all appear in the same sentence! But that the medical term for this made it sound as if circ'ing is just a completion of natural design. I just about puked down the phone.

Just venting.


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## rainbowmoon (Oct 17, 2003)

I thought the foreskin wasn't even retractable at birth? is this a real condition or did they retract him?








that anyone would think circ is natural


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## Frankly Speaking (May 24, 2002)

There are several possibilities here.

There is definitely a possibilty that he has been forcibly retracted already. I jusst wonder how the doctor even knew the child was retractile if he/she wasn't retracting the child! It appears that even if the child was naturally retractile, they were definitely mistreating the child in violation of The AAP's published guidelines.

The second possibility is that the child was actually naturally retractile. There is some evidence that a very small percentage of boys are retractile at birth or shortly there after. Personally, I don't believe these percentages and suspect that they were "naturally retractile" only after they had been forcibly retracted.

Another scenario is a birth defect called aposthia where the foreskin is only partially formed or completely absent. This is probably the genesis of most of the "partially circumcised at birth" reports. However, this is extremely rare occuring in maybe 1 in 10,000 births so it is not likely.

There is also an increasingly common birth defect called hypospadius where the urinary opening is not at the tip of the penis and is often accompanied by a partially formed foreskin. The increasing incidence of this birth defect is being blamed on increasing levels of estrogen in the water supply coming from birth control use upstream and from commercial cattle and pig farming operations upstream from the water supply intake.

Finally, there are certain Asian populations that have a genetically naturally short foreskin and this could be diagnosed by an uneducated physician as a partial circumcision.

Frank


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## Nathan1097 (Nov 20, 2001)

Or, it could just be a dumb medical professional! The visiting pediatrician from my youngest's dr's office at the time came to do the routine newborn check-up in the hospital and commented to me that he wouldn't need a circumcision as he already had a natural one.







He most certainly has nothing of the kind and his foreskin covers the end of his glans so... She may have been trying to gently talk me out of getting him done- even though he had on a tshirt that said "nocirc" and a sign in his bassinet, etc.


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## hakunangovi (Feb 15, 2002)

.DW was a nurse for quite a few years in a remote community, and I remember her telling me of one baby that was born with a retractile foreskin. How did they know? Well, as I recall his foreskin was somewhat retracted when they changed him. The Dr was present, and he made sure the nurses placed the baby's foreskin forward after they had cleaned him up. That is the only instance that I have heard of up to now.


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## Frankly Speaking (May 24, 2002)

Thanks, Howard. Although I had seen the statistics, I had never heard of this actually happening before with a real life baby.

Frank


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## Quirky (Jun 18, 2002)

Deirdre, at least you saved whatever it is he has, and you should be darned proud of yourself! As you know, my track record is oh, about 0 for 3 with family and friends.


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## beachrock (Apr 26, 2003)

Quote:


Originally Posted by *Frankly Speaking*
There is also an increasingly common birth defect called hypospadius where the urinary opening is not at the tip of the penis and is often accompanied by a partially formed foreskin. The increasing incidence of this birth defect is being blamed on increasing levels of estrogen in the water supply coming from birth control use upstream and from commercial cattle and pig farming operations upstream from the water supply intake.

Frank

As usual Frank, you are right on. My nephew also has hypospadius. I have seen this child's foreskin and it does appear very short, barely covering the glans. (Not that I have seen 100's of normal foreskins







). He was born in rural Missouri, so the cattle/pig farming connection could definitely be there.

My sil originally thought that they would circ when he had his corrective surgery for the hypospadius. Now they plan to not circ at all, thank heavens.


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## Frankly Speaking (May 24, 2002)

That's great to hear! Apparently they have done a bit of research on this and that's good.

Hypospadius causes the urinary opening to be anywhere from just off center of the tip of the penis to severe cases where it can even be below the scrotum. In cases where it is off center, the foreskin may be complete and the hypospadius would not even be noticeable until the foreskin retracts (or is forcibly stripped away during circumcision) In these minor cases, I believe it is best left alone as the cure can be worse than the problem given the vagarities of surgery and the possibility of unexpected outcomes. Most men who have these minor cases of hypospadius are quite content with their slight misformation and have no intent for any surgical intervention. I would consider any case where the opening is on the glans to be minor. However, it seems doctors are at the ready with their scapels and are mostly eager to correct even the most minor case with the recommendation that it be done at the earliest possible time.

Generally, the foreskin is used as raw donor material for the repair of hypospadious. The good thing is that there is a procedure developed in Scotland that does not use the foreskin at all and the results have been excellent, comparable to the procedure that uses the foreskin and eliminates the circumcision that accompanies the former method. The bad thing is that few doctors in the US are aware of this less invasive procedure and even when they are advised of it, seem reluctant to even investigate it much less try it. That only shows how hide bound and inflexible the American medical profession is.

In cases where the opening is on the glans and the foreskin is complete or mostly complete, I recommend that any hypospadius repair be posponed until the foreskin is retractile and the severity can be assessed without harm to the boy. At that time, it will be far less invasive and it will be fairly clear how it will affect him. If the opening is anywhere below the glans, in virtually all cases, there will be only a hooded foreskin over the top of the glans or no foreskin at all. In these cases, it will be clear what the extent of the deformity is from birth and in virtually all cases the foreskin will be non functional or marginally functional and repair as soon as reasonable is acceptable.

However, most often, the physician tries to check for hypospadius immediately after birth even when there is no outward evidence it exists and they usually do it by retracting for adherent foreskin. WRONG! If there is no outward evidence, there is no need to check for it until the foreskin is retractile. However, doctors who do this often issue dire warnings to parents that this condition can affect their son's ability to reproduce. The rationalization is that if the urinary opening is not at the tip, his semen can spill outside the vagina, preventing fertilization. Sure, this can be the case in severe cases but in minor cases, this is not legitimate as the opening will be close enough to the tip to deliver the semen inside the vagina.

The estrogen in the water supply not only originates from livestock farms but also from municipal water treatment plants upstream where estrogen from human use of birth control puts the estrogen in to the water supply and then it is taken in in the water supply of cities downstream. I have seen some fairly convincing statistical evidence that it is involved in several areas such as both male and female fertility and birth rates. It also appears that hypospadius and epispadius is also more common in cities that get this "downstream" water supply. The evidence is not conclusive but definitely interesting.

I have a theory that our increasing population will be self limiting for future population growth. That is, I don't think we have much worry about over populating the planet. I think as the population increases and we live in closer proximity to each other, certain limiting forces will kick in. For instance, natural disasters like the recent Indian Ocean tsunami will kill increasingly more people as the population increases. Epidemics such as HIV/AIDS, ebola and such will become far more common and will kill increasingly more people. The extreme measures to assure birth and survival of premature and defective/deformed babies will put far more defective genes in our gene pool increasing the numbers of babies that will not survive or reprodce and in an effort to limit family size, the water supply will have estrogen concentrations that will make conception more difficult and even those that want large families will have trouble conceiving those large families. I may be totally off base with my thinking but I see evidence of all of the elements lining up already.

Frank


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## Charmie981 (May 30, 2002)

Quote:


Originally Posted by *Frankly Speaking*
Thanks, Howard. Although I had seen the statistics, I had never heard of this actually happening before with a real life baby.
Frank

My DS2 is like this. From day one, you could occasionally see the glans during a diaper change. He was born at a birth center with a MW, and never left my sight. He has never stayed with anyone who didn't know how to care for an intact penis, and I am 100% sure that he has NEVER been retracted. His forskin isn't short, it just bunches up behind his glans occasionally.

Funny story: my friend who takes care of the boys when I'm at births just about had a fit the first time he retracted during a diaper change. I guess I hadn't warned her, but she called her husband in and said "what's wrong with his penis?!?" Her husband, who has been pro-circ for a long time (and has now just given up the fight), said "his foreskin is retracted. there's nothing wrong with him...that's normal." She still laughs about how she's all anti-circ and a retracted forskin freaked her out more than her pro-circ husband. I think it's mostly b/c, although she's anti-circ, she's only had girls so far and changing a boy's diaper is just different







.

Anyway...the point is that sometimes early retraction does happen naturally, although I'ver never thought to call my son "naturally circumcised" uke.


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## njeb (Sep 10, 2002)

Back in 1979, a friend of mine decided against circ'ing her baby because he was born with a short foreskin which only partially covered the glans. I babysat for him his first year of life. If memory serves me right, I believe he was also retractable. So, in his case, being born with a short foreskin helped this baby escape the horrors of circumcision.


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